[Pathophysiological rationale and management of anxio-depressive syndrome among cancer patients]

After the diagnosis of cancer, it is very common for patients to present an anxiety-depressive syndrome, whether diagnosed or not. All psychiatric disorders combined, their prevalence is estimated at up to 50% across all cancers. However, patients' ability to live with their illness is uneven, and psychiatric disorders often appear during follow-up, to the detriment of their survival. This highlights the importance of better preventing, screening, diagnosing, and treating this phenomenon, which can be explained by neurobiology. Yet, the prescription of antidepressants remains insufficient in oncology, as at least 3 out of 4 patients do not receive antidepressant treatment at the time of a major depressive episode diagnosis. The omission of this prescription by oncologists may be explained by a lack of knowledge on the subject, fear of drug interactions, the difficulty of distinguishing between neoplasia and psychiatric symptoms, or even personal reluctance to prescribe these drugs. However, many studies discuss the reduction in quality of life and life expectancy in oncology patients, which requires psychiatric attention. The prescription of antidepressants can therefore be an effective and complementary means to enhance the patient's quality of life and potentially increase overall survival through bio-psycho-social mechanisms. This review article aims to highlight the physiopathology and usefulness of antidepressants in the oncological context in addition to psychotherapeutic techniques and to clarify the stakes of antidepressant prescription for all cancer professionals.