Anxiety and Depression in Patients with Cancer. A Case Report

Abstract

After the finish of the chemotherapy infusion, at the interview, the patient reports feeling safe, denies any self-harm or self-injurious thoughts, denies use of illicit substances and alcohol. She says that the impact of hair loss is very depressive for her. In these conditions, the oncologist decide to discuss an initial treatment plan with her that includes individual counseling. Individual counseling helps the patient to complete her palliative therapies and increase her confident after the post-chemotherapy CT exam result. However, there is progression of her disease after 6 months. After this exam, she becomes despondent and is struggling to complete daily activities. She reports specific symptoms for depressive disorder: sleeping poorly and lacking appetite, and no longer enjoys spending time with her friends and family or pursuing her interests. She is preoccupied with death and has difficulty concentrating, but fortunately denies any suicidal ideation or death wishes. It was started the second line chemotherapy protocol. At this time the patient shows abandonment behavior, autolytic thoughts and drug ingestion triggered by acute family conflict, requiring psychiatric re-assessment and specialist treatment. Conclusion: Depression remains an under-recognised comorbidity in cancer patients, with major implications on patient suffering, mortality and healthcare expenditure. Depression in cancer is markedly different from depression in healthy individuals, and involves a unique symptomatology.

Keywords

• anxiety
• depression
• ovarian cancer
• oncology
• psycho-oncology