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July 24, 1981

Management of Depression in the Patient With Advanced Cancer

JAMA. 1981;246(4):373-376. doi:10.1001/jama.1981.03320040045032

AS MEDICAL therapies continue to lengthen survival time of patients with illnesses, quality of survival and the emotional consequences of illness and its treatment become more prominent. While many physicians generally assume that the distress associated with cancer is accounted for by the physical morbidity, it is now appreciated that at least half of the distress associated with cancer is due to issues involving emotional and social adjustment. Depression in some form is an issue that must be faced by many patients and clinicians dealing with advanced cancer and is the most frequent reason for psychiatric referral in this population. However, the development of a systematic approach to the evaluation of depression in cancer patients has been hampered by the scientifically unsupported general view that depression is a natural part of the disease and that all cancer patients are depressed. The question "Wouldn't you be depressed if you had cancer?"