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Dealing with Depression: Communicating with Cancer Patients and Grieving Relatives

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New Challenges in Communication with Cancer Patients

Abstract

Cancer is an extremely stressful event for both the patients and their families, potentially leading to the development of depression, which has been shown to have a general prevalence of 15–25%. When left unaddressed, depression has a great negative influence on quality of life, coping strategies, and active participation in medical care of both patient and caregivers. The relational components of effective communication with depressed cancer patients and their family members include the clinician’s availability for listening, exploring emotions, identifying affective problems, and providing empathic responses, in order to promote reciprocal trust and consolidate the therapeutic alliance. Of first importance is correct assessment of the symptoms (e.g., cognitive-affective dimensions with/without exclusion of neurovegetative symptoms), for a correct diagnosis (e.g., differentiating major depression from minor depression, adjustment disorder, demoralization). Suicide assessment is extremely important in the context of cancer care. A second aspect is intervention, at the counseling level or more specific psychotherapeutic treatment. Several types of psychological therapy have been proved to be effective in treating depression of cancer patients and family members (e.g., cognitive-behavior therapy, supportive-expressive group psychotherapy, interpersonal psychotherapy, complicated grief therapy, family-focused grief therapy). A sensitive, collaborative, comprehensive approach to the diagnosis and treatment of depression is the cornerstone of communication. Clinical education and training of cancer care professionals and integration with psychooncologists are mandatory for providing adequate care to cancer patients and their families with depression.

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References

  1. Akechi T, Okuyama T, Onishi J, Morita T, Furukawa TA. Psychotherapy for depression among incurable cancer patients. Cochrane Database Syst Rev. 2008;(2):CD005537.

    Google Scholar 

  2. Allumbaugh DL, Hoyt W. Effectiveness of grief therapy: a meta-analysis. J Couns Psychol. 1999;46:370–80.

    Article  Google Scholar 

  3. American Psychiatric Association. Practice guideline for the assessment and treatment of patients with suicidal behaviors. Washington: American Psychiatric Association; 2003.

    Google Scholar 

  4. Angelino AF, Treisman GJ. Major depression and demoralization in cancer patients: diagnostic and treatment considerations. Support Care Cancer. 2001;9:344–9.

    Article  PubMed  CAS  Google Scholar 

  5. Arora NK, Finney Rutten LJ, Gustafson DH, Moser R, Hawkins RP. Perceived helpfulness and impact of social support provided by family, friends, and health care providers to women newly diagnosed with breast cancer. Psychooncology. 2007;16(5):474–86.

    Article  PubMed  Google Scholar 

  6. Baider L, Cooper CL, De-Nour K, editors. Cancer and the family. 2nd ed. Sussex, UK: Wiley; 2000.

    Google Scholar 

  7. Boelen PA, Van Den Bout J. Complicated grief, depression and anxiety as distinct postloss syndromes: a confirmatory factor analysis study. Am J Psychiatry. 2005;162(11):2175–7.

    Article  PubMed  Google Scholar 

  8. Bonanno GA, Boerner K. The stage theory of grief. JAMA. 2007;297:2693.

    Article  PubMed  CAS  Google Scholar 

  9. Bonanno GA, Wortman CB, Nesse RM. Prospective patterns of resilience and maladjustment during widowhood. Psychol Aging. 2004;19(2):260–71.

    Article  PubMed  Google Scholar 

  10. Bottomley A. Depression in cancer patients: a literature review. Eur J Cancer Care (Engl). 1998;7(3):181–91.

    Article  CAS  Google Scholar 

  11. Brintzenhofe-Szoc KM, Levin TT, Li Y, Kissane DW, Zabora JR. Mixed anxiety/depression symptoms in a large cancer cohort: prevalence by cancer type. Psychosomatics. 2009;50:383–91.

    Article  PubMed  Google Scholar 

  12. Cockram CA, Doros G, de Figueiredo JM. Diagnosis and measurement of subjective incompetence: the clinical hallmark of demoralization. Psychother Psychosom. 2009;78:342–5.

    Article  PubMed  Google Scholar 

  13. Corruble E, Chouinard VA, Letierce A, Gorwood PA, Chouinard G. Is DSM-IV bereavement exclusion for major depressive episode relevant to severity and pattern of symptoms? A case-control, cross-sectional study. J Clin Psychiatry. 2009;70:1091–7.

    Article  PubMed  Google Scholar 

  14. Currier JM, Neimeyer RA, Berman JS. The effectiveness of psychotherapeutic interventions for bereaved persons: a comprehensive quantitative review. Psychol Bull. 2008;134:648–61.

    Article  PubMed  Google Scholar 

  15. Derogatis LR, Morrow GR, Fetting J, Penman D, Piasetsky S, Schmale AM, et al. The prevalence of psychiatric disorders among cancer patients. JAMA. 1983;249:751–7.

    Article  PubMed  CAS  Google Scholar 

  16. Epstein RM, Street RL Jr. Patient-centered communication in cancer care: promoting healing and reducing suffering. NIH Publication No. 07-6225. Bethesda: National Cancer Institute; 2007.

    Google Scholar 

  17. Fallowfield L, Jenkins V. Effective communication skills are the key to good cancer care. Eur J Cancer. 1999;35:1592–7.

    Article  PubMed  CAS  Google Scholar 

  18. Fallowfield L, Ratcliffe D, Jenkins V, Saul J. Psychiatric morbidity and its recognition by doctors in patients with cancer. Br J Cancer. 2001;84(8):1011–5.

    Article  PubMed  CAS  Google Scholar 

  19. Friðriksdóttir N, Saevarsdóttir T, Halfdánardóttir SÍ, Jónsdóttir A, Magnúsdóttir H, Olafsdóttir KL, et al. Family members of cancer patients: needs, quality of life and symptoms of anxiety and depression. Acta Oncol. 2011;50:252–8.

    Article  PubMed  Google Scholar 

  20. Giese-Davis J, Collie K, Rancourt KM, Neri E, Kraemer HC, Spiegel D. Decrease in depression symptoms is associated with longer survival in patients with metastatic breast cancer: a secondary analysis. J Clin Oncol. 2011;29:413–20.

    Article  PubMed  Google Scholar 

  21. Goebel S, von Harscher M, Mehdorn HM. Comorbid mental disorders and psychosocial distress in patients with brain tumours and their spouses in the early treatment phase. Support Care Cancer. 2011;19(11):1797–805.

    Article  PubMed  Google Scholar 

  22. Grassi L. Bereavement in families with relative dying of cancer. Curr Opin Support Palliat Care. 2007;1:43–9.

    Article  PubMed  Google Scholar 

  23. Grassi L, Biancosino B, Marmai L, Rossi E, Sabato S. Psychological factors affecting oncology conditions. In: Porcelli P, Sonino N, editors. Psychological factors affecting medical conditions. A new classification for DSM-V, vol. 28. Basel: Karger; 2007.

    Google Scholar 

  24. Grassi L, Holland JC, Johansen C, Koch U, Fawzy F. Psychiatric concomitants of cancer, screening procedures, and training of health care professionals in oncology: The paradigms of psycho-oncology in the psychiatry field. In: Christodoulou GN, editor. Advances in psychiatry, vol. 2. Athens: World Psychiatric Association; 2005.

    Google Scholar 

  25. Grassi L, Nanni MG, Uchitomi Y, Riba M. Pharmacotherapy of depression in people with cancer. In: Kissane D, Maj M, Sartorius N, editors. Depression and cancer. London: Wiley; 2011.

    Google Scholar 

  26. Grassi L, Riba M. Depressive disorders in oncology. In: Riba M, Grassi L, editors. WPA educational programme on depressive disorders, vol II: physical illness and depression. Geneva: World Psychiatric Association; 2008.

    Google Scholar 

  27. Grassi L, Riba M. New frontiers and challenges of psychiatry in oncology and palliative care. In: Christodoulou GN, Mezzich JE, editors. Advances in psychiatry, vol. III. Athens: World Psychiatric Association; 2009.

    Google Scholar 

  28. Grassi L, Rossi E, Caruso R, Nanni MG, Pedrazzi S, Sofritti S, et al. Educational intervention in cancer outpatient clinics on routine screening for emotional distress: an observational study. Psychooncology. 2011;20:669–74.

    Article  PubMed  Google Scholar 

  29. Grassi L, Sabato S, Rossi E, Marmai L, Biancosino B. Effects of supportive-expressive group therapy in breast cancer patients with affective disorders: a pilot study. Psychother Psychosom. 2010;79:39–47.

    Article  PubMed  Google Scholar 

  30. Greer S. Bereavement care: some clinical observations. Psychooncology. 2010;19:1156–60.

    Article  PubMed  Google Scholar 

  31. Gregurek R, Bras M, Dordević V, Ratković AS, Brajković L. Psychological problems of patients with cancer. Psychiatr Danub. 2010;22(2):227–30.

    PubMed  Google Scholar 

  32. Guidi J, Fava GA, Picardi A, Porcelli P, Bellomo A, Grandi S, et al. Subtyping depression in the medically ill by cluster analysis. J Affect Disord. 2011;132(3):383–8.

    Article  PubMed  Google Scholar 

  33. Hamer M, Chida Y, Molloy GJ. Psychological distress and cancer mortality. J Psychosom Res. 2009;66:255–8.

    Article  PubMed  Google Scholar 

  34. Hensley PL. Treatment of bereavement-related depression and traumatic grief. J Affect Disord. 2006;92:117–24.

    Article  PubMed  Google Scholar 

  35. Holtslander LF, McMillan SC. Depressive symptoms, grief, and complicated grief among family caregivers of patients with advanced cancer three months into bereavement. Oncol Nurs Forum. 2011;38(1):60–5.

    Article  PubMed  Google Scholar 

  36. Jacobsen PB, Jim HS. Psychosocial interventions for anxiety and depression in adult cancer patients: achievements and challenges. CA Cancer J Clin. 2008;58:214–30.

    Article  PubMed  Google Scholar 

  37. Johansen C, Grassi L. International psycho-oncology: present and future directions. In: Holland JC, editor. Handbook of psycho-oncology. New York: Oxford University Press; 2010.

    Google Scholar 

  38. Kendler K, Myers J, Zisook S. Does bereavement-related major depression differ from major depression associated with other stressful life events? Am J Psychiatry. 2008;165:1449–55.

    Article  PubMed  Google Scholar 

  39. Kissane DW, Bloch S. Family focused grief therapy: a model of family-centred care during palliative care and bereavement. Buckingham: Open University Press; 2002.

    Google Scholar 

  40. Kissane DW, Levin T, Hales S, Lo C, Rodin G. Psychotherapy for depression in cancer and palliative care. In: Kissane DW, Maj M, Sartorius N, editors. Depression and cancer. Chichester: Wiley; 2011.

    Google Scholar 

  41. Kissane DW, McKenzie M, Bloch S, Moskowitz C, McKenzie DP, O’Neill I. Family focused grief therapy: a randomized, controlled trial in palliative care and bereavement. Am J Psychiatry. 2006;163:1208–18.

    Article  PubMed  Google Scholar 

  42. Kutner JS, Kilbourn KM. Bereavement: addressing challenges faced by advanced cancer patients, their caregivers, and their physicians. Prim Care. 2009;36(4):825–44.

    Article  PubMed  Google Scholar 

  43. Lannen PK, Wolfe J, Prigerson HG, Onelov E, Kreicbergs UC. Unresolved grief in a national sample of bereaved parents: impaired mental and physical health 4 to 9 years later. J Clin Oncol. 2008;26(36):5870–6.

    Article  PubMed  Google Scholar 

  44. Levenson JC, Frank E, Cheng Y, Rucci P, Janney CA, Houck P, et al. Comparative outcomes among the problem areas of interpersonal psychotherapy for depression. Depress Anxiety. 2010;27:434–40.

    Article  PubMed  CAS  Google Scholar 

  45. Love AW. Progress in understanding grief, complicated grief, and caring for the bereaved. Contemp Nurse. 2007;27(1):73–83.

    Article  PubMed  Google Scholar 

  46. Maciejewski PK, Zhang B, Block SD, Prigerson HG. An empirical examination of the stage theory of grief. JAMA. 2007;297(7):716–23.

    Article  PubMed  CAS  Google Scholar 

  47. Maguire P. Improving the recognition of concerns and affective disorders in cancer patients. Ann Oncol. 2002;13 Suppl 4:177–81.

    Article  PubMed  Google Scholar 

  48. Maguire P, Pitceathly C. Key communication skills and how to acquire them. BMJ. 2002;325:697–700.

    Article  PubMed  Google Scholar 

  49. Mangelli L, Fava GA, Grandi S, Grassi L, Ottolini F, Porcelli P, et al. Assessing demoralization and depression in the setting of medical disease. J Clin Psychiatry. 2005;66:391–4.

    Article  PubMed  Google Scholar 

  50. Massie MJ. Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr. 2004;32:57–71.

    Article  PubMed  Google Scholar 

  51. Mehnert A, Vehling S. Cancer patients: loss of meaning, demoralization and embitterment. In: Maercker A, Linden M, editors. Embitterment: societal, psychological, and clinical perspectives. Berlin: Springer; 2010.

    Google Scholar 

  52. Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12(2):160–74.

    Article  PubMed  Google Scholar 

  53. National Institute for Clinical Excellence. Self-harm—the short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. London: National Institute for Clinical Excellence; 2004.

    Google Scholar 

  54. Ng CG, Boks MP, Zainal NZ, de Wit NJ. The prevalence and pharmacotherapy of depression in cancer patients. J Affect Disord. 2011;131(1–3):1–7.

    Article  PubMed  CAS  Google Scholar 

  55. Osborn RL, Demoncada AC, Feuerstein M. Psychosocial interventions for depression, anxiety, and quality of life in cancer survivors: meta-analyses. Int J Psychiatry Med. 2006;36:13–34.

    Article  PubMed  Google Scholar 

  56. Pasquini M, Biondi M. Depression in cancer patients: a critical review. Clin Pract Epidemiol Ment Health. 2007;3:1–9.

    Article  Google Scholar 

  57. Pellegrino R, Formica V, Portarena I, Mariotti S, Grenga I, Del Monte G, et al. Caregiver distress in the early phases of cancer. Anticancer Res. 2010;30(11):4657–63.

    PubMed  Google Scholar 

  58. Pitceathly C, Maguire P. The psychological impact of cancer on patients’ partners and other key relatives: a review. Eur J Cancer. 2003;39:1517–24.

    Article  PubMed  CAS  Google Scholar 

  59. Priegerson HG, Horowitz MJ, Jacobs SC, Parkes CM, Aslan M, Goodkin K, et al. Prolonged grief disorder: psychometric validation of criteria proposed for DSM-IV and ICD-11. PLoS Med. 2009;6(8):e100121.

    Google Scholar 

  60. Priegerson HG, Vanderwerker LC, Maciejewski PK. Prolonged grief disorder: a case for inclusion in DSM-IV. In: Stroebe M, Hansson R, Schut H, Stroebe W, editors. Handbook of bereavement research and practice: 21st-century perspective, chapter 8. Washington: Psychological Press; 2008. p. 165–86.

    Google Scholar 

  61. Prigerson HG, Maciejewski PK. Grief and acceptance as opposite sides of the same coin: setting a research agenda to study peaceful acceptance of loss. Br J Psychiatry. 2008;193(6):435–7.

    Article  PubMed  Google Scholar 

  62. Reeve JL, Lloyd-Williams M, Dowrick C. Revisiting depression in palliative care settings: the need to focus on clinical utility over validity. Palliat Med. 2008;22:383–91.

    Article  PubMed  CAS  Google Scholar 

  63. Reich M. Depression and cancer: recent data on clinical issues, research challenges and treatment approaches. Curr Opin Oncol. 2008;20:353–9.

    Article  PubMed  Google Scholar 

  64. Robson A, Scrutton F, Wilkinson L, MacLeod F. The risk of suicide in cancer patients: a review of the literature. Psychooncology. 2010;19:1250–8.

    Article  PubMed  Google Scholar 

  65. Schnur JB, Montgomery GH. A systematic review of therapeutic alliance, group cohesion, empathy, and goal consensus/collaboration in psychotherapeutic interventions in cancer: uncommon factors? Clin Psychol Rev. 2010;30:238–47.

    Article  PubMed  Google Scholar 

  66. Schut H, Stroebe M, Van Den Bout J, Terheggen M. The efficacy of bereavement interventions: who benefits? In: Stroebe MS, Hansson RO, Stroebe W, Schut H, editors. Handbook of bereavement research. Washington, DC: American Psychological Association; 2001.

    Google Scholar 

  67. Sharpe M, Strong V, Allen K, Rush R, Postma K, Tulloh A, et al. Major depression in outpatients attending a regional cancer centre: screening and unmet treatment needs. Br J Cancer. 2004;90:314–20.

    Article  PubMed  CAS  Google Scholar 

  68. Shear K, Frank E, Houck PR, Reynolds III CF. Treatment of complicated grief: a randomized controlled trial. JAMA. 2005;293:2601–8.

    Article  PubMed  CAS  Google Scholar 

  69. Shear K, Mulhare E. Attachment, loss and complicated grief. Dev Psychobiol. 2005;47:253–67.

    Article  PubMed  Google Scholar 

  70. Shear MK, Simon N, Wall M, Zisook S, Neimeyer R, Duan N, et al. Complicated grief and related bereavement issues for DSM-5. Depress Anxiety. 2011;28:103–17.

    Article  PubMed  Google Scholar 

  71. Spiegel D, Classen C. Group therapy for cancer patients: a research-based handbook of psychosocial care. New York: Basic Books; 2000.

    Google Scholar 

  72. Stroebe M, Schut H, Stroebe W. Health outcomes of bereavement. Lancet. 2007;370:1960–73.

    Article  PubMed  Google Scholar 

  73. Stroebe M, Van Son M, Stroebe W, Kleber R, Schut H, Van den Bout J. On the classification and diagnosis of pathological grief. Clin Psychol Rev. 2000;20(1):57–75.

    Article  PubMed  CAS  Google Scholar 

  74. Thornton LM, Andersen BL, Schuler TA, Carson III WE. A psychological intervention reduces inflammatory markers by alleviating depressive symptoms: secondary analysis of a randomized controlled trial. Psychosom Med. 2009;71:715–24.

    Article  PubMed  CAS  Google Scholar 

  75. Tomarken A, Holland J, Schachter S, Vanderwerker L, Zuckerman E, Nelson C, et al. Factors of complicated grief pre-death in caregivers of cancer patients. Psychooncology. 2007;17:105–11.

    Google Scholar 

  76. Vanderwerker LC, Jacobs SC, Parkes CM, Priegerson HG. An exploration of associations between separation anxiety in childhood and complicated grief in later life. J Nerv Ment Dis. 2006;194:1–3.

    Article  Google Scholar 

  77. Vogel BA, Leonhart R, Helmes AW. Communication matters: the impact of communication and participation in decision making on breast cancer patients’ depression and quality of life. Patient Educ Couns. 2009;77:391–7.

    Article  PubMed  Google Scholar 

  78. Wakefield JC, Schmitz MF, Baer JC. Did narrowing the major depression bereavement exclusion from DSM-III-R to DSM-IV increase validity? Evidence from the National Comorbidity Survey. J Nerv Ment Dis. 2011;199:66–73.

    Article  PubMed  Google Scholar 

  79. Wakefield JC, Schmitz MF, First MB, Horwitz AV. Extending the bereavement exclusion for major depression to other losses: evidence from the National Comorbidity Survey. Arch Gen Psychiatry. 2007;64:433–40.

    Article  PubMed  Google Scholar 

  80. Wasteson E, Brenne E, Higginson IJ, Hotopf M, Lloyd-Williams M, Kaasa S, et al. European Palliative Care Research Collaborative (EPCRC). Depression assessment and classification in palliative cancer patients: a systematic literature review. Palliat Med. 2009;23:739–53.

    Article  PubMed  Google Scholar 

  81. Watson M, Kissane D, editors. The international psycho-oncology society’s training guide for psychological therapies with cancer patients. London: Wiley; 2011.

    Google Scholar 

  82. Weissman M, Markowitz J, Klerman G. Comprehensive guide to interpersonal psychotherapy. New York: Basic Books; 2000.

    Google Scholar 

  83. Weissman MM, Markowitz JC, Klerman GL. Clinician’s quick guide to interpersonal psychotherapy. New York: Oxford University Press; 2007.

    Google Scholar 

  84. Wellish DK. Family issues in palliative care. In: Chochinov HM, Breitbart W, editors. Handbook of psychiatry in palliative medicine. New York: Oxford University Press; 2000.

    Google Scholar 

  85. Williams S, Dale J. The effectiveness of treatment for depression/depressive symptoms in adults with cancer: a systematic review. Br J Cancer. 2006;94:372–90.

    Article  PubMed  CAS  Google Scholar 

  86. Wittouck C, Van Autreve S, De Jaegere E, Portzky G, van Heeringen K. The prevention and treatment of complicated grief: a meta-analysis. Clin Psychol Rev. 2011;31:69–78.

    Article  PubMed  Google Scholar 

  87. Worden JW. Grief counseling and grief therapy. A handbook for the mental health practitioner. 4th ed. New York: Springer; 2008.

    Google Scholar 

  88. Zabora J, Brintzenhofe-Szoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psychooncology. 2001;10:19–28.

    Article  PubMed  CAS  Google Scholar 

  89. Zaider T, Kissane D. The assessment and management of family distress during palliative care. Curr Opin Support Palliat Care. 2009;3:67–71.

    Article  PubMed  Google Scholar 

  90. Zeitlin SV. Grief and bereavement. Prim Care. 2001;28(2):415–25.

    Article  PubMed  CAS  Google Scholar 

  91. Zisook S, Shear K. Grief and bereavement: what psychiatrists need to know. World Psychiatry. 2009;8:67–74.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Section of Psychiatry, Department of Biomedical and Specialty Surgical Siences, University of Ferrara, Corso Giovecca 203, Ferrara, 4410, Italy

    Luigi Grassi, Rosangela Caruso & Maria Giulia Nanni

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  1. Luigi Grassi
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  2. Rosangela Caruso
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  3. Maria Giulia Nanni
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Correspondence to Luigi Grassi .

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  1. , Department of Medicine, New York University Medical School, First Avenue 530, New York, 10016, USA

    Antonella Surbone

  2. Institute of Oncology, Zaloška 2, Ljubljana, 1000, Slovenia

    Matjaž Zwitter

  3. Institute of Oncology, Zaloška 2, Ljubljana, 1000, Ljubljana-Center, Slovenia

    Mirjana Rajer

  4. 38th Street 2838, Astoria, 11103, New York, USA

    Richard Stiefel

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Grassi, L., Caruso, R., Nanni, M.G. (2013). Dealing with Depression: Communicating with Cancer Patients and Grieving Relatives. In: Surbone, A., Zwitter, M., Rajer, M., Stiefel, R. (eds) New Challenges in Communication with Cancer Patients. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-3369-9_6

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