Psychiatric symptoms in cancer patients. Is the cause organic or psychologic?
Because cancer and its treatment have so many effects on the CNS, the diagnosis of psychiatric symptoms in cancer patients is problematic. Naturally there are psychologic and psychosocial issues that often sufficiently explain why a patient appears distressed. Dealing with psychologic adjustment is always an important part of the management of patients with severe medical, as opposed to psychiatric, illness, whether or not biologic components of the psychologic problem can be identified and addressed. The most frequent error physicians make in evaluating psychiatric symptoms is to assume that a psychologic explanation is sufficient. Expressions such as "Wouldn't you be depressed if you had cancer?" are often used to excuse failure to pursue further evaluation. Careful reviews of cases in which cancer patients were labeled as having psychologic problems have consistently shown a high incidence of misdiagnosis. Correct diagnosis and treatment of an underlying organic disorder can alleviate symptoms that impair the patient's innate coping resources, allowing him or her to grapple more effectively with adverse circumstances.