Illness and death of leukemic patients
Santo-Domingo Carrasco, J.
Sangre 26(5-C): 1046-1053
1981
ISSN/ISBN: 0036-4355 PMID: 7323925 Document Number: 172149
Consideration of aspects in the treatment of leukemic disease is important because of both the frequency with which these patients show psychopathologic alterations and the interest they may achieve when establishing the therapeutic approach. The psychiatric alterations found in leukemic patients are frequently the consequence of an organic brain lesion appearing as a disease complication or treatment side effect. Leukemia by itself is an alteration-inducing situation which, if prolonged, may induce anomalous personality development in children. In both children and adults, the remisssions and relapses which appear during the disease course bring about progressive anxiety, which may, in turn, be enhanced by some therapeutic measures including isolation. Defensive and adjusting mechanisms regarding death may arise in children, their therapeutic management being necessary in every phase of the disease. The information offered must be adequate, and this should be extended to the patient's family; the attention paid to family might effectively improve the disease course. The emotional status of the patient's parents and consorts or relatives need attention, by individual or group techniques. Hospital family notions and actual family dynamics are important for understanding the defense and adjustment mechanism in both children or adults. The adjustment to disease, its relapses and the worries about death comprise a process in which the treatment team plays a different role in each stage, these being the pre death, the social death, the psychic death, and the biological death. Anxiety and depressive troubles may present among the treating team when facing such situations. Whenever the adjustment mechanisms of patients, relatives, and working team are recognized or elusively distorted, global therapeutic efficacy will decrease as the complications increase.