Anxio-depressive Syndrome – Biopsychosocial Model of Supportive Care
Authors:
J. Švec 1; P. Švec 2; V. Bencová 1; V. Krčméry 3
Authors‘ workplace:
I. onkologická klinika LF UK a Onkologický ústav sv. Alžbety, Bratislava, Slovenská republika
1; Katedra farmakológie, Farmakologická fakulta, UK v Bratislave, Slovenská republika
2; Katedra verejného zdravotníctva, Vysoká škola zdravotníctva a sociálnej práce Sv. Alžbety, Bratislava, Slovenská republika
3
Published in:
Klin Onkol 2015; 28(3): 177-182
Category:
Reviews
doi:
https://doi.org/10.14735/amko2015177
Overview
Background:
Acute stress in patients experiencing cancer diagnosis and the post-traumatic stress disorder in cancer survivors results in impaired overall quality of life mainly due to associated psychological and physical alterations, including anxiety, depression, sleep disturbances, cognitive dysfunctions, fatigue, pain, cachexia and others. Recent studies revealed a new insight into molecular mechanisms contributing to the development of cancer-related co morbidities. It has been shown that adverse psychosomatic reactions including cancer depression to emotional cancer distress result from neuroendocrinne dysfunctions, disruption of the hypothalamus- pituitary-adrenal axis and sympathetic nervous system, serotonin-dopamine interactions and circadian sleep- wake rhythm disruption.
Aim:
The aim of the present study was to evaluate clinical studies oriented toward elucidation of the hypothesis that cancer-related anxio- depressive syndrome is the major disorder leading to the development of accompanying psychosomatic disruptions.
Material and Methods:
The data of the biopsychosocial approach in the treatment of cancer presented in the current literature were collecting using appropriate electronic databases and were elaborated in the form of meta-analysis of 24 selected publications. Results: According to relevant clinical studies, psychosocial interventions and psychopharmacological treatment has been shown to reduce cancer symptomatology and to improve the ability of patients to cope with the disease. Thus, one of the key pillars of supportive care in oncology is stress reduction. Cognitive- behavioral interventions and group psychosocial therapies have shown to reduce stress from the diagnosis and treatment, to palliate depression and to help in restoring the circadian rhythm. Psychopharamacological interventions are the most useful approaches in the reduction of stress-induced cancer comorbidities. In the presented study, a plausible role of stress reduction in the protection of cancer patients from posttraumatic and anxio- depressive syndrome, physical and psychical suffering, from decrease of patient’s quality of life, ability to cope with the disease and cooperate in cancer treatment has been analyzed.
Conclusion:
Implementation of the biopsychosocial model of cancer care needs further cooperation between behavioral scientists and clinical oncologists attempted to elucidate further possibilities of psychosocial and pharmacological interventions leading to the regulation of stress-induced alterations of the neurotransmitter system and neuroendocrinne dysfunctions reduction of cancer-related co morbidities and improvement of patients survival time.
Key words:
cancer – behavioral risk profile – anxio- depressive syndrome – paraneoplastic syndrome – neurohumoral dysfunction – psychosocial and pharmacological intervention
The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.
Submitted:
30. 7. 2014
Accepted:
8. 4. 2015
Sources
1. Jacobsson PB, Holland JC, Steensma DA. Caring for the whole patient: the science of psychosocial care. J Clin Oncol 2012; 30(11): 1151– 1153. doi: 10.1200/ JCO.2011.41.4078.
2. Bencova V, Bella J, Svec J. Psychosocial morbidity and psychosocial support needs of breast cancer survivors one and three years after breast- conserving surgery. Psychooncology 2011; 20 (Suppl 2): 112– 113.
3. Miller AH, Ancoli- Israel S, Bower JE et al. Neuroendocrine- immune mechanisms of behavioral comorbidities in patients with cancer. J Clin Oncol 2008; 26(6): 971– 986. doi: 10.1200/ JCO.2007.10.7805.
4. Thaker PH, Sood AK. Neuroendocrine influences on cancer biology. Semin Cancer Biol 2008; 18(3): 164– 170. doi: 10.1016/ j.semcancer.2007.12.005.
5. Caspi A, Sugden K, Moffitt TE. Influence of life stress on depression: moderation by a polymorphism in the 5- HHT gene. Science 2003; 301(5631): 386– 389.
6. Reiche EM, Nunes SO, Morimoto HK. Stress, depression, the immune system and cancer. Lancet Oncol 2004; 5(10): 617– 625.
7. Spiegel D. Mind matters in cancer survival. JAMA 2011; 305(5): 502– 513. doi: 10.1001/ jama.2011.69.
8. Holland JC, Alici V. Management of distress in cancer patients. J Support Oncol 2010; 8(1): 4– 12.
9. Grassi L, Holland JC, Johansen C et al. Psychiatric concomitants of cancer. Screening procedures, and training of health professionals in oncology. Adv Psychiatry 2005; 2: 59– 66.
10. Parchman ML, Burge SK. The patient- physician relationship, primary care attributes and preventive services. Family Med 2004; 36(1): 22– 27.
11. Nowy DM, Aigner CJ. The biopsychosocial model in cancer pain. Curr Opin Suppot Palliat Care 2014; 8(2):117– 123. doi: 10.1097/ SPC.0000000000000046.
12. Kangas M, Bovbjerg DH, Montgomery GH. Cancer-related fatigue: a systematic and metaanalytic review of non-pharmacological therapies for cancer patients. Psychol Bull 2008; 134(5): 700– 741. doi: 10.1037/ a0012825.
13. Gorin SS, Krebs P, Badr H et al. Meta-analysis of psychosocial interventions to reduce pain in patients with cancer. J Clin Oncol 2012; 30(5): 539– 547. doi: 10.1200/ JCO.2011.37.0437.
14. Johannessen- Henry CT, Deltorr J, Bidstrup PE et al. Associations between faith, distress, and mental adjustment – a Danish survivorship study. Acta Oncol 2013; 52(2): 364– 371. doi: 10.3109/ 0284186X.2012.744141.
15. King D, Miranda P, Gor B et al. Adressing cancer health disparities using a global biopsychosocial approach. Cancer 2010; 116(2): 264– 269. doi: 10.1002/ cncr.24765.
16. Andersen BL, Thornton LM, Shapiro CL. Biobehavioral, immune, and health benefits following recurrence for psychological intervention participants. Clin Cancer Res 2010; 16(12): 3270– 3278. doi: 10.1158/ 1078- 0432.CCR- 10- 0278.
17. Yehuda R, Teicher MH, Trestman RL et al. Cortisol regulation in posttrumatic stress disorder and major depression: a chronobiological analysis. Biol Psychiatry 1996; 40(2): 79– 88.
18. Artherholt SB, Fann JR. Psychosocial care in cancer. Curr Psychiatry Rep 2012; 14(1): 23– 29. doi: 10.1007/ s11920- 011- 0246- 7.
19. Bredart A, Bouleuc, C, Dolbeault S. Doctor- patient communication and satisfaction with care in oncology. Curr Opin Oncol 2005; 17(4): 351– 354.
20. McDowell ME, Occhipinti S, Ferguson M et al. Predictors of change in unmet supportive care needs in cancer. Psychooncology 2010; 19(5): 508– 516. doi: 10.1002/ pon.1604.
21. Sibille K, Greene A, Bush JP. Preparing physicians for the 21 century: Communicating skills and the promotion of health behavior change. Ann Behav Sci Med Educ 2011; 16(1): 7– 13.
22. Bencová V. Komunikácia ako súčasť suportívnej terapie v onkológii. Klin Onkol 2013; 26(3): 195– 200. doi: 10.14735/ amko2013195.
23. Goodwin PJ, Leszcz M, Ennis M. The effect of group psychological support on survival in metastatic breast cancer. New Eng J Med 2001; 345(24): 1719– 1726.
24. Rehse B, Pukrop R. Effect of psychosocial intervention on quality of life in adult cancer patients. Meta-analysis of 37 published outcome studies. Patient Educat Commun 2003; 50(2): 179– 186.
25. White P (ed.). Psychosocial medicine: an integrated approach to understanding disease. Oxford: Oxford University Press 2005.
26. Giacobbe P, Mayberg HS, Lozano AM. Treatment resistant depression as a future of brain homeostatic mechanisms: implications for deep brain stimulation. Exp Neurol 2009; 219(1): 41– 42. doi: 10.1016/ j.expneurol.2009.04.028.
27. Toftegård Andersen L, Voigt Hansen M, Rosenberg J et al. Pharmacological treatment of depression in women with breast cancer: a systematic review. Breast Cancer Res Treat 2011; 141(3): 325– 330.
28. Frankel RU, Guill TE, McDaniel SH (eds). The biopsychosocial approach: past, present, and future. Rochester: Rochester Univ Press 2002.
29. Nowy DM, Aigner CJ. The biopsychosocial model in cancer pain. Curr Opin Suppot Palliat Care 2014; 8(2): 117– 123. doi: 10.1097/ SPC.0000000000000046.
30. Temoshok LR. Rethinking research on biopsychosocial interventions in psychosocial oncology. Psychooncology 2004; 13(7): 460– 467.
31. Loscalzo M, Clark L, Pal S et al. Role of psychosocial screening in cancer care. Cancer J 2013; 19(5): 414– 420. doi: 10.1097/ PPO.0b013e3182a5bce2.
32. Palesh O, Butler LD, Koopman C. Stress histoty and breast cancer recurrence. J Psychosom Res 2007; 63(3): 233– 239.
33. Howell D, Mayo S, Currie S et al. Psychosocial health care needs assessment of adult cancer patients: a consensus- base guideline. Support Care Cancer 2012; 20(12): 3343– 3354.
34. Spiegel D. Mind matters in cancer survival. JAMA 2011; 305(5): 502– 503. doi: 10.1001/ jama.2011.69.
35. Raudenska J, Javurková A. Diagnostika a zvládání deprese v terminálním stádiu nádorového onomocnení. Paliat Med Liečba Bolesti 2011; 4(1): 12– 15.
36. Sedlacek L, Slovackova B, Slanska I et al. Depression symptoms and health-related quality of life among patients with metastatic breast cancer in programe of palliative care. Neoplasma 2009; 56(6): 467– 472.
37. Onitilo AA, Nietert PJ, Egede LE. Effect of depression on all-cause mortality of adults with cancer and differential effects by cancer site. Gen Hosp Psychiatry 2006; 28(5): 396– 402.
38. Currier MB, Nemeroff CB. Depression as a risk for cancer: from pathophysiological advances to treatment implications. Ann Rev Med 2014; 65: 203– 221. doi: 10.1146/ annurev- med- 061212- 171507.
39. Slovacek L, Slanska I, Slovackova B et al. Screening for depression of metastatic ovarian cancer in a programe of palliative care. Bratisl Lek Listy 2009; 110(10): 655– 659.
40. Lloyd- Williams M, Payne S, Reeve J et al. Thoughts of selfharm and depression and prognostic factors in palliative care. J Affect Disorders 2013; 166: 324– 329. doi: 10.1016/ j.jad.2014.05.029.
41. Russo SJ, Nestler EJ. The brain record circuity and mood disorders. Nat Rev Neurosci 2013; 14(9): 609– 625. doi: 10.1038/nrn3381.
Labels
Paediatric clinical oncology Surgery Clinical oncologyArticle was published in
Clinical Oncology
2015 Issue 3
Most read in this issue
- New Findings in Methotrexate Pharmacology – Diagnostic Possibilities and Impact on Clinical Care
- Podávání kontinuálních infuzí cytostatik pomocí elastomerických infuzorů
- Tumour Hypoxia – Molecular Mechanisms and Clinical Relevance
- Early Integration of Palliative Care into Standard Oncology Care – Benefits, Limitations, Barriers and Types of Palliative Care