Paranoia and Dysmorphophobia

The association between depres sion and cancer is indeed strong and the suggestion of a possible immunologic link between the two entities is certainly appealing.The authors propose that anti bodies against tumor-related proteins, because of cross-reactivity with CNS proteins that are conceivably identical to serotonin receptors, may interfere with the brain activity of serotonin and thus lead to depressive symptoms.Although this is a reasonable hypothesis, there are conceivably other, more direct ways in which immune factors can provide the necessary link between depres sion and cancer.Preliminary data from our own laboratory (Kronfol et a!, 1982) as well as others (Linn et a!, 1982) suggest that depression may be associated with an impairment in cell-mediated immunity, elements of which are said to protect the organism against cancer (Penn, 1981).Since depressive symp toms usually antedate clinical manifestations of cancer, we therefore propose that depression may impair host defense mechanisms, thus allowing neo plastic cells to proliferate and spread out of control in certain predisposed individuals.The etiology of cancer is complex and still eludes our complete understand ing.Genetic predisposition , environmental factors, pharmacologic agents, hormones, diet and life style have all been suggested as possible contributing factors.When severe depression precedes cancer, the depressive illness may present an additional risk.