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Depressive Disorders 

Depressive Disorders
Chapter:
Depressive Disorders
Source:
Psycho-Oncology (3 ed.)
Author(s):

Peter Fitzgerald

, Kimberley Miller

, Madeline Li

, and Gary Rodin

DOI:
10.1093/med/9780199363315.003.0037

The prevalence, clinical features, pathophysiology, diagnostic and treatment approaches for the spectrum of depressive disorders in cancer patients are reviewed in this chapter. Major depression is a serious comorbidity, occurring in up to 16% of cancer patients and significantly impairing quality of life and engagement in cancer treatment. Subthreshold depressive disorders are even more common, and are also associated with significant functional impairment. Milder depressive symptoms, such as those associated with an adjustment disorder or subthreshold depression, may not benefit from antidepressant medication, while moderate to severe major depression often does. Collaborative care models that may include pharmacologic and psychologic interventions are emerging as efficacious in the treatment of depression in cancer and other medical populations. Future research is needed to better define the phenomenology of subthreshold depression in cancer patients, and to strengthen the evidence base for both the pharmacotherapy and psychotherapy of depression in cancer.

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