ABSTRACT
It is now widely accepted that cancer and its treatments constitute a stress factor imposed to cancer patients and their relatives to a significant extent, leading to adjustment efforts (or coping) and possibly psychopathological disturbances. There is a remarkable heterogeneity in patients’ responses to these stress factors. A prevalence of psychopathological disturbances in cancer patients has been reported in many studies. In 1983, the Psychosocial Collaborative Oncology Group observed a prevalence rate of 47% of psychiatric disorders in a cohort of cancer patients (inpatient and outpatient populations of three cancer centers) (1). Most importantly, this rate was approximately twice that reported for psychiatrics disorders in medical patients, and three times the modal estimate for the general population reported in the literature. As a diagnostic category, adjustment disorders accounted for 68% of all diagnoses. Other diagnoses were major affective disorders (13%), organic mental disorders (8%), personality disorders (7%), and anxiety disorders (4%). Most patients with psychopathological disturbances have depression or anxiety as the principal symptom. Most of these conditions are treatable disorders. It should be recalled at this level that cancer patients have an increased risk of suicide compared with the risk found in the general population, particularly during the first year after diagnosis. Therefore, the assumption that emotional distress, one of the most frequent expressions of a difficulty to cope or a psychopathological disturbance, is just a foreseeable and ordinary “reaction” to cancer has to be reconsidered. Finally, cancer affects not only the patients, but also their relatives to a significant extent. The important prevalence of psychological problems and psychopathological disturbances that have been reported in oncology underlines the need for psychological and psychopharmacological interventions designed specifically for cancer patients and their significant others. Preserving the quality of life of the patients and their families as much as possible has become a major goal in cancer care. These issues will be addressed in the “Psycho-oncology” section of this chapter.
