SMOGOOO SCIENCEBETTER MEDICINEESMOEST PRACTICE0PENSPECAL ARTICLEAnxiety and depression in adult cancer patients:ESMO Clinical PracticeGuidelineL Grassi,R.Caruso,M.B.Riba2,M.Loyd-Williams5,D.Kissane,G.Rodin,D.McFarland,R.Campos-R6denas1,R.Zachariae112 D.Santini&C.I.Ripamonti4,on behalf of the ESMO Guidelines CommitteeInstitute of Psychiatry,Department of Neuroscience and Rehabilitation,University of Ferrara,Ferrara,Italy,Department of Psychiatry,University of Michigan,AnnArbor;3University of Michigan Rogel Cancer Center,University of Michigan,Ann Arbor,USA;Academic Palliative and Supportive Care Studies Group (APSCSG),Primary Care and Mental Health,University of Liverpool,Liverpool;Department of Supportive and Palliative Care,Liverpool John Moores University,Liverpool,UK;Department of Psychiatry,Monash University and Monash Medical Centre,Monash Health,Clayton,Australia;'Department of Supportive Care,Princess MargaretCancer Centre,Toronto,Canada;Department of Psychiatry,University of Rochester,Rochester;Wilmont Cancer Institute,University of Rochester Medical CenterRochester USA;Department of Psychiatry,Hospital Clinico Universitario Lozano Blesa,University of Zaragoza,Zaragoza,Spain;Unit for Psychooncology and HealthPsychology,Department of Oncology,Aarhus University Hospital,Aarhus;"Department of Psychology and Behavioural Sciences,Aarhus University,Aarhus,DenmarkUOC Medical Oncology,AUSL Latina,Sapienza University of Rome,Aprilia;Oncology-Supportive Care in Cancer,Department of Oncology&HaematologyFondazione IRCCS,Istituto Nazionale dei Tumori di Milano,Milan,ItalyAvailable online 14 March 2023Key words:anxiety,depression,cancer,oncology,psychiatry,psycho-oncologyINTRODUCTIONAssociation Diagnostic and Statistical Manual of MentalAnxiety and depression are the most common psychologicalDisorders(DSM),fifth edition-Text Revision(DSM-5-TR).5symptoms in patients with cancer,irrespective of diseaseThis clinical practice guideline(CPG)provides an up-to-stage,primary cancer site and phase of treatment.Symp-date,evidence-based approach to assessing and managingtoms may range from nonpathological states,such as con-anxiety and depression as a spectrum of psychiatric disor-cems,worry,sense of uncertainty,sadness and increasedders in patients with cancer.In 2013,the DSM reclassifiedlevels of hopelessness,to specific psychiatric syndromespost-traumatic stress disorder (PTSD),which is a further(i.e.anxiety and depressive disorders).The latter are asso-significant problem in patients with cancer,from 'anxietyciated with significant distress and marked disability,poordisorders'to 'stress and stress-related spectrum disorders'.quality of life (QoL),increased physical symptoms (e.g.painTherefore,this CPG will discuss adjustment disorders withor nausea),poor adherence to treatment,increased risk ofanxious or depressed mood,but PTSD will not be covered.suicide (in people with depression),poorer prognosis andThe authors followed the levels of evidence and grades of
