摘要

The evaluation of psychiatric disorders related to cancer has been the subject of intense research in psycho-oncology. Psychopathological disturbances have an average prevalence of 35−45% and may be classified as "classical" psychiatric disorders (e.g., adjustment, anxiety, depressive disorders) and neuropsychiatric disorders (e.g., cognitive disorders secondary to treatment, delirium). Several problems have emerged in using the most common nosological systems, such as the International Classification of Diseases (ICD) and Diagnostic and Statistical Manual of Mental Disorders (DSM), because of their limits in specificity and sensitivity and in catching certain clinically significant dimensions (e.g., health anxiety, demoralization, irritable mood), which can be identified through other systems, such as the Diagnostic Criteria for Psychosomatic Research. The need to monitor psychosocial morbidity (i.e., "caseness") in cancer has determined the development of screening tools that have shown good levels of sensitivity and specificity. Among the psychopathological conditions that are strongly related to biological factors, the most common are cognitive disorders secondary to treatment (so-called chemo-brain) and delirium. The knowledge of the risk factors for both psychiatric and neuropsychiatric syndromes, including some specific problems, such as suicide, should be part of the training of healthcare professionals working in cancer centers. Furthermore, the barriers that still prevent comprehensive care to cancer patients should be identified and overcome.