Psychiatric Issues in Pediatric Oncology: Diagnosis and Management

Psychiatric issues in pediatric oncology describe the role of the consultation-liaison child psychiatrist in psycho-oncology. The chapter begins with general considerations for psychiatric diagnosis, treatment planning, and psychopharmacology in medically complex children and adolescents with cancer. The authors discuss specific psychiatric disorders and symptoms including depression, suicidal ideation, anxiety, posttraumatic symptoms, delirium and drug withdrawal syndromes, neurocognitive impairment, and other cancer treatment-related psychiatric symptoms. The evidence base for psychopharmacology in this population, efficacy and safety data, and cancer-specific prescribing concerns are reviewed in detail including commonly seen side effects, oncology-specific uses of certain drugs, and recommended monitoring practices in medically ill patients. Clinical cases demonstrate common presentations and treatment issues. The chapter highlights the critical importance of the recognition, diagnosis, and management of psychiatric comorbidities for patient safety, relief of suffering, and optimal quality of life through cancer treatment and describes the specialized role of the child psychiatrist consultant as an expert who collaborates in the multimodal, integrated care of the child and family.