Defense mechanisms and coping style at very next diagnostic period in advanced and metastatic cancer.

e21610 Background: In 2009, the International PsychoOncology Society endorsed distress as the sixth vital sign in cancer care, cancerrelated distress is common at pivotal periods the diagnostic, treatment, recovery, and recurrence phases. Therefore, in the Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders (DSMIV), being diagnosed with a lifethreatening illness such as cancer was included for the first time as a potential traumatic event that could induce posttraumatic stress disorder (PTSD). In illness case, most often, the patient adopt primitive defense mechanisms (regression, repression, defense denial, projection) to block disease emergence in personal destiny. The adoption of more efficient defense mechanisms (intellectualization, sublimation) takes time and psychological growing up. Methods: We analyzed patients newly diagnosed in advanced or metastatic stage of cancer admitted to our department in the last 6 months. The patients had to have indication for specific treatment,either chemotherapy or radiotherapy. It has made an initial assessment of defense mechanisms and adaptation to the disease through questionnaires and open interviews conducted by psychologist. Results: 116 of 128 patients (90.625%) are sometimes defensive and only 6.25% showed strong defensive trends.Defensive mechanisms have been identified as mainly: repression 64.06%, denial 60.93% and intellectualization 57.81%. With predilection, 32 patients (25%) used as coping style the acceptance, 39,06% used the planning and 35,93% used the active coping. Conclusions: Immediately after diagnosis and initiation of specific treatment, most patients with metastatic or advanced cancer are sometimes defensive (repression, denial and intellectualization) and used coping styles like acceptance, planning and active coping. Further research with regular reassessment of patients can bring important elements on dynamic of the adjustment process, allowing identification of external intervention methods to improve the quality of life.