Medical School of Lisbon, University of Lisbon, University clinic of Medical Psychology and Psychiatry, Lisbon, Portugal
Currently, cancer has moved from an acute to a chronic disease model and from a biomedical perspective to a biopsychosocial one. This movement implies the recognition of common psychiatric comorbidities, such as depression, and the impact of both disorders in a life trajectory. The purpose of this presentation is to highlight the challenge that depression in cancer represents to patients and clinicians and discuss the importance of integrated treatment approaches.
Negative emotions such as sadness or fear, but also depression and anxiety can impair patients’ ability to regulate their emotional distress. Furthermore depression, afflicting more than 10% of patients, leads to a poorer quality of life (QOL) and outcomes, occasioning higher rates of mortality in cancer. The overlapping of symptoms such as fatigue, loss of appetite, weight change and cognitive difficulties may compromise an early diagnosis of depression in an oncologic disease and delay the intervention to minimize its negative effects. Etiologically, biological and psychosocial factors are involved in the pathophysiology of depression in cancer, and the identification of such pathways holds a major importance to the development of new treatment modalities.
In conclusion, the threatening nature of cancer can activate emotions and feelings of vulnerability that interfere with the adaptive resources required to deal with the disease. New research in psychosocial and biologic processes linked to depression and cancer can foster the advance of integrated treatments.