The World Health Organization (WHO) reports forecast an increase of cancer incidence of 40% in high-income countries and more than 80% in low-income countries by 2030, and a rise of both mortality and long survivorship. Consequently, the agenda of psychiatry in oncology and palliative medicine needs to be reviewed and updated.

The mental health implications of oncologic diseases have been in fact repeatedly stressed in the last 40 years as needing attention in clinical practice, as part of person-centered interdisciplinary care. At least 30% of patients with cancer are reported to receive a psychiatric diagnosis (e.g., major depression, depressive spectrum, stress-related and anxiety disorders), while a higher percentage show other clinically relevant psychosocial conditions (e.g., demoralization, health anxiety, irritable mood)¹.

Mental health problems amongst patients and their families are associated with reduction of quality of life, impairment in social relationships, longer rehabilitation time, poorer adherence to treatment, abnormal illness behaviour, and possibly shorter survival². In advanced cancer patients, these problems are even more evident, with a series of significant psychiatric and psychosocial conditions that should be a target of end-of-life care.

For these reasons, it has been stated that “it is not possible to deliver good-quality cancer care without addressing patient’s psychosocial health needs”³. Today, it is part of the oncology agenda worldwide that psychosocial cancer care should be recognized as a universal human right; that the psychosocial domain should be integrated into routine cancer care; and that distress should be measured as the 6th vital sign after temperature, blood pressure, pulse, respiratory rate and pain in patients with cancer⁴.

The significant advances of research in the area of psycho-oncology have favored the development, implementation and dissemination of evidence-based treatments, both in terms of psychotherapy (e.g., supportive-expressive psychotherapy, cognitive-behavioural and cognitive-existential therapy, meaning centered psychotherapy) and integrated pharmacotherapy for psychiatric disorders and cancer-related symptoms (e.g., pain, hot flashes). However, inequalities exist in the development of psychosocial oncology worldwide. Significant economic constraints within health systems may undermine both the monitoring of distress and the process of referral to mental health services and psychiatric treatment⁵.

A new challenge is represented by the debate on euthanasia and physician-assist­ed death, in which psychiatry and psycho-oncology have a specific role. Also, the im­plications of cancer screening and treatment among people with severe mental illness are an extremely important part of the psycho-oncology and palliative care agenda.

The WPA Section on Psycho-Oncology and Palliative Care was founded in the late 1980s with the specific aim of fostering psychiatry and behavioural sciences within all fields of oncology and palliative care. The main goal is to provide optimal psychosocial care to patients at all stages of disease and survivorship, as well as support to families.

The Section is committed to collect and disseminate scientific information on the most common psychopathological and psychosocial problems of patients with cancer and their families; and to establish working relations with other organizations in the field of psycho-oncology and palliative care at the international level.

Collaboration with other WPA Sections, especially that on Psychiatry, Medicine and Primary Care, has been established over time, with presentations at WPA meetings worldwide and production of books^6-8, scientific papers and book chapters. A num­ber of other WPA Sections have the potential to be involved in this collaboration.

Today, psycho-oncology and psychiatry in palliative care are recognized as disciplines in themselves, within the wider field of consultation-liaison psychiatry. Many medical student and psychiatry residency programs as well as fellowships in consultation-liaison psychiatry include clinical rotations in psycho-oncology and palliative care. Screening for distress is now an accepted part of protocols in cancer centers and there is a growth of research aimed to better understand how to screen and provide psychiatric care using evidence-based guidelines and protocols⁹.

Our Section has had a leading role in ad­dressing the multiple issues related to patients with co-occurring oncologic and psychiatric conditions. It will continue to work in order to improve the quality of training as well as of clinical care and research in this interdisciplinary area worldwide. Scholarly activities will continue to include opportunities for scientific presentations and training at WPA meetings, as well as collaborative research and clinical projects.

世界卫生组织 (WHO) 报告预测，到 2030 年，高收入国家的癌症发病率将增加 40%，低收入国家的癌症发病率将增加 80% 以上，死亡率和长期生存率也会上升。因此，需要审查和更新肿瘤学和姑息医学中的精神病学议程。

事实上，在过去 40 年里，作为以人为本的跨学科护理的一部分，肿瘤疾病对心理健康的影响已经被反复强调，需要在临床实践中予以关注。据报道，至少 30% 的癌症患者接受了精神科诊断（例如，重度抑郁症、抑郁症谱系、压力相关障碍和焦虑症），而更高比例的癌症患者则表现出其他临床相关的心理社会状况（例如，士气低落、健康焦虑、心情烦躁） ¹ ．

患者及其家人的心理健康问题与生活质量下降、社会关系受损、康复时间较长、治疗依从性较差、疾病行为异常以及可能较短的生存期有关² 。在晚期癌症患者中，这些问题更加明显，存在一系列严重的精神和心理社会状况，应该成为临终关怀的目标。

由于这些原因，有人指出“如果不满足患者的社会心理健康需求，就不可能提供高质量的癌症护理” ³ 。如今，社会心理癌症护理应被视为一项普遍人权，已成为全球肿瘤学议程的一部分；社会心理领域应纳入常规癌症护理；对于癌症患者来说，痛苦应作为继体温、血压、脉搏、呼吸频率和疼痛之后的第六大生命体征进行测量⁴ 。

心理肿瘤学领域研究的重大进展有利于循证治疗的开发、实施和传播，无论是在心理治疗方面（例如支持表达心理治疗、认知行为和认知存在治疗、以意义为中心的治疗）心理治疗）以及针对精神疾病和癌症相关症状（例如疼痛、潮热）的综合药物治疗。然而，世界范围内社会心理肿瘤学的发展存在不平等。卫生系统内的重大经济限制可能会破坏对痛苦的监测以及转诊至精神卫生服务和精神科治疗的过程⁵ 。

关于安乐死和医生协助死亡的争论代表了一个新的挑战，其中精神病学和心理肿瘤学发挥着特殊作用。此外，癌症筛查和治疗对严重精神疾病患者的影响是心理肿瘤学和姑息治疗议程中极其重要的一部分。

WPA 心理肿瘤学和姑息治疗科成立于 20 世纪 80 年代末，其具体目标是在肿瘤学和姑息治疗的所有领域内促进精神病学和行为科学的发展。主要目标是为处于疾病和生存各个阶段的患者提供最佳的社会心理护理，并为家庭提供支持。

该科致力于收集和传播有关癌症患者及其家人最常见的精神病理和社会心理问题的科学信息；并与国际上心理肿瘤学和姑息治疗领域的其他组织建立工作关系。

随着时间的推移，与 WPA 其他部门的合作，特别是在精神病学、医学和初级保健方面的合作，已经建立起来，在世界各地的 WPA 会议上进行了演讲，并出版了书籍^6-8 、科学论文和书籍章节。 WPA 的许多其他部门也有可能参与这种合作。

如今，在咨询联络精神病学的更广泛领域内，姑息治疗中的心理肿瘤学和精神病学本身被认为是学科。许多医学生和精神病学住院医师计划以及咨询联络精神病学研究金包括心理肿瘤学和姑息治疗的临床轮转。痛苦筛查现已成为癌症中心方案中公认的一部分，并且越来越多的研究旨在更好地了解如何使用基于证据的指南和方案进行筛查和提供精神护理⁹ 。

我们的部门在解决与同时发生的肿瘤和精神疾病患者相关的多个问题方面发挥了主导作用。它将继续努力提高全球这一跨学科领域的培训以及临床护理和研究的质量。学术活动将继续包括在 WPA 会议上进行科学演讲和培训的机会，以及合作研究和临床项目。