[Management of psychiatric symptoms in cancer patients]

Depression in cancer patients is common and occurs throughout the course of cancer illness. The prevalence of major depression in cancer patients was reported to range from 6 to 42%. This reflects various cancer-related variables, such as pain and low performance status as well as risks for major depression. To avoid under-diagnosing depression in cancer patients, examinations should include not only psychological symptoms, but also physical symptoms. Treatment includes patient education, counseling, behavioral techniques and antidepressant medications. In palliative care settings, life review interviews might be effective for treating. Delirium occurs in approximately 15% to 20% of hospitalized people with cancer and in approximately 30% to 80% of terminally ill people with cancer. The management of delirium includes interventions that are directed both at the underlying causes and the symptoms of the disorder. Identification and correction of the underlying causes of delirium must take place together with symptomatic and environmental-supportive therapies. Haloperidol, a neuroleptic agent (antipsychotic) that is a potent dopamine blocker, is the drug of choice for the treatment of delirium in persons with cancer because of the low incidence of related cardiovascular and anticholinergic effects.