| Abstract [eng] |
Objective: to present a clinical case of a 37-year-old patient with cervical cancer and depression, to review the association between cervical cancer and depression, the pathogenesis of depression in palliative patients, the diagnosis, pharmacological and non-pharmacological treatment in the scientific literature. Methods: a descriptive literature review was performed using key words in Pubmed, Medscape databases. Case report: A 37-year-old female patient was referred to a psychiatrist for anxiety and sadness. She was diagnosed with moderate depression and received treatment with antidepressants and art therapy, which was effective. Results: Undiagnosed and untreated depressive symptoms in cancer are associated with more pronounced physical symptoms, reduced quality of life, disease progression and increased mortality. Diagnosis of depression in palliative patients is complicated by the overlap between cancer and depressive symptoms and the difficulty in differentiating depressive symptoms from feelings of fear and uncertainty in a life-threatening illness. Psychoeducation and psychological interventions aimed at depression management and behavioral change, combined with antidepressants as needed, are recognized as the most effective treatment for patients with cancer and depression. Pharmacological treatments are selected according to the symptoms of depression and cancer-related symptoms and the possible side effects of the drug, with selective serotonin reuptake inhibitors being a priority. Psychological interventions are suggested according to the needs of the patient and the availability of psychotherapeutic services in the country, with cognitive behavioral therapy and mindfulness-based interventions showing the most evidence. Conclusions: High-quality clinical data on the choice of psychiatric medications and psychological interventions in palliative patients are lacking due to the characteristics of the cancer and depression populations and methodological differences between studies. Current treatments in Lithuania are in line with recommendations in the international literature but are not accessible to all patients. Further development of palliative medicine services in Lithuania is needed. |
