Pancreatic Cancer Associated With Psychotic Depression – A Case Report

Abstract

Pancreatic cancer is an aggressive form of cancer with increasing incidence and a 5-year survival rate of 4% for all stages. Depression and anxiety have a higher prevalence than the general population in all cancer types. Also, rates of depression in patients with pancreatic cancer are higher than in patients with other types of gastrointestinal neoplasms. Depression in pancreatic cancer has also been shown to impair quality of life, so early and adequate antidepressant treatment is an essential component of comprehensive supportive care.

We would like to report the case of a 67-year-old female patient, with no previous psychiatric history, brought to the psychiatry emergency unit by her husband for psycho-motor agitation, persecutory delusions, delusional jealousy and bizarre behavior. According to her husband, the symptoms started insidiously over the last few weeks and that she attempted suicide by drug overdose three days before admission to our clinic, which she denies. Three years prior to her hospitalization the patient received surgical, radiotherapy and chemotherapy treatment for a base of tongue tumor and 6 months prior to her psychiatric admission, the was diagnosed with cephalic pancreatic neoplasm for which she received seven cycles of chemotherapy. Treatment with mirtazapine, risperidone, and lorazepam was initiated. The evolution was favorable and the patient was discharged one week later.

Early recognition and treatment of mood disorders associated with cancer are important because, left untreated, they may lead to difficulty in managing symptoms, increased demand for health services and low adherence to treatment.

Disclosure of interest

The authors have not supplied their declaration of competing interest.