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Characteristic and management of the psychotic patient in oncology


Bulletin du Cancer. Volume 96, Number 2, 227-37, février 2009, Synthèse

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Author(s) : M Reich, C Gaudron

Summary : Not so familiarised with the mental pathology, the oncologist has to deal with psychotic patients and cannot hide their psychiatric problems. Some adjustments need to be implemented in order to obtain the best compliance to cancer care. In the face of such prejudices, resistances and fantasies driven by these patients qualified as “crazy”, a close collaboration between the oncology department and the psycho-oncology team is essential in order to make easier and to optimise management’s adequacy. Besides the adjustment of antipsychotic treatment to the somatic context, the liaison work with the caregivers’ team made of explanations and advises remains a major step of the psychotic patient care. Some clinical case reports will illustrate this reflection, which will bring us to challenge the actual epidemiological hypothesis regarding the possible link between psychosis and cancer. Then, the indication of antipsychotic medications in oncology will be discussed. Finally, ethic issues such as informed consent and refusal of treatment in psychotic patients will be approached.

Keywords : psychosis, schizophrenia, antipsychotic medications, cancer, psycho-oncology

 

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