PSYCHO-ONCOLOGY DIVISION

24.PSYCHO-ONCOLOGY DIVISION

    Psycho-Oncology has focused on two aspects of cancer; the psychosocial impacts of cancer on the quality of life (QOL) of the patient, family and staff, and the role that psychosocial and behavioral factors may play in cancer risk and survival. Established in September 1995, the Psycho-Oncology Division has focused on the psychosocial impacts of cancer on patient QOL, especially depression.
Psychiatric Epidemiology of Depression and Other Psychological Distress in Cancer Patients

    Psychiatric prevalence studies in Western countries have revealed that approximately half of patients with all stages of cancer showed distress, with depression being the most common manifestation. To clarify the prevalence and the correlated factors of depression in Japanese cancer patients after disclosure of the cancer diagnosis including recurrence, termination of the curative treatments, and genetic high-risk, patients with various stages of cancer are now systematically assessed using the Semi-structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (SCID). Of 129 newly diagnosed, unresectable nonsmall lung cancer patients before treatment, 19% met the criteria for depression.⁽²⁶⁴⁾ Of 148 randomly selected postoperative breast cancer patients, 23% suffered from depression based on the Hospital Anxiety and Depression Scale.⁽²⁶⁵⁾ The correlated factors were a relatively younger age, pain, having children with health problems, and having a low fighting spirit and a high degree of helplessness/hopelessness, respectively. Taken together with the previous findings in systemically assessed patients with various stages of cancer,^(266-²⁶⁹⁾ the results suggest that the prevalence of depression was highest after disclosure of recurrence of breast cancer.
Psychiatric Intervention for Depression and Other Psychological Distress in Cancer Patients

    The need for a large variety of psychosocial interventions has increased along with the rising numbers of cancer patients surviving for longer periods. The primary goals of psychosocial interventions designed for cancer patients are enhancement of QOL and adaptive coping.^(270,²⁷¹⁾ The relatively structured, psychosocial and psychopharmacological intervention for recurrent breast cancer patients is now being prepared to determine its effect in reducing psychological distress and enhancing coping in a clinical trial.
    An algorithm for the psychopharmacological treatment of depression in advanced cancer patients has been developed, since the treatment strategy for depression in advanced cancer patients had not been established. The revised algorithm is now being prepared.
    To clarify the impact of physician support on psychological responses, including depression, psychological distress and coping (such as fighting spirit and helplessness/hopelessness) in cancer patients, 226 patients after curative resection for non-small cell lung cancer were enrolled in a longitudinal study.^(272-²⁷⁴⁾ Multivariate analyses revealed that only physician support had a significant impact on the patient's fighting spirit, independently. Furthermore, this effect was limited to female patients or patients with no history of depression. In postoperative patients with non-small cell lung cancer, physician support may have a significant impact on the patient's fighting spirit but this effect appears to be limited to patients of female gender or with no history of depression.
Refractory Symptoms in Advanced Cancer

    Fatigue is one of the most frequent and refractory symptoms in cancer patients. To clarify the prevalence of fatigue and its correlated factors, and to develop a screening method for fatigue in patients with advanced lung cancer, 157 patients participated in the study.⁽²⁷⁵⁾ Thus, 59% had experienced clinical fatigue based on the Cancer Fatigue Scale (CFS). Logistic analysis revealed that symptoms of dyspnea on walking, appetite loss, and depression were significant correlated factors. The CFS was found to have sufficient sensitivity and specificity for use as a screening tool.
    To clarify the correlated factors of suicidal ideation in cancer patients with depression, the consultation data on the referred patients were examined. The results suggested that severity of depression and poor physical functioning might be associated with suicidal ideation.⁽²⁷⁶⁾




24.PSYCHO-ONCOLOGY DIVISION



	Psycho-Oncology has focused on two aspects of cancer; the psychosocial impacts of cancer on the quality of life (QOL) of the patient, family and staff, and the role that psychosocial and behavioral factors may play in cancer risk and survival. Established in September 1995, the Psycho-Oncology Division has focused on the psychosocial impacts of cancer on patient QOL, especially depression. Psychiatric Epidemiology of Depression and Other Psychological Distress in Cancer Patients Psychiatric prevalence studies in Western countries have revealed that approximately half of patients with all stages of cancer showed distress, with depression being the most common manifestation. To clarify the prevalence and the correlated factors of depression in Japanese cancer patients after disclosure of the cancer diagnosis including recurrence, termination of the curative treatments, and genetic high-risk, patients with various stages of cancer are now systematically assessed using the Semi-structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders (SCID). Of 129 newly diagnosed, unresectable nonsmall lung cancer patients before treatment, 19% met the criteria for depression.⁽²⁶⁴⁾ Of 148 randomly selected postoperative breast cancer patients, 23% suffered from depression based on the Hospital Anxiety and Depression Scale.⁽²⁶⁵⁾ The correlated factors were a relatively younger age, pain, having children with health problems, and having a low fighting spirit and a high degree of helplessness/hopelessness, respectively. Taken together with the previous findings in systemically assessed patients with various stages of cancer,^(266-²⁶⁹⁾ the results suggest that the prevalence of depression was highest after disclosure of recurrence of breast cancer. Psychiatric Intervention for Depression and Other Psychological Distress in Cancer Patients The need for a large variety of psychosocial interventions has increased along with the rising numbers of cancer patients surviving for longer periods. The primary goals of psychosocial interventions designed for cancer patients are enhancement of QOL and adaptive coping.^(270,²⁷¹⁾ The relatively structured, psychosocial and psychopharmacological intervention for recurrent breast cancer patients is now being prepared to determine its effect in reducing psychological distress and enhancing coping in a clinical trial. An algorithm for the psychopharmacological treatment of depression in advanced cancer patients has been developed, since the treatment strategy for depression in advanced cancer patients had not been established. The revised algorithm is now being prepared. To clarify the impact of physician support on psychological responses, including depression, psychological distress and coping (such as fighting spirit and helplessness/hopelessness) in cancer patients, 226 patients after curative resection for non-small cell lung cancer were enrolled in a longitudinal study.^(272-²⁷⁴⁾ Multivariate analyses revealed that only physician support had a significant impact on the patient's fighting spirit, independently. Furthermore, this effect was limited to female patients or patients with no history of depression. In postoperative patients with non-small cell lung cancer, physician support may have a significant impact on the patient's fighting spirit but this effect appears to be limited to patients of female gender or with no history of depression. Refractory Symptoms in Advanced Cancer Fatigue is one of the most frequent and refractory symptoms in cancer patients. To clarify the prevalence of fatigue and its correlated factors, and to develop a screening method for fatigue in patients with advanced lung cancer, 157 patients participated in the study.⁽²⁷⁵⁾ Thus, 59% had experienced clinical fatigue based on the Cancer Fatigue Scale (CFS). Logistic analysis revealed that symptoms of dyspnea on walking, appetite loss, and depression were significant correlated factors. The CFS was found to have sufficient sensitivity and specificity for use as a screening tool. To clarify the correlated factors of suicidal ideation in cancer patients with depression, the consultation data on the referred patients were examined. The results suggested that severity of depression and poor physical functioning might be associated with suicidal ideation.⁽²⁷⁶⁾