Depression and anxiety in oncology: the oncologist's perspective

Depression and anxiety frequently occur in oncology patients and have a significant impact on patient quality of life, health care utilization, and even disease outcome. Depression and anxiety are eminently treatable, and therefore psychiatric assessment and appropriate intervention should form an integral component of management strategy in patients with cancer. It is essential that patients are recognized at an early stage, so that resources can be targeted effectively at those most at risk of developing psychiatric morbidity. Evaluation techniques that can identify signs or symptoms of depression and anxiety and can be incorporated into the program of a busy oncology clinic or in the primary care setting are therefore needed. Diagnosis of depression and anxiety may be facilitated by using primary screening tools, such as the Hospital Anxiety and Depression Scale questionnaire, and by considering factors such as family psychiatric history, levels of family support, and degrees of pain suffered by the patient. In this article, the issues surrounding diagnosis of depression and anxiety in cancer patients and the benefits of early intervention are considered from the point of view of the oncologist.