Psychiatric disorders in advanced cancer

Miovic, Michael; Block, Susan

doi:10.1002/cncr.22980

Cited by 376Cancer survivorship and carePalliative and Oncologic CarePalliative Care and End-of-Life Issues

Psychiatric disorders in advanced cancer

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Miovic, Michael, Block, Susan·2007·Cancer

DOI 10.1002/cncr.22980

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Abstract

BACKGROUND.: Emotional distress and psychiatric disorders are common among patients with advanced cancer. Oncologists play an important role in screening for these conditions, providing first‐line treatment and referring patients for further evaluation and treatment when indicated. METHODS.: The literature on psycho‐oncology was reviewed, focusing on the epidemiology, assessment, and treatment of psychiatric disorders (adjustment disorders, major depression, anxiety and post‐traumatic stress, personality disorders, substance abuse, and major mental disorders such as schizophrenia and bipolar disorder) in patients with advanced cancer. Communication skills and the role of the oncologist in dealing with end‐of‐life issues were also reviewed. Relevant data were summarized from the most recent systematic reviews, epidemiological studies, and intervention trials. Clinical recommendations are provided. RESULTS.: About 50% of patients with advanced cancer meet criteria for a psychiatric disorder, the most common being adjustment disorders (11%–35%) and major depression (5%–26%). Both psychosocial and pharmacological treatments are effective for anxiety and depression, although existing studies have methodological limitations. Collaboration with mental health specialists is recommended for patients with personality disorders, major mental illness, and substance abuse problems. Effective communication involves active listening, exploring emotion and meaning, addressing prognosis, and discussing end‐of‐life issues when relevant. CONCLUSIONS.: Treating psychiatric conditions improves quality of life in patients with advanced cancer. Oncologists play a key role in screening for psychiatric disorders, initiating first‐line treatments for depression and anxiety, and communicating with patients and caregivers about prognosis and end‐of‐life issues. Cancer 2007. © 2007 American Cancer Society.

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Up to half of adults with metastatic cancer report elevated anxiety or depression.
“Up to half of adults with metastatic cancer report elevated anxiety or depression [9, 16, 17]”
From A randomized controlled trial of a multi-modal palliative care intervention to promote advance care planning and psychological well-being among adults with advanced cancer: study protocol. (2022) · cites this paper as [9]
The Epidemiology of Psychiatric Disorders in Advanced Cancer section says about 50% or more of patients with advanced cancer meet criteria for a psychiatric disorder, but that figure includes adjustment disorder. The anxiety epidemiology section reports significant anxiety symptoms in 25%–48% of cancer patients generally. Neither figure specifically establishes that up to half of adults with metastatic cancer report elevated anxiety or depression. (LLM, conf=0.85)
Experimental — accuracy not yet measured
Adults with advanced cancer report a range of palliative care challenges, including anxiety and depression, spiritual/existential needs, fear of dying/death, and physical symptoms.
“Adults with advanced cancer report a range of palliative care challenges, including anxiety and depression in the face of imminent loss and how to make the most of their remaining time, spiritual/ existential needs related to making sense of their illness, fear of dying/death, and physical symptoms [4–11].”
From A randomized controlled trial of a multi-modal palliative care intervention to promote advance care planning and psychological well-being among adults with advanced cancer: study protocol. (2022) · cites this paper as [9]

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Akechi T, Okamura H, Nishiwaki Y, Uchitomi Y. Psychiat- ric disorders and associated and predictive factors in patients with unresectable nonsmall cell lung carcinoma: a longitudinal study. Cancer. 2001;92:2609-2622.
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Authors: Miovic, M., & Block, S.
Affiliations: Brigham and Women's Hospital (US)
Corresponding author: Miovic, Michael
ORCID: Miovic, Michael
Block, Susan
Venue: Cancer
Publisher: Wiley
Published: 2007-09-19
Volume: 110
Issue: 8
Pages: 1665-1676
ISSN: 0008-543X (ISSN-L)
1097-0142
DOI: 10.1002/cncr.22980
OpenAlex: W1983640879
Cited by: 376
References: 118
Citations by year: 2026: 15 · 2025: 14 · 2024: 21 · 2023: 12 · 2022: 13 · 2021: 19 · 2020: 11 · 2019: 24 · 2018: 24 · 2017: 20 · 2016: 16 · 2015: 27 · 2014: 26 · 2013: 28 · 2012: 30
FWCI: 1.58
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations: Cancer (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Oncology › Cancer survivorship and care
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
Keywords: advanced cancer, mental illness, psycho-oncology, depression, anxiety, post-traumatic stress, adjustment disorder, personality disorders, substance abuse, schizophrenia, bipolar disorder, end-of-life communication, screening, psychosocial interventions, pharmacotherapy, quality of life
MeSH terms: Mental Disorders, Humans, Neoplasms, Psychotropic Drugs

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