Evaluation of the Self-Aggresive Behavior Risk Factors in Oncologic Patients

摘要

The oncologic patient suffers from the negative influence of psychological, social and organic variables that decrease quality of life, social relationships, self-image and even the personal axiological system. Patients diagnosed with cancer could perceive suicide as an escape from pain, invalidity, disturbed relationships, lack of perspective or could consider self-induced death as an extreme measure in order to regain control of their minds. We assessed a group of oncologic patients in various stages of their illness for delineating a management strategy tailored for specific suicide risk factors in this vulnerable population. The most significant risk factors associated with suicidal ideation, intentions or plans to self-induce death, are the perceived severity of illness, high scores of depression and anxiety, several items of depression rating scales, in particular hopelessness and anhedonia, severe pain, prior suicide attempts or suicidal ideation and the site of cancer (lung, colonic and pharyngeal). Patients presenting self-aggressive risk in the oncologic population have a high degree of perceived dependence, therefore the lack of control over their own life could also be a significant risk factor. The management of these vulnerabilities to suicide needs to be envisaged in oncologic patients and a therapeutic team consisting in a psychiatrist and a clinical psychologist should be included in the routine evaluations of a patient presenting risks factors for self-aggression. The active detection and monitoring of the risk factors is considered a first stage of the management, followed by the individual vulnerabilities/protective factors analysis and inclusion of the patient in a psychotherapeutic and/or pharmacologic approach.