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Influence of the pathological psychological state of cancer patients on their decisions

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Abstract

The diagnosis of cancer in many cases provokes a crisis, resulting in an increase of regression and defence mechanisms (splitting, projective identification, projection, denial, repression). This article reviews the increased sensitivity, the partial and temporary narrowing of consciousness, and the weakening of reality control. In many cases fluctuating depersonalisation and derealisation develop. At our Institute we performed a complex psychological examination of 41 patients, suffering from malignant lymphoma, immediately after informing them of the diagnosis but prior to their first treatment. The psychological examination of volunteering patients involved an initial interview, Rorschach and Szondi projective tests, a Wechsler intelligence test and a discussion of the results with the patient. The relatively frequent temporary pathological psychic conditions exert an influence on the decisions of patients make about their treatment and interventions, and may also influence the doctor patient relationship.

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References

  1. Artiss KL, Levine AS (1973) Doctorpatient relation in severe illness. N Engl J Med 288:1210–1214

    PubMed  Google Scholar 

  2. Astrow AB (1994) Rethinking cancer. Lancet 343:494–495

    PubMed  Google Scholar 

  3. Balint M (1957) The doctor, his patient and the illness. Pitman, London

    Google Scholar 

  4. Balint M (1989) The basic fault. Therapeutic aspects of regression. Tavistock/Routledge, London New York

    Google Scholar 

  5. Berard RMF, Viljoen G (1994) Psycho-oncology and the general practitioner. CME 12:1175–1181

    Google Scholar 

  6. Bloom JR, Fobair P, Gritz E, et al (1993) Psychosocial outcomes of cancer: a comparative analysis of Hodgkin's disease and testicular cancer. J Clin Oncol 11:979–988

    PubMed  Google Scholar 

  7. Bronner-Huszar J (1971) The psychological aspects of cancer in man. Psychosomatics 12:133–138

    PubMed  Google Scholar 

  8. Derogatis LR, Morrow GR (1983) The prevalence of psychiatric disorders among cancer patients. J Am Med Assoc 249:751–757

    Google Scholar 

  9. Dunn SM, Patterson PU, Butow PN, et al (1993) Cancer by another name: a randomized trial of the effects of euphemism and uncertainty in communicating with cancer patients. J Clin Oncol 11:989–996

    PubMed  Google Scholar 

  10. Gluck M (1977) Overcoming stresses in communication with the fatally ill. Milit Med, 926–928

  11. Goldstein WN (1991) Clarification of projective identification. Am J Psychiatry 148:153–161

    PubMed  Google Scholar 

  12. Greer S (1983) Cancer and the mind. Br J Psychiatry 143:535–543

    PubMed  Google Scholar 

  13. Guex P (1994) An introduction to psycho-oncology. Routledge, London New York

    Google Scholar 

  14. Harrison J, Maguire P (1994) Predictors of psychiatric morbidity in cancer patients. Br J Psychiatry 165:593–598

    PubMed  Google Scholar 

  15. Holmes J (1993) John Bowlby — Attachment theory. Routledge, London New York

    Google Scholar 

  16. Holland JC, Rowland JH (1981) Interventions in the treatment of cancer: an historical review. (Perspectives on behavioral medicine) Academic Press, New York

    Google Scholar 

  17. Holland JC, Rowland JH (1989) Handbook of psychooncology. Oxford University Press, New York

    Google Scholar 

  18. Jess P (1994) Personality pattern in peptic ulcer disease: a cohort study. J Intern Med 236:271–274

    PubMed  Google Scholar 

  19. Johnson J, Lane C (1993) Role of support groups in cancer care. Support Care Cancer 1:52–56

    PubMed  Google Scholar 

  20. Klein M (1946) Notes on some schizoid mechanisms. Int J Psychoanal 27:99–110

    Google Scholar 

  21. Lake B (1985) Concept of ego strength in psychotherapy. Br J Psychiatry 147:471–478

    PubMed  Google Scholar 

  22. Lerman C, Lustbader E, Rimer B, et al (1995) Effects of individualized breast cancer risk counseling: a randomized trial. J Natl Cancer Inst 87:286–292

    PubMed  Google Scholar 

  23. Matthews DA, Suchman AL, Branch WT (1993) Making “connexions": enhancing the therapeutic potential of patient-clinician relationship. Ann Intern Med 118:973–977

    PubMed  Google Scholar 

  24. Mor V, Rice C (1993) Physician use among patients receiving cancer chemotherapy. Cancer 71:15–21

    Google Scholar 

  25. Moyers B (1993) Healing and the mind. Doubleday, New York London Toronto

    Google Scholar 

  26. Razavi D, Delvaux N, Bredart A, et al (1992) Screening for psychiatric disorders in a lymphoma out-patient population. Eur J Cancer 28A:1869–1872

    PubMed  Google Scholar 

  27. Riskó Á (1993) About the individual psychotherapy of cancer patients in case of pathological psychological state. psychiatr Hung 5:409–420

    Google Scholar 

  28. Ropponen P, Siimes MA, Rautonen J, et al (1991) Psychosexual problems in male childhood malignancy survivors. Acta Psychiatr Scand 85:143–146

    Google Scholar 

  29. Roberts RA, Blunt SM (1994) The psychological reaction of women to a colposcopy clinic. Br J Obstet Gynaecol 101:751–752

    PubMed  Google Scholar 

  30. Sell L, Devlin B, Bourke SJ, et al (1993) Communicating the diagnosis of lung cancer. Respir Med 87:61–63

    Google Scholar 

  31. Spitz R (1965) The first year of life. International Universities Press, New York

    Google Scholar 

  32. Simpson M, Buckman R, Stewart M, et al (1991) Doctor-patient communication: the Toronto consensus statement. Br Med J 303:1385–1387

    Google Scholar 

  33. Stiller CA (1994) Cancer in adolescence. Br Med J 308:1382–1383

    Google Scholar 

  34. Tsiantis J (1994) The preventive effect of early interventions. Bibl Psychiatr 165:26–30

    PubMed  Google Scholar 

  35. Worden VW, Sobel HJ (1978) Ego strength and psychosocial adaptation to cancer. Psychosom Med 40:585–591

    PubMed  Google Scholar 

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This article is based on our lecture delivered at the OEICI “Quality of Life” Congress, Bled, Slovenia, 13 May 1995

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Riskó, Á., Fleischmann, T., Molnár, Z. et al. Influence of the pathological psychological state of cancer patients on their decisions. Support Care Cancer 4, 51–55 (1996). https://doi.org/10.1007/BF01769876

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