[Psychological and psychiatric problems in cancer patients in the general hospital]

Cancer is the most common cause of death after heart disease. The patient diagnosed with cancer confronts high levels of emotional distress, while he has to make crucial decisions about his treatment. As a life threatening illness, it is a traumatic stressor which triggers overwhelming feelings and affects the patient's functioning. There is a variety of psychological responses. Anger, fear, anxiety, hopelessness attend the diagnosis of cancer. Fifty percent of affected individuals develop psychiatric disorders, such as Stress Response Syndromes like Acute Response Syndromes, Post-traumatic Stress Disorder, Major Depression, Adjustment Disorders, and Delirium. The members of consultation-liaison psychiatry intervene in a wide spectrum of psychiatric complications of cancer. Also, there are patients with major psychiatric disorders such as schizophrenia who develop cancer and the psychiatrist has to give them an understanding of the illness and to facilitate their active participation in the medical treatment. The main purpose is co-operation between consultation liaison psychiatrists and physicians. Psychiatrists make efforts to promote a better understanding of schizophrenia among physicians and to fight the stigma attached to the disease. The risk of suicide is higher in cancer patients, than in general population and the identification of patients at increased risk of suicide among affected individuals such as those with major depression, alcohol abusers, uncontrolled pain, advanced illness is a very important step in suicide prevention. When the end of life is approaching, psychiatrists have to face physical problems, psychological symptoms and issues of existence, which pose special challenges for the patient. The psychiatrist has to help him to reduce the psychological pain and to encourage his family to listen to his wishes. The consultationliaison psychiatrists intervene at every stage of cancer from the prevention and the preclinical cancer, to palliative care and end-of-life, with diagnosis and effective therapy.