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Diagnostic Issues

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Psychopharmacology in Oncology and Palliative Care

Abstract

The chapter provides a summary of the main issues related to the assessment of the psychological reactions and/or psychopathological disorders in oncology and palliative care. A careful psychiatric interview and a proper mental status examination (MSE) are the means by which a psychiatric diagnosis is made, as a mandatory step when prescribing psychotropic drugs. During the assessment, a detailed description and evaluation of the emotional and behavioral signs and symptoms indicative of a psychiatric disturbance should be carried out. Several other variables need also to be considered (e.g., attachment styles, coping, defense mechanisms, stressful life events, social support) in order to fully understand the patient’s status. Furthermore, a definite assessment of the patient’s physical functioning and the general medical condition, in liaison with the healthcare professionals, is a necessary component of the psychiatric diagnostic process. The Diagnostic and Statistical Manual for Mental Disorders (DSM-5) and the International Classification of Diseases (ICD-10) are the most common taxonomic systems to classify psychiatric disorders. Changes in the diagnostic criteria, especially with regard to the rubrics of adjustment disorders, depressive disorders, somatic symptom disorders, and psychological factors affecting a medical condition, have however been proposed when the DSM or the ICD are applied in oncology and palliative care settings. The Diagnostic Criteria for Psychosomatic Research (DCPR) are useful for a more precise identification of psychosocial conditions affecting cancer patients, including health anxiety, demoralization, and somatic symptom presentation of distress. A psychosomatic integrative approach is thus necessary in the psychiatric diagnostic process.

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Authors and Affiliations

  1. Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy

    Luigi Grassi & Maria Giulia Nanni

  2. Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA

    Michelle Riba (Director)

  3. Psycho-Onclology Program, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA

    Michelle Riba (Director)

Authors
  1. Luigi Grassi
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  2. Maria Giulia Nanni
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  3. Michelle Riba
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Correspondence to Luigi Grassi .

Editor information

Editors and Affiliations

  1. Biomedical & Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy

    Luigi Grassi

  2. Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA

    Michelle Riba

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Grassi, L., Nanni, M.G., Riba, M. (2014). Diagnostic Issues. In: Grassi, L., Riba, M. (eds) Psychopharmacology in Oncology and Palliative Care. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40134-3_3

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  • DOI: https://doi.org/10.1007/978-3-642-40134-3_3

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-40133-6

  • Online ISBN: 978-3-642-40134-3

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