Decrease of anxio-depressive disorders in cancer with non drug psychotherapies

Marie-Frédérique Bacqué

Abstract


Background/Purpose: Cancer is well known for its psychological and psychiatric aftermath. About 40% of cancer patients present psychological or psychiatric troubles. First in contrast with the survival stakes, the psychopathological symptoms have been then ignored because they were confounding factors with the illness effect such as sadness, psychomotor slowing down or cognitive impairment. These troubles are now well known in international classifications (ICD, DSM-5) : from miss adaptation to delusion and especially anxio-depressive troubles.

With its increasing worldwide frequency cancer has become a prominent figure of modern misfortune. Psycho-oncologyis the new branch of scientific knowledge that links cancer somatic consequences to their psychological expressions. Psycho-oncology opens a large area in psychopathology. But psycho-oncology is also interested in psychosociology. Cancer social representations interfere individually as with the group in cancer prevention and cancer detection.

To decrease excessive anxiety in people cancer screening, countries must adapt their messages and work out a discourse that speaks to everybody. Furthermore, each gender, generation and personality has his specific prejudices. This reflexion introduces first  attempts of setting limits to psychotraumatism in cancer disclosure. Many symptoms could be avoided with a right training of doctors and caregivers. To begin a specific way to announce cancer will be exposed with authentic and empathic progressive approach of truth.

Methods: Qualitative methods are preferentially used to expose somebody to what the majority consider as a death threat. With the humanization of healthcare, doctors can not announce cancer anymore in a corridor nor by phone neither with an email.  This first step of the « working alliance » between doctor and patient realizes the conditions of what Jimmie Holland calls the « patient total care » : a holistic approach of the patient in his environment. The second step is the restoration of the continuous identity of the patient despite the illness. The narration of his story is necessary to integrate the breach of the diagnosis. Listening to this story is often the task of the psychologist. Sometimes doctors or nurses try to consolidate the patient personality but it takes special skills and a lot of time. For example some specific questions like « What is difficult for you at this moment ? » or « what are your life priorities ? » can build a clinical approach, deeply in trapsychic more than humanistic. It’s an ethic matter.  Some psychopathological symptoms may impair patients global state. The clinician may wonder about present symptoms as well as previous crisis disruptions. He will take into account the transference upon him, the caregivers and all the institution. Transferanceisa freudian concept thatincludesun conscious feelings usually reserved to parents but shifted on doctors or caregivers. The positive part of the transference will help patients to trust and accept to be cured by the oncology team.

Results: Announcing cancer is the doctor’s work. In psychotraumatic conditions, a psychological accompanying is useful to help the patient to bind the traumatic disclosure to his emotional life. The psychodynamic therapy (PT) is a deep in trapsychic work while the cognitivo-behavioral therapy (CBT) is a way to adapt patient to illness and treatment. In PT patient is deeply committed to change his way of mentalizing (connecting affects to behaviors). Both are helpful without additional drugs.

Conclusion: Psycho-oncological approach of cancer recognizes multi-factoriality of cancer aetiology and cure. Beyond simple understanding of psychological states it offers an integrative approach of the patient as a unique person in his culture and interpersonal environment.

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Cite this article as:  Bacqué M. Decrease of anxio-depressive disorders in cancer with non drug psychotherapies. Int J Cancer Ther Oncol 2015; 3(4):3403.

[This abstract was presented at the BIT’s 8th Annual World Cancer Congress, which was held from May 15-17, 2015 in Beijing, China.]




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International Journal of Cancer Therapy and Oncology (ISSN 2330-4049)

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