CME Article

Distress, Demoralization, and Depression in Cancer Survivorship

Lorenzo Norris, MD; Mandi Pratt-Chapman, MA; Julie A. Noblick, MPH; Rebecca Cowens-Alvarado, MPH

  • Psychiatric Annals
  • September 2011 - Volume 41 · Issue 9: 433-438
  • DOI: 10.3928/00485713-20110829-04
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Abstract

In the field of cancer survivorship, clinicians and patients have struggled with the meaning of the term “distress.”1–3 This difficulty, in part, arises from the multifactorial nature of the “distress” concept.1,4,5

Distress can overlap with many other psychological states, including grief, loss, demoralization, sadness, and clinical depression. Although these states share common features, they are not synonymous.6,7 The term “distress”4,8 is thought to carry fewer stigmas than the words “depression,” “sadness,” or “anxiety.” In recent years, multiple organizations9–11 have called for clinicians to screen for distress in all phases of the cancer care continuum, on the theory that a positive distress screen will be a “red flag” for other pertinent issues (Figure 1, see page 434).

AUTHORS

Lorenzo Norris, MD, is Director, Psychiatric Consultation-Liaison Service; and Assistant Professor of Psychiatry, The George Washington University, Department of Psychiatry and Behavioral Sciences, Washington, DC. Mandi Pratt-Chapman, MA, is Associate Director, George Washington Cancer Institute Community Programs; and Co-Director, National Cancer Survivorship Resource Center, George Washington Cancer Institute, Washington, DC. Julie A. Noblick, MPH, is Senior Program Associate, Psychosomatic Clinics, The George Washington University, Department of Psychiatry and Behavioral Sciences. Rebecca Cowens-Alvarado, MPH, is Director, Cancer Control Mission Strategy; and Co-Director, National Cancer Survivorship Resource Center.

Dr. Norris, Ms. Pratt-Chapman, Ms. Noblick, and Ms. Cowens-Alvarado have disclosed no relevant financial relationships.

Address correspondence to: Lorenzo Norris, MD, The George Washington University Department of Psychiatry and Behavioral Sciences, 2150 Pennsylvania Ave., NW, 8th Floor, Washington, DC 20037; fax: 202-741-2891; email: .lnorris@mfa.gwu.edu

doi: 10.3928/00485713-20110829-04

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