NEUROPSYCHIATRIC SYNDROMES AND PSYCHOLOGICAL SYMPTOMS IN PATIENTS WITH ADVANCED CANCER

This article represents the contributions of the panel on ''Neuropsych iatric Syndromes and Psychological Symptoms'' of the National Cancer I nstitute of Canada Workshop on Symptom Control and Supportive Care in Patients with Advanced Cancer. The panel's presentations focused on mo od disorders and cognitive disorders, and described the current state of knowledge regarding prevalence, assessment, and intervention. Recom mendations for future research are presented based on a consensus of t he panel as to the need to fill glaring gaps in our current stab of kn owledge, and a desire to improve the quality of research in this area of palliative medicine. Recommendations for future research on neurops ychiatric symptoms and syndromes in palliative care include (1) adopti on of uniform terminology (taxonomy of disorders) and diagnostic class ification systems, (2) utilization of existing validated tools and mea sures in prevalence and intervention research, (3) development of new tools and measures that are more applicable and relevant to the pallia tive care setting, (4) encouragement for studies of the prevalence of neuropsychiatric symptoms and syndromes, (5) promotion of intervention studies utilizing pharmacologic and nonpharmacologic treatments for d epressive disorders and cognitive disorders in advanced cancer patient s, and (6) expansion of the focus of such research to other neuropsych iatric disorders (for example, anxiety disorders, posttraumatic stress disorders, and sleep disorders), symptoms (fatigue and tension) and r elated issues (suicidal ideation and desire for hastened death).