Depression and anxiety in oncology: the psychiatrist's perspective

Depression and anxiety are frequently undiagnosed and untreated in cancer patients, resulting in a significant negative impact on quality of life and disease outcome. Furthermore, although effective therapies for depression and anxiety are available, there have been few clinical trials of pharmacotherapy in cancer patients. This article explores how the diagnosis of depression and anxiety can be improved in cancer patients and reviews current treatment options in the oncology setting. The Hospital Anxiety and Depression Scale, a simple, patient-administered questionnaire, is effective in screening for psychiatric symptoms at an early stage of cancer treatment, particularly if vulnerable individuals can be identified and targeted. Selective serotonin reuptake inhibitors are currently first-choice therapy for depression, and many of the drugs in the class are effective in anxiety disorders. Further studies of these agents in the oncology setting are warranted.