History of psycho-oncology: Overcoming attitudinal and conceptual barriers
History of psycho-oncology: Overcoming attitudinal and conceptual barriers
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DOI：
10.1097/00006842-200203000-00004
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发表时间：
2002-03-01
影响因子：
3.3
通讯作者：
Holland, JC
中科院分区：
文献类型：
--
作者：
Holland, JC
心理肿瘤学的正式开始可以追溯到20世纪70年代中期，当时让人无法用语言形容的“癌症”这个词的污名被淡化到可以揭示诊断的程度，患者对自己疾病的感受可以第一次得到探索。然而，第二个耻辱导致人们对癌症心理层面的兴趣发展较晚：对精神疾病和心理问题的消极态度，甚至在医学疾病的背景下也是如此。理解这些历史基础很重要，因为它们继续影响着当代人们对癌症及其精神共病和心理社会问题的态度和信念。在上个世纪的最后25年里，心理肿瘤学成为肿瘤学的一个子专业，拥有自己的知识体系，对癌症治疗做出了贡献。在新的千年里，一个重要的文献基础、培训计划和广泛的研究议程已经演变成在癌症连续统一体的各个点上的应用：改变生活方式和习惯以降低癌症风险的行为研究；确保早期发现的行为和态度的研究；与遗传风险和检测相关的心理问题的研究；积极治疗期间的症状控制(焦虑、抑郁、精神错乱、疼痛和疲劳)；癌症幸存者的心理后遗症的管理；以及姑息和临终关怀的心理方面的管理。心理神经免疫学正在积极探索与癌症风险和生存相关的心理和生理领域之间的联系。这些领域的研究将占据新世纪第一季度的研究议程。在第三个千年之初，心理肿瘤学已经成熟，它是肿瘤学中最年轻的分支学科之一，是会诊联络精神病学中定义最明确的分支学科之一，也是广泛应用行为科学和社会科学的多学科价值的一个例子。
The formal beginnings of psycho-oncology date to the mid-1970s, when the stigma making the word "cancer" unspeakable was diminished to the point that the diagnosis could be revealed and the feelings of patients about their illness could be explored for the first time. However, a second stigma has contributed to the late development of interest in the psychological dimensions of cancer: negative attitudes attached to mental illness and psychological problems, even in the context of medical illness. It is important to understand these historical underpinnings because they continue to color contemporary attitudes and beliefs about cancer and its psychiatric comorbidity and psychosocial problems. Over the last quarter of the past century, psycho-oncology became a subspecialty of oncology with its own body of knowledge contributing to cancer care. In the new millennium, a significant base of literature, training programs, and a broad research agenda have evolved with applications at all points on the cancer continuum: behavioral research in changing lifestyle and habits to reduce cancer risk; study of behaviors and attitudes to ensure early detection; study of psychological issues related to genetic risk and testing; symptom control (anxiety, depression, delirium, pain, and fatigue) during active treatment; management of psychological sequelae in cancer survivors; and management of the psychological aspects of palliative and end-of-life care. Links between psychological and physiological domains of relevance to cancer risk and survival are being actively explored through psychoneuroimmunology. Research in these areas will occupy the research agenda for the first quarter of the new century. At the start of the third millennium, psycho-oncology has come of age as one of the youngest subspecialties of oncology, as one of the most clearly defined subspecialties of consultation-liaison psychiatry, and as an example of the value of a broad multidisciplinary application of the behavioral and social sciences.