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Psychiatric, behavioral, and cognitive disorders in patients with extracranial cancers

Published online by Cambridge University Press:  23 July 2018

Gabriella Pravettoni ,
Bernardo Dell’Osso ,
Tommaso Bocci ,
Francesca Cortese ,
Roberta Ferrucci ,
Valentina Lampis ,
Chiara Rosci  and
Alberto Priori
Gabriella Pravettoni
Affiliation:
Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy Psycho-Oncology Division, European Institute of Oncology, Milan, Italy
Bernardo Dell’Osso
Affiliation:
Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy Department of Mental Health, Fondazione IRCCS Ca’ Granda Policlinico, Milan, Italy Department of Psychiatry and Behavioral Sciences, Bipolar Disorders Clinic, Stanford University, Stanford, California, USA “Aldo Ravelli” Research Center for Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
Tommaso Bocci
Affiliation:
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy Unit of Clinical Neurophysiology, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
Francesca Cortese
Affiliation:
Unit of Clinical Neurophysiology, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy
Roberta Ferrucci
Affiliation:
Unit of Clinical Neurophysiology, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy “Aldo Ravelli” Research Center for Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy
Valentina Lampis
Affiliation:
Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
Chiara Rosci
Affiliation:
Neurology Section, ASST Santi Paolo e Carlo, Milan, Italy
Alberto Priori*
Affiliation:
“Aldo Ravelli” Research Center for Experimental Brain Therapeutics, Department of Health Sciences, University of Milan, Milan, Italy Neurology Section, ASST Santi Paolo e Carlo, Milan, Italy
*
*Address for correspondence: Prof. Alberto Priori, Clinica Neurologica, Università degli Studi di Milano, Polo Universitario San Paolo, Via A. Di Rudinì 8, 20122 Milano, Italy. (Email: alberto.priori@unimi.it)
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Abstract

Patients with cancer may report neuropsychiatric abnormalities including cognitive impairment, behavioral disturbances, and psychiatric disorders that potentially worsen their quality of life, reduce their treatment response, and aggravate their overall prognosis. Neuropsychiatric disturbances have a different pathophysiology, including immuno-inflammatory and neuroendocrine mechanisms, as a consequence of oncologic treatments (chemo- and radio-therapy). Among clinicians involved in the management of such patients, psychiatrists need to pay particular attention in recognizing behavioral disturbances that arise in oncologic patients, and determining those that may be effectively treated with psychotropic medications, psychotherapeutic interventions, and an integration of them. Through the contribution of different clinicians actively involved in the management of oncological patients, the present review is ultimately aimed at updating psychiatrists in relation to the pathophysiological mechanisms responsible for the onset of cognitive, affective, and behavioral syndromes in these patients, along with epidemiologic and clinical considerations and therapeutic perspectives.

Keywords

Cognitive impairmentextracranial cancerneuropathologypsychiatric symptomstreatment
Type
Review
Information
CNS Spectrums , Volume 23 , Special Issue 6: Theme: Neuropsychiatry , December 2018 , pp. 388 - 401
Copyright
© Cambridge University Press 2018 

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