grup treatement strategies-mayo clinic

grup treatement strategies-mayo clinic - 1538 Structured...

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Mayo Clin Proc . 2003;78:1538-1543 1538 © 2003 Mayo Foundation for Medical Education and Research Review Group and Individual Treatment Strategies for Distress in Cancer Patients M ATTHEW M. C LARK , P H D; J. M ICHAEL B OSTWICK , MD; AND T ERESA A. R UMMANS , MD From the Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minn. This work was supported in part by a research grant from the Linse Bock Foundation and the Mayo Clinic Cancer Center. Individual reprints of this article are not available. Address corre- spondence to Matthew M. Clark, PhD, Department of Psychiatry and Psychology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (e- mail: [email protected]). D istress has been identified as “an unpleasant experi- ence of an emotional, psychological, social, or spiri- tual nature that interferes with the ability to cope with cancer treatment.” 1 Although an estimated 35% of cancer patients will experience distress, 2 less than one third of these distressed cancer patients will be referred for mental health treatment. 1 Several studies have specifically analyzed the prevalence of both clinical and subclinical distress in cancer patients. Of 160 women with stage I or II breast cancer who participated in a structured diagnostic clinical interview, 5% had symptoms of posttraumatic stress disor- der, and 11% reported major depressive symptoms. 3 Simi- larly, Whelan et al 4 found a high rate of psychosocial symp- toms in 134 patients newly diagnosed with breast, colorectal, head and neck, lung, prostate, or nonmelanoma skin cancer. Of these patients, 66% reported fatigue; 61%, pessimism or anxiety; 48%, insomnia; 42%, inadequately controlled pain; and 33%, significant distress. To cope with these difficulties, patients believed that help with informational needs (85%), social concerns (66%), and activities of daily living (41%) would be beneficial. In a study of 1109 patients with cancer at various stages and sites, 21.5% had mild depression, 12.5% had moderate depression, and 2% experienced severe depression. 5 Clearly, the prevalence of anxiety, depression, and distress is high in cancer populations. Many cancer patients experience distress during the course of their illness. Recently, the National Comprehen- sive Cancer Network recommended that all cancer pa- tients receive evaluation and treatment of distress as a routine part of their care. For some patients, psychosocial interventions may be helpful, but which patients benefit from what type of psychosocial interventions is unclear. To highlight the importance of this problem, this article ex- amines the prevalence of distress in cancer patients and reviews the evidence that supports that cancer patients benefit from group and individual treatment strategies. Several randomized studies have examined the effects of group or individual therapy on both the emotional and the physiological well-being of cancer patients. Both indi- vidual and group interventions that are structured have proved effective in reducing distress. Clearly, more inves- tigation is warranted and future research is needed to
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This note was uploaded on 03/06/2011 for the course PSYCH 212 taught by Professor Dansullivan during the Spring '11 term at NYU.

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grup treatement strategies-mayo clinic - 1538 Structured...

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