The prevalence, detection and intervention for depression and anxiety in oncology

Clinical depression is the most prevalent psychiatric disorder amongst cancer patients and is associated with significant functional impairment, although often under-diagnosed and untreated. In one study, only 6% of patients with clinical depression were identified by their oncologists. The detection of and intervention for anxiety and depression in oncology is widely debated in the literature. Diagnosing clinically significant distress amongst cancer patients requires sensitivity as many symptoms of depression are very similar to those of some cancers themselves. The two detection methods discussed in the literature are either self report questionnaires (i.e., HADS) and diagnostic clinical interviews. There are several techniques described in the literature that have shown to be effective in reducing anxiety and depression in oncology. These can be broken down into four main categories, namely, cognitive behavioural therapy (CBT), counselling, drug therapy and complementary therapies, and it is acknowledged that patients receiving any type of intervention generally cope better than those who receive none at all. The effective management of anxiety and depression is dependent on the ability of health professionals to establish a rapport with patients and pick up on cues, regardless of whether intervention is necessary. However, an obvious lack of time and resources within the NHS can be a limiting factor, thus all health care professionals must take more responsibility for the detection of anxiety and depression, followed by the appropriate referral.