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Minerva Pediatrica 2013 December;65(6):651-67

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: Italian

Psycho-organic diseases in children and adolescents affected by pediatric neoplasms

Clerici C. A. ^{1, 2}, Giacon B. ³, Veneroni L. ¹, Ferrari A. ³, Luksch R. ³, Meazza C. ³, Polastri D. ³, Simonetti F. ³, Massimino M. ³ ✉

¹ Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti Università degli Studi di Milano, Milano, Italia; ² SSD Psicologia Clinica, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italia; ³ S.C. Pediatria, Fondazione IRCCS, Istituto Nazionale dei Tumori, Milano, Italia

At Pediatric Oncology Centers, psychological intervention and psychotherapy are generally offered to children and adolescents for supporting their adjustment to disease and treatment. The clinical practice, however, point out that cognitive and emotional symptoms, such as psychic distortions, fatigue, anxiety, irritability and depression, are sustained by biological mechanisms connected with disease and treatment and not respondent to psychological consultation and to other psychosocial resources. These manifestations could interfere with treatment or with the long-term adjustment and call for psychopharmacological treatments. Biological factors able to cause these alterations are not yet studied in depth in clinical tradition and scientific literature on the integration of psychological and psychopharmacological intervention in pediatric oncology is still poor. In this paper organic components of psychic and behavioral alterations in the course of disease are illustrated, considering the symptoms, causes and possible remedies in the light of the most recent interdisciplinary views. The main mechanism connected with oncologic treatments – chemotherapy, surgery, radiotherapy – and responsible for psycho-organic alterations in children and adolescent with cancer are also described.