Skip to main content
Erschienen in: Wiener Medizinische Wochenschrift 15-16/2015

01.08.2015 | themenschwerpunkt

Depression bei onkologischen PatientInnen

verfasst von: Univ.-Prof. Dr. Barbara Sperner-Unterweger

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 15-16/2015

Einloggen, um Zugang zu erhalten

Zusammenfassung

KrebspatientInnen leiden oft an depressiven Syndromen bzw. depressiven Störungen. Obwohl bestimmte „Risikophasen“ bekannt sind, in denen depressive Symptome häufiger auftreten können, wie z. B. nach Diagnosestellung, muss betont werden, dass sich diese Symptomatik zu jedem Zeitpunkt im Krankheitsverlauf entwickeln kann. Dazu finden sich sehr unterschiedliche Prävalenzangaben (bis zu 60 %), was neben anderen Faktoren, vor allem die diagnostischen Schwierigkeiten widerspiegelt. Depressive Symptomatik bei KrebspatientInnen wird seitens der behandelnden Onkologen nur in 15–50 % erkannt und zu einem noch geringeren Prozentsatz auch adäquat behandelt. Daraus ergeben sich massive Einbußen für die subjektive Lebensqualität dieser Patientengruppe. Darüber hinaus werden auch objektive Einschränkungen wie verminderte Compliance/Adherence sowie schlechtere Prognose diskutiert. Vor allem ist zu betonen, dass eine depressive Symptomatik ein deutlich höheres Risiko für Suizidalität mit sich bringt.
Obwohl die Anzahl an klinischen Studien zur Behandlung der depressiven Symptomatik bei KrebspatientInnen weder im psychotherapeutischen noch im psychopharmakologischen Bereich groß ist, kann doch von guten therapeutischen Möglichkeiten gesprochen werden.
Literatur
1.
Zurück zum Zitat Brown LF, Kroenke K, Theobald D, Wu J, Carpenter JS, Tu W. The association of depression and anxiey with health-related quality of life in cancer patients with depression and/or pain. Psychooncology. 2010;19:734–41.PubMedCentralPubMedCrossRef Brown LF, Kroenke K, Theobald D, Wu J, Carpenter JS, Tu W. The association of depression and anxiey with health-related quality of life in cancer patients with depression and/or pain. Psychooncology. 2010;19:734–41.PubMedCentralPubMedCrossRef
2.
Zurück zum Zitat Kissane DW, Smith GC. Consultation-liaison psychiatry in an Australian oncology unit. Aust NZJ Psychiatry. 1996;30(3):397–404.CrossRef Kissane DW, Smith GC. Consultation-liaison psychiatry in an Australian oncology unit. Aust NZJ Psychiatry. 1996;30(3):397–404.CrossRef
3.
Zurück zum Zitat Grassi L, Gritti P, Rigatelli M, Gala C. Psychosocial problems secondary to cancer: an Italian multicenter survey of consultation-liaison psychiatry in oncology. Italian Consultation-Liaison-Group. Eur J Cancer. 2000;36:579–85.PubMedCrossRef Grassi L, Gritti P, Rigatelli M, Gala C. Psychosocial problems secondary to cancer: an Italian multicenter survey of consultation-liaison psychiatry in oncology. Italian Consultation-Liaison-Group. Eur J Cancer. 2000;36:579–85.PubMedCrossRef
4.
Zurück zum Zitat Linden A, Vodermaier A, Mackenzie R, Greig D. Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender and age. J Affect Disord. 2012;141(2–3):343–51.PubMedCrossRef Linden A, Vodermaier A, Mackenzie R, Greig D. Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender and age. J Affect Disord. 2012;141(2–3):343–51.PubMedCrossRef
5.
Zurück zum Zitat Mitchel AJ, Chan M, Bhatti H, Halton M, Grassi L, Johannen C, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematologica, and palliative care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12:160–74.CrossRef Mitchel AJ, Chan M, Bhatti H, Halton M, Grassi L, Johannen C, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematologica, and palliative care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12:160–74.CrossRef
6.
Zurück zum Zitat House A. Mood disorders in the physically ill-problems of definition and measurement. J Psychosom Res. 1988;32:345–53.PubMedCrossRef House A. Mood disorders in the physically ill-problems of definition and measurement. J Psychosom Res. 1988;32:345–53.PubMedCrossRef
7.
Zurück zum Zitat Keller M, Sommerfeldt S, Fischer C, Knight L, Riesbeck M, Löwe B, et al. Recognition of distress and psychiatric morbidity in cancer patients: a multi-method approach. Ann Oncol. 2004;15(8):1243–9.PubMedCrossRef Keller M, Sommerfeldt S, Fischer C, Knight L, Riesbeck M, Löwe B, et al. Recognition of distress and psychiatric morbidity in cancer patients: a multi-method approach. Ann Oncol. 2004;15(8):1243–9.PubMedCrossRef
8.
Zurück zum Zitat 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.PubMedCentralPubMedCrossRef 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.PubMedCentralPubMedCrossRef
9.
Zurück zum Zitat Lederberg MS. Psychooncology. 8. Aufl. Bd. 2. Philadelphia: Lippincott Williams and Wilkins; 2005. S. 2225. Lederberg MS. Psychooncology. 8. Aufl. Bd. 2. Philadelphia: Lippincott Williams and Wilkins; 2005. S. 2225.
10.
Zurück zum Zitat Endicott J. Measurement of depression in patients with cancer. Cancer. 1984;53:2243–8.PubMed Endicott J. Measurement of depression in patients with cancer. Cancer. 1984;53:2243–8.PubMed
12.
Zurück zum Zitat National Institute of Health State-of-the Science Panel, Unützer J, Vernon SW, Patrick DL, Ferketich SL, Frame PS, et al. National institute of health state-of-the science conference statement: symptom management in cancer: pain, depression, and fatigue, July 15–17, 2002. J Natl Cancer Inst. 2003;95:1110–7. National Institute of Health State-of-the Science Panel, Unützer J, Vernon SW, Patrick DL, Ferketich SL, Frame PS, et al. National institute of health state-of-the science conference statement: symptom management in cancer: pain, depression, and fatigue, July 15–17, 2002. J Natl Cancer Inst. 2003;95:1110–7.
13.
Zurück zum Zitat Raison CL, Demetrashvili M, Capuron L, Miller AH. Neuropsychiatric adverse effects of interferon-alpha: recognition and management. CNS Drugs. 2005;19:105–23.PubMedCentralPubMedCrossRef Raison CL, Demetrashvili M, Capuron L, Miller AH. Neuropsychiatric adverse effects of interferon-alpha: recognition and management. CNS Drugs. 2005;19:105–23.PubMedCentralPubMedCrossRef
14.
Zurück zum Zitat Raison CL, Capuron L, Miller AH. Cytokines sing the blues: inflammation and the pathogenesis of depression. Trend Immunol. 2006;27:24–31.CrossRef Raison CL, Capuron L, Miller AH. Cytokines sing the blues: inflammation and the pathogenesis of depression. Trend Immunol. 2006;27:24–31.CrossRef
15.
Zurück zum Zitat Irwin M. Psychoneuroimmunology of depression: clinical implications. Brain Behav Immun. 2002;16(1):1–16.PubMedCrossRef Irwin M. Psychoneuroimmunology of depression: clinical implications. Brain Behav Immun. 2002;16(1):1–16.PubMedCrossRef
16.
Zurück zum Zitat Miller AH, Ancoli-Isreal S, Bower JE, Capuron L, Irwin MR. Neuroendocrine-immune mechanisms of behavioral comorbidities in patients with cancer. J Clin Oncol. 2008;36(6):971–82.CrossRef Miller AH, Ancoli-Isreal S, Bower JE, Capuron L, Irwin MR. Neuroendocrine-immune mechanisms of behavioral comorbidities in patients with cancer. J Clin Oncol. 2008;36(6):971–82.CrossRef
17.
Zurück zum Zitat Illman J, Corringham R, Robin D, Davis HM, Rossi JF, Cella D, Trikha M. Are inflammatory cytokines the common link between cancer-associated cachexia and depression? Support Oncol. 2005;3:37–50. Illman J, Corringham R, Robin D, Davis HM, Rossi JF, Cella D, Trikha M. Are inflammatory cytokines the common link between cancer-associated cachexia and depression? Support Oncol. 2005;3:37–50.
18.
Zurück zum Zitat Raison CL, Miller AH. Depression in cancer: new developments regarding diagnosis and treatment. Biol Psychiatry. 2003;54:283–94.PubMedCrossRef Raison CL, Miller AH. Depression in cancer: new developments regarding diagnosis and treatment. Biol Psychiatry. 2003;54:283–94.PubMedCrossRef
19.
Zurück zum Zitat Spiegel D, Butler LD, Giese-Davis J, Koopman C, Miller E, DiMiceli S, et al. Effects of supportive-expressive group therapy on survival of patients with metastatic breast cancer: a randomized prospective trial. Cancer. 2007;110:1130–8.PubMedCrossRef Spiegel D, Butler LD, Giese-Davis J, Koopman C, Miller E, DiMiceli S, et al. Effects of supportive-expressive group therapy on survival of patients with metastatic breast cancer: a randomized prospective trial. Cancer. 2007;110:1130–8.PubMedCrossRef
20.
Zurück zum Zitat Kissane DF, Love A, Hatton A, Block S, Smith G, Clarke DM, et al. Effect of cognitive-existential group therapy on survival in early-stage breast cancer. J Clin Oncol. 2004;22:4255–60.PubMedCrossRef Kissane DF, Love A, Hatton A, Block S, Smith G, Clarke DM, et al. Effect of cognitive-existential group therapy on survival in early-stage breast cancer. J Clin Oncol. 2004;22:4255–60.PubMedCrossRef
21.
Zurück zum Zitat Kissane DW, Grabsch B, Clarke DM, Smith GC, Love AV, Block S, et al. Supportive-expressive group therapy for women with metastatic breast cancer: survival and psychosocial outcome from a randomized controlled trial. Psychooncology. 2007;16:277–86.PubMedCrossRef Kissane DW, Grabsch B, Clarke DM, Smith GC, Love AV, Block S, et al. Supportive-expressive group therapy for women with metastatic breast cancer: survival and psychosocial outcome from a randomized controlled trial. Psychooncology. 2007;16:277–86.PubMedCrossRef
22.
Zurück zum Zitat Satin JR, Linden W, Phillips MJ. Depression as a predictor of disease progression and mortality in cancer patients: a meta-analysis. Cancer. 2009;115:5349–61.PubMedCrossRef Satin JR, Linden W, Phillips MJ. Depression as a predictor of disease progression and mortality in cancer patients: a meta-analysis. Cancer. 2009;115:5349–61.PubMedCrossRef
23.
Zurück zum Zitat Andersen BL, Yang HC, Farrar WB, Golden-Kreuz DM, Emery CF, Thornton LM, et al. Psychologic intervention improves survival for breast cancer patients: a randomized clinical trial. Cancer. 2008;113:413–20. Andersen BL, Yang HC, Farrar WB, Golden-Kreuz DM, Emery CF, Thornton LM, et al. Psychologic intervention improves survival for breast cancer patients: a randomized clinical trial. Cancer. 2008;113:413–20.
24.
Zurück zum Zitat Giese-Davis J, Collie K, Rancourt KM Neri E, Kraemer HC, Spiegel D. Decrease in depression symptoms in associated with longer survival in patients with metastatic breast cancer: a secondary analysis. J Clin Oncol. 2011;29:413–20.PubMedCentralPubMedCrossRef Giese-Davis J, Collie K, Rancourt KM Neri E, Kraemer HC, Spiegel D. Decrease in depression symptoms in associated with longer survival in patients with metastatic breast cancer: a secondary analysis. J Clin Oncol. 2011;29:413–20.PubMedCentralPubMedCrossRef
25.
Zurück zum Zitat Oberaigner W, Sperner-Unterweger B, Fiegl M, Geiger-Gritsch S, Haring C. Increased suicide risk in cancer patients in Tyrol/Austria. Gen Hosp Psychiatry. 2014;36:483–7.PubMedCrossRef Oberaigner W, Sperner-Unterweger B, Fiegl M, Geiger-Gritsch S, Haring C. Increased suicide risk in cancer patients in Tyrol/Austria. Gen Hosp Psychiatry. 2014;36:483–7.PubMedCrossRef
26.
Zurück zum Zitat Ell K, Sanchez K, Vourlekis B, Lee PJ, Dwight-Johnson M, Lagomasino I, et al. Depression, correlates of depression, and receipt of depression care among low-income women with breast or gynaecologic cancer. J Clin Oncol. 2005;23:3052–60.PubMedCentralPubMedCrossRef Ell K, Sanchez K, Vourlekis B, Lee PJ, Dwight-Johnson M, Lagomasino I, et al. Depression, correlates of depression, and receipt of depression care among low-income women with breast or gynaecologic cancer. J Clin Oncol. 2005;23:3052–60.PubMedCentralPubMedCrossRef
27.
Zurück zum Zitat Sharpe M, Strong V, Allen K, Rush R, Maguiere P, House A, et al. Management of major depression in outpatients attending a cancer centre: a preliminary evaluation of a multicomponent cancer nurse-delivered intervention. Br J Cancer. 2004;90:310–3.PubMedCentralPubMedCrossRef Sharpe M, Strong V, Allen K, Rush R, Maguiere P, House A, et al. Management of major depression in outpatients attending a cancer centre: a preliminary evaluation of a multicomponent cancer nurse-delivered intervention. Br J Cancer. 2004;90:310–3.PubMedCentralPubMedCrossRef
28.
Zurück zum Zitat Osborn RL, Demoncada AC, Feuerstein M. Psychosocial interventions for depression, anxiety and quality of life in cancer survivors: meta-analyses. Int J Psychiatr Med. 2006;36:13–34.CrossRef Osborn RL, Demoncada AC, Feuerstein M. Psychosocial interventions for depression, anxiety and quality of life in cancer survivors: meta-analyses. Int J Psychiatr Med. 2006;36:13–34.CrossRef
29.
Zurück zum Zitat Hart SL, Hoyt MA, Diefenbach M, Anderson DR, Kolbourn KM, Craft LL, et al. Meta-analysis of efficacy of interventions for elevated depressive symptoms in adults diagnosed with cancer. J Natl Cancer Inst. 2012;104:990–1004.PubMedCentralPubMedCrossRef Hart SL, Hoyt MA, Diefenbach M, Anderson DR, Kolbourn KM, Craft LL, et al. Meta-analysis of efficacy of interventions for elevated depressive symptoms in adults diagnosed with cancer. J Natl Cancer Inst. 2012;104:990–1004.PubMedCentralPubMedCrossRef
30.
Zurück zum Zitat Sharpe M, Walker J, Holm-Hansen C, Martin P, Symeonides S, Guroley C, et al. Integrated collaborative care for comorbid major depression in patients with cancer (SMaRT Oncology-2): a multicentre randomized controlled effectiveness trial. Lancet. 2014;384:1099–108.PubMedCrossRef Sharpe M, Walker J, Holm-Hansen C, Martin P, Symeonides S, Guroley C, et al. Integrated collaborative care for comorbid major depression in patients with cancer (SMaRT Oncology-2): a multicentre randomized controlled effectiveness trial. Lancet. 2014;384:1099–108.PubMedCrossRef
31.
Zurück zum Zitat Walker J, Hansen CH, Martin P, Symeonides S, Gourley C, Wall L, et al. Integrated collaborative care for major depression comorbid with a poor prognosis cancer (SMaRT Oncology-3): a multicentre randomized controlled trial in patients with lung cancer. Lancet Oncol. 2014;15:1168–76.PubMedCrossRef Walker J, Hansen CH, Martin P, Symeonides S, Gourley C, Wall L, et al. Integrated collaborative care for major depression comorbid with a poor prognosis cancer (SMaRT Oncology-3): a multicentre randomized controlled trial in patients with lung cancer. Lancet Oncol. 2014;15:1168–76.PubMedCrossRef
32.
Zurück zum Zitat Michelini S, Cassano GB, Frare F, Perugi G. Long-term use of benzodiazepines: tolerance, dependence and clinical problems in anxiety and mood disorders. Pharmacopsychiatry. 1996;29:127–34.PubMedCrossRef Michelini S, Cassano GB, Frare F, Perugi G. Long-term use of benzodiazepines: tolerance, dependence and clinical problems in anxiety and mood disorders. Pharmacopsychiatry. 1996;29:127–34.PubMedCrossRef
33.
Zurück zum Zitat Salzman C. The benzodiazepine controversy: therapeutic effects versus dependence, withdrawal and toxicity. Harv Rev Psychiatry. 1997;4:279–82.PubMedCrossRef Salzman C. The benzodiazepine controversy: therapeutic effects versus dependence, withdrawal and toxicity. Harv Rev Psychiatry. 1997;4:279–82.PubMedCrossRef
34.
35.
Zurück zum Zitat Raison CL, Miller AH. Depression in cancer: new developments regarding diagnosis and treatment. Biol Psychiatry. 2003;54:283–94.PubMedCrossRef Raison CL, Miller AH. Depression in cancer: new developments regarding diagnosis and treatment. Biol Psychiatry. 2003;54:283–94.PubMedCrossRef
36.
Zurück zum Zitat Laoutidis ZG, Mathiak K. Antidepressants in the treatment of depression/depressive symptoms in cancer patients: a systematic review and meta-analysis. BMC Psychiatry. 2013;13:140–60.PubMedCentralPubMedCrossRef Laoutidis ZG, Mathiak K. Antidepressants in the treatment of depression/depressive symptoms in cancer patients: a systematic review and meta-analysis. BMC Psychiatry. 2013;13:140–60.PubMedCentralPubMedCrossRef
37.
Zurück zum Zitat Theobald DE. Cancer pain, fatigue, distress, and insomnia in cancer patients. Clin Cornesone. 2004;6(Suppl 1D):15–21.CrossRef Theobald DE. Cancer pain, fatigue, distress, and insomnia in cancer patients. Clin Cornesone. 2004;6(Suppl 1D):15–21.CrossRef
38.
Zurück zum Zitat Forssell H, Tasmuth T, Tenovuo O, Hampf G, Kalso E. Venlafaxine in the treatment of atypical facial pain: a randomized controlled trial. J Orofac Pain. 2004;18:131–7.PubMed Forssell H, Tasmuth T, Tenovuo O, Hampf G, Kalso E. Venlafaxine in the treatment of atypical facial pain: a randomized controlled trial. J Orofac Pain. 2004;18:131–7.PubMed
39.
Zurück zum Zitat Tasmuth T, Hartel B, Kalso E. Venlafaxine in neuropathic pain following treatment of breast cancer. Eur J Pain. 2002;6:17–24.PubMedCrossRef Tasmuth T, Hartel B, Kalso E. Venlafaxine in neuropathic pain following treatment of breast cancer. Eur J Pain. 2002;6:17–24.PubMedCrossRef
40.
Zurück zum Zitat Miller KE, Adams SM, Miller MM. Antidepressant medication use in palliative care. Am J Hosp Palliat Care. 2006;23:127–33.PubMedCrossRef Miller KE, Adams SM, Miller MM. Antidepressant medication use in palliative care. Am J Hosp Palliat Care. 2006;23:127–33.PubMedCrossRef
41.
Zurück zum Zitat Grothe DR, Scheckner B, Albano D. Treatment of pain syndromes with venlafaxine. Pharmacotherapy. 2004;24:621–9.PubMedCrossRef Grothe DR, Scheckner B, Albano D. Treatment of pain syndromes with venlafaxine. Pharmacotherapy. 2004;24:621–9.PubMedCrossRef
42.
Zurück zum Zitat Naidu MU, Ramana GV, Rani PU, Mohan IK, Suman A, Roy R. Chemotherapy-induced and/or radiation therapy-induced oral mucositis-complicating the treatment of cancer. Neoplasia. 2004;6:423–31.PubMedCentralPubMedCrossRef Naidu MU, Ramana GV, Rani PU, Mohan IK, Suman A, Roy R. Chemotherapy-induced and/or radiation therapy-induced oral mucositis-complicating the treatment of cancer. Neoplasia. 2004;6:423–31.PubMedCentralPubMedCrossRef
43.
Zurück zum Zitat Makino H. Treatment and care of neurotoxicity from taxane anticancer agents. Breast Cancer. 2004;11:100–4.PubMedCrossRef Makino H. Treatment and care of neurotoxicity from taxane anticancer agents. Breast Cancer. 2004;11:100–4.PubMedCrossRef
44.
Zurück zum Zitat Walsky RL, Astuccio AV, Obach RS. Evaluation of 227 drugs for in vitro inhibition of cytochrome P450 2B6. J Clin Pharmacol. 2006;46:1526–438.CrossRef Walsky RL, Astuccio AV, Obach RS. Evaluation of 227 drugs for in vitro inhibition of cytochrome P450 2B6. J Clin Pharmacol. 2006;46:1526–438.CrossRef
45.
Zurück zum Zitat Baber R, Hickey M, Kwik M. Therapy for menopausal symptoms during and after treatment for breast cancer: safety considerations. Drug Saf. 2005;28:1085–100.PubMedCrossRef Baber R, Hickey M, Kwik M. Therapy for menopausal symptoms during and after treatment for breast cancer: safety considerations. Drug Saf. 2005;28:1085–100.PubMedCrossRef
46.
Zurück zum Zitat Stearns V, Johnson MD, Rae JM, Morocho A, Novielli A, Bhargava P, et al. Active tamoxifen metabolite plasma concentrations after coadministration of tamoxefin and the selective serotonin reuptake inhibitor paroxetine. J Natl Cancer Inst. 2003;95:1759–64.CrossRef Stearns V, Johnson MD, Rae JM, Morocho A, Novielli A, Bhargava P, et al. Active tamoxifen metabolite plasma concentrations after coadministration of tamoxefin and the selective serotonin reuptake inhibitor paroxetine. J Natl Cancer Inst. 2003;95:1759–64.CrossRef
47.
Zurück zum Zitat Rogers JF, Nafziger AN, Bertino JS Jr. Pharmacogenetics affects dosing, efficacy, and toxicity of cytochrome P450-metabolized drugs. Am J Med. 2002;113:746–50.PubMedCrossRef Rogers JF, Nafziger AN, Bertino JS Jr. Pharmacogenetics affects dosing, efficacy, and toxicity of cytochrome P450-metabolized drugs. Am J Med. 2002;113:746–50.PubMedCrossRef
48.
Metadaten
Titel
Depression bei onkologischen PatientInnen
verfasst von
Univ.-Prof. Dr. Barbara Sperner-Unterweger
Publikationsdatum
01.08.2015
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 15-16/2015
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-015-0363-8

Weitere Artikel der Ausgabe 15-16/2015

Wiener Medizinische Wochenschrift 15-16/2015 Zur Ausgabe