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Portigliatti Pomeri A, La Salvia A, Carletto S, Oliva F, Ostacoli L. EMDR in Cancer Patients: A Systematic Review. Front Psychol 2021; 11:590204. [PMID: 33536968 PMCID: PMC7847844 DOI: 10.3389/fpsyg.2020.590204] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 12/16/2020] [Indexed: 11/24/2022] Open
Abstract
Background: Psychological distress is common among patients with cancer, with severe consequences on their quality of life. Anxiety and depression are the most common clinical presentation of psychological distress in cancer patients, but in some cases cancer may represent a traumatic event resulting in posttraumatic stress disorder (PTSD). Currently, Eye Movement Desensitization and Reprocessing (EMDR) therapy is considered an evidence-based treatment for PTSD, but recent studies also showed its effectiveness for anxiety and depression. The aim of the present systematic review is to summarize the current literature on the effect of EMDR on cancer-related psychological distress. Methods: A literature search was conducted for peer-reviewed articles about "EMDR" and "cancer patients" in the following electronic databases: PubMed, MEDLINE, Science Direct, Google Scholar, and Cochrane library. Results: Our search identified 7 studies in which EMDR was used with a total of 140 cancer patients. The psychiatric diagnosis was PTSD in 3 studies. Otherwise, the diagnosis concerned the anxious and depressive disorder spectrum. Overall, EMDR treatment schedules used were highly heterogeneous, with a different number of sessions (from 2 to 12) and a different duration of therapy (up to 4 months). However, across all studies analyzed EMDR therapy was judged to be adequate in reducing symptoms of psychological distress in this population. Conclusions: According to the results of our analysis, the level of evidence regarding EMDR efficacy in cancer patients is limited by the scarcity of studies and their low methodological quality. Although better quality research is needed, available data suggest that EMDR could be a promising treatment for psychological distress in patients with cancer.
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Affiliation(s)
| | - Anna La Salvia
- Department of Oncology, 12 de Octubre University Hospital, Madrid, Spain
| | - Sara Carletto
- Department of Neuroscience “Rita Levi Montalcini”, University of Torino, Torino, Italy
- Clinical Psychology Unit, University Hospital City of Science and Health, Torino, Italy
| | - Francesco Oliva
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, Italy
| | - Luca Ostacoli
- Clinical Psychology Unit, University Hospital City of Science and Health, Torino, Italy
- Department of Clinical and Biological Sciences, University of Torino, Orbassano, Italy
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Stigma associated with parental depression or cancer: Impact on spouse and offspring's cortisol levels and socioemotional functioning. Dev Psychopathol 2021; 32:1822-1837. [DOI: 10.1017/s0954579420001431] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
AbstractStress associated with caring for a mentally ill spouse can adversely affect the health status of caregivers and their children. Adding to the stress of caregiving is the stigma often placed against spouses and children of people with mental illness. Contrary to mental illness, many physical disorders such as cancer may be less stigmatized (expect pulmonary cancer). In this study, we measured externalized and internalized stigma, as well as psychological (depressive symptoms and stressful life events) and physiological (basal salivary cortisol levels) markers of stress in 115 spouses and 154 children of parents suffering from major depressive disorder, cancer, or no illness (control group). The results show that spouses and children from families with parental depression present significantly more externalized stigma than spouses and children from families with parental cancer or no illness, although we find no group differences on internalized stigma. The analysis did not show a significant group difference either for spouses or their children on depressive symptomatology, although spouses from the parental depression group reported greater work/family stress. Finally, we found that although for both spouses children the awakening cortisol response was greater on weekdays than on weekend days, salivary cortisol levels did not differ between groups. Bayes factor calculated on the null result for cortisol levels was greater than 100, providing strong evidence for the null hypothesis H0. Altogether, these results suggest an impact of stigma toward mental health disorder on psychological markers of stress but no impact of stigma on physiological markers of stress. We suggest that these results may be due to the characteristics of the families who participated in the present study.
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53
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Li ZHJ, Wang M, Ingledew PA. Depression in cancer: quality assessment of online patient education resources. Psychooncology 2021; 30:400-407. [PMID: 33179340 DOI: 10.1002/pon.5591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Revised: 10/26/2020] [Accepted: 11/06/2020] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Psychiatric comorbidities are common among cancer patients. However, little is known about the quality of online information regarding these conditions. This study uses a validated tool to systematically determine the strengths and limitations of websites addressing depression in cancer patients. METHODS The term "depression in cancer patients" was searched online using the search engines Google, Yippy, and Dogpile. A set of predetermined inclusion/exclusion criteria was applied to all search results, which yielded 48 websites for inclusion. A validated rating tool was used to score the websites based on the six domains of Affiliation, Accountability, Interactivity, Structure & Organization, Readability, and Content Quality. The results were analyzed using descriptive statistics. RESULTS Of the 48 websites evaluated, 50% were commercial. 63% of websites identified authorship, 54% cited reliable sources, 37% provided links, and 38% were updated within the last 2 years. 94% of websites featured a search engine and 60% had at least four structural tools. Average readability was at a grade 12.3 level using the Flesch-Kincaid scale and 11.3 using the Simple Measure of Gobbledygook Index. The most completely and accurately covered topics of depression were symptoms and treatment-83% and 73% respectively. Its prevention and prognosis were not covered by any of the websites. CONCLUSIONS A validated rating tool was applied to evaluate the quality of online information for depression in cancer patients. Website accountability was poor, readability was often at a level that is too difficult for the lay audience, and the topics of prevention and prognosis were seldom covered.
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Affiliation(s)
- Zhang Hao Jim Li
- University of British Columbia, Vancouver, British Columbia, Canada
| | - Mingyang Wang
- Discipline of Psychiatry, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Paris-Ann Ingledew
- Department of Surgery, Division of Radiation Oncology, University of British Columbia, Vancouver, British Columbia, Canada.,BC Cancer Agency Vancouver Centre, Vancouver, British Columbia, Canada
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Daria S, Proma MA, Shahriar M, Islam SMA, Bhuiyan MA, Islam MR. Serum interferon-gamma level is associated with drug-naïve major depressive disorder. SAGE Open Med 2020; 8:2050312120974169. [PMID: 33282305 PMCID: PMC7682211 DOI: 10.1177/2050312120974169] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 10/26/2020] [Indexed: 01/30/2023] Open
Abstract
Objectives: Major depressive disorder is a leading heterogeneous psychiatric illness manifested by persistent low mood, a feeling of sadness, and diminished interest in daily activities. Many biological, genetic, and social factors are thought to be linked with depression. But any suitable early risk assessment markers are absent for this illness. Therefore, we aimed to investigate the serum levels of IFN-γ in major depressive disorder patients to further investigate the association between serum levels of this cytokine and major depression. Methods: This prospective case-control study enrolled 120 major depressive disorder patients and 100 healthy controls matched by age, sex, and body mass index. A qualified psychiatrist diagnosed the major depressive disorder patients and evaluated healthy controls according to the Diagnostic and Statistical Manual of Mental Health Disorders (5th ed.; DSM-5). The Hamilton depression rating scale was applied for all the study participants to measure the severity of depression. Serum IFN-γ levels were measured by a commercially available enzyme-linked immunosorbent assay kit (Boster Biological Technology, Pleasanton, CA, USA). Results: This study observed that serum IFN-γ levels were significantly decreased in major depressive disorder patients compared to healthy controls. A significant negative correlation (r = −0.375; p < 0.001) was obtained between serum IFN-γ levels and Hamilton depression scores. Receiver operating characteristic analysis showed good diagnostic performance of lowered serum IFN-γ levels in depression with an area under the curve at 0.790. Conclusion: We suggest the altered serum IFN-γ levels are associated with the pathophysiology of depression. The reduced levels of serum IFN-γ might be used as an early risk assessment tool for major depression.
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Affiliation(s)
- Sohel Daria
- Department of Pharmacy, University of Asia Pacific, Dhaka, Bangladesh
| | | | - Mohammad Shahriar
- Department of Pharmacy, University of Asia Pacific, Dhaka, Bangladesh
| | | | | | - Md Rabiul Islam
- Department of Pharmacy, University of Asia Pacific, Dhaka, Bangladesh
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55
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Harris J, Purssell E, Cornelius V, Ream E, Jones A, Armes J. Development and internal validation of a predictive risk model for anxiety after completion of treatment for early stage breast cancer. J Patient Rep Outcomes 2020; 4:103. [PMID: 33275165 PMCID: PMC7718350 DOI: 10.1186/s41687-020-00267-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Accepted: 11/08/2020] [Indexed: 12/23/2022] Open
Abstract
Objective To develop a predictive risk model (PRM) for patient-reported anxiety after treatment completion for early stage breast cancer suitable for use in practice and underpinned by advances in data science and risk prediction. Methods Secondary analysis of a prospective survey of > 800 women at the end of treatment and again 6 months later using patient reported outcome (PRO) the hospital anxiety and depression scale-anxiety (HADS-A) and > 20 candidate predictors. Multiple imputation using chained equations (for missing data) and least absolute shrinkage and selection operator (LASSO) were used to select predictors. Final multivariable linear model performance was assessed (R2) and bootstrapped for internal validation. Results Five predictors of anxiety selected by LASSO were HADS-A (Beta 0.73; 95% CI 0.681, 0.785); HAD-depression (Beta 0.095; 95% CI 0.020, 0.182) and having caring responsibilities (Beta 0.488; 95% CI 0.084, 0.866) increased risk, whereas being older (Beta − 0.010; 95% CI -0.028, 0.004) and owning a home (Beta 0.432; 95% CI -0.954, 0.078) reduced the risk. The final model explained 60% of variance and bias was low (− 0.006 to 0.002). Conclusions Different modelling approaches are needed to predict rather than explain patient reported outcomes. We developed a parsimonious and pragmatic PRM. External validation is required prior to translation to digital tool and evaluation of clinical implementation. The routine use of PROs and data driven PRM in practice provides a new opportunity to target supportive care and specialist interventions for cancer patients. Supplementary Information The online version contains supplementary material available at 10.1186/s41687-020-00267-w.
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Affiliation(s)
- Jenny Harris
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Kate Granger Building, Priestley Road, Guildford, Surrey, GU2 7YH, UK.
| | - Edward Purssell
- School of Health Sciences, City, University of London, London, UK
| | - Victoria Cornelius
- Imperial Clinical Trials Unit (ICTU), School of Public Health, Faculty of Medicine, Imperial College London, London, UK
| | - Emma Ream
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Kate Granger Building, Priestley Road, Guildford, Surrey, GU2 7YH, UK
| | - Anne Jones
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Jo Armes
- School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Kate Granger Building, Priestley Road, Guildford, Surrey, GU2 7YH, UK
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56
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Bosman JT, Bood ZM, Scherer-Rath M, Dörr H, Christophe N, Sprangers MAG, van Laarhoven HWM. The effects of art therapy on anxiety, depression, and quality of life in adults with cancer: a systematic literature review. Support Care Cancer 2020; 29:2289-2298. [PMID: 33188476 PMCID: PMC7981299 DOI: 10.1007/s00520-020-05869-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 10/29/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE While there is increasing evidence for the effectiveness of psychosocial support programs for cancer patients, little attention has been paid to creativity or art as a way of addressing their psychological problems and improving quality of life. This review provides an overview of interventional studies that investigate the effects of art therapy interventions on anxiety, depression, and quality of life in adults with cancer. METHODS We conducted a literature review with a systematic search. The databases PubMed/MEDLINE, PsycINFO, and EMBASE were searched for articles on art therapy among adult (18 years and above) cancer patients, published between September 2009 up to September 2019. Search terms were established for each database specifically. A total of 731 publications was assessed for relevance by title and abstract. The remaining 496 articles were examined using three inclusion criteria: interventions were guided by an artist or art therapist, participants were actively involved in the creative process, and anxiety, depression, and/or quality of life were included as outcome measures. Methodological quality of the included studies was appraised using specific checklists. RESULTS Seven papers met the inclusion criteria. Data was extracted from three non-randomized intervention studies and four randomized controlled trials. All studies used a quantitative design with validated outcome measures. Four articles described positive effects of art therapy on anxiety, depression, or quality of life in adults with cancer. CONCLUSION Art therapy could possibly help decrease symptoms of anxiety and depression, and improve quality of life in adult cancer patients. However, because of the heterogeneity of the interventions and limited methodological quality of the studies, further research using stringent methods is needed.
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Affiliation(s)
- J T Bosman
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9; D3-312, 1105 AZ, Amsterdam, The Netherlands
| | - Z M Bood
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9; D3-312, 1105 AZ, Amsterdam, The Netherlands.
| | - M Scherer-Rath
- Faculty of Philosophy, Theology and Religious Studies, Radboud University-Nijmegen, Nijmegen, The Netherlands
| | - H Dörr
- University of the Art Utrecht, Utrecht, The Netherlands
| | - N Christophe
- University of the Art Utrecht, Utrecht, The Netherlands
| | - M A G Sprangers
- Department of Medical Psychology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - H W M van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Meibergdreef 9; D3-312, 1105 AZ, Amsterdam, The Netherlands.
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Distress and Quality of Life Among Patients with Advanced Genitourinary Cancers. Eur Urol Focus 2020; 6:1150-1154. [PMID: 31711933 DOI: 10.1016/j.euf.2019.10.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/20/2019] [Accepted: 10/17/2019] [Indexed: 11/21/2022]
Abstract
Patients with advanced genitourinary cancers face many challenges throughout their disease trajectory, and many will experience clinically relevant psychosocial distress. Certain groups, including female gender, younger age (and older age for suicide), unmarried status, and non-clear cell histology, remain at a higher risk, and evidence suggests that those with kidney and bladder cancers may be at an increased risk of suicide. Routine psychosocial screening, with brief validated tools, has the ability to identify patients' unmet needs, assist the health care team in addressing such symptoms, and subsequently improve quality of life, adherence, and clinical outcomes. Effective supportive care modalities are available that address common patient needs in the context of incurable disease (eg, emotional and physical symptoms); however, challenges remain in terms of patient acceptance and access through insurance coverage. As a result, remote home-based interventions have emerged with the potential to mitigate emotional symptom burden and improve disease adjustment. In this study, we highlight studies reporting on the prevalence of psychosocial distress and associated risk factors in advanced genitourinary cancers, and review evidence-based interventions for the management of distress, including distress screening and psychosocial interventions. PATIENT SUMMARY: This mini-review reports the prevalence of psychosocial distress and associated risk factors among patients with advanced kidney, bladder, or prostate cancer. We found that patients with these types of advanced genitourinary cancers are at a great risk of distress, including suicide, with consequent impairments in quality of life. We recommend that a distress screening program be incorporated as the standard of care and that referrals to appropriate psychosocial interventions be available to assist patients in greatest need.
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Ftanou M, Pascoe MC, Ellen S. Psychosocial Interventions for End‐of‐Life Care: An Invited Commentary. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12305] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Maria Ftanou
- Psychosocial Oncology Program, Peter MacCallum Cancer Centre,
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne,
| | - Michaela C Pascoe
- Department of Cancer Experiences Research, Peter MacCallum Cancer Centre,
| | - Steve Ellen
- Psychosocial Oncology Program, Peter MacCallum Cancer Centre,
- Department of Psychiatry, The Melbourne Medical School, The University of Melbourne,
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59
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Mogami T, Onuma E, Aoki M, Kamiya N, Sukegawa A, Miyagi E, Sakakibara H. Increased anxiety and depression in patients with gynecologic cancers during the COVID-19 pandemic: A retrospective study from Japan. Int J Gynaecol Obstet 2020; 152:457-458. [PMID: 33155289 PMCID: PMC9087569 DOI: 10.1002/ijgo.13470] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 10/22/2020] [Accepted: 11/04/2020] [Indexed: 11/11/2022]
Affiliation(s)
- Tae Mogami
- Department of Gynecology, Yokohama City University Medical Center, Yokohama, Japan
| | - Emi Onuma
- Department of Gynecology, Yokohama City University Medical Center, Yokohama, Japan
| | - Mihoko Aoki
- Department of Gynecology, Yokohama City University Medical Center, Yokohama, Japan
| | - Natsuko Kamiya
- Department of Obstetrics and Gynecology, Yokohama City University, Yokohama, Japan
| | - Akiko Sukegawa
- Department of Obstetrics and Gynecology, Yokohama City University, Yokohama, Japan
| | - Etsuko Miyagi
- Department of Obstetrics and Gynecology, Yokohama City University, Yokohama, Japan
| | - Hideya Sakakibara
- Department of Gynecology, Yokohama City University Medical Center, Yokohama, Japan
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Miaskowski C, Paul SM, Snowberg K, Abbott M, Borno H, Chang S, Chen LM, Cohen B, Hammer MJ, Kenfield SA, Kober KM, Levine JD, Pozzar R, Rhoads KF, Van Blarigan EL, Van Loon K. Stress and Symptom Burden in Oncology Patients During the COVID-19 Pandemic. J Pain Symptom Manage 2020; 60:e25-e34. [PMID: 32889039 PMCID: PMC7462969 DOI: 10.1016/j.jpainsymman.2020.08.037] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/24/2020] [Accepted: 08/28/2020] [Indexed: 12/11/2022]
Abstract
CONTEXT No information is available on oncology patients' level of stress and symptom burden during the coronavirus disease 2019 (COVID-19) pandemic. OBJECTIVES To evaluate for differences in demographic and clinical characteristics, levels of social isolation and loneliness, and the occurrence and severity of common symptoms between oncology patients with low vs. high levels of COVID-19 and cancer-related stress. In addition, to determine which of these characteristics were associated with membership in the high-stressed group. METHODS Patients were 18 years and older; had a diagnosis of cancer; and were able to complete an online survey. RESULTS Of the 187 patients in this study, 31.6% were categorized in the stressed group (Impact of Event Scale-Revised [score of ≥24]). Stressed group's Impact of Event Scale-Revised score exceeds previous benchmarks in oncology patients and equates with probable post-traumatic stress disorder. In this stressed group, patients reported occurrence rates for depression (71.2%), anxiety (78.0%), sleep disturbance (78.0%), evening fatigue (55.9%), cognitive impairment (91.5%), and pain (75.9%). Symptom severity scores equate with clinically meaningful levels for each symptom. CONCLUSION We identified alarmingly high rates of stress and an extraordinarily high symptom burden among patients with cancer, exceeding those previously benchmarked in this population and on par with noncancer patients with post-traumatic stress disorder. Given that the COVID-19 pandemic will likely impact cancer care for an indefinite period, clinicians must exhibit increased vigilance in their assessments of patients' level of stress and symptom burden. Moreover, an increase in referrals to appropriate supportive care resources must be prioritized for high-risk patients.
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Affiliation(s)
| | - Steven M Paul
- School of Nursing, University of California, San Francisco, California, USA
| | - Karin Snowberg
- School of Nursing, University of California, San Francisco, California, USA
| | - Maura Abbott
- Columbia University Medical Center, New York, New York, USA
| | - Hala Borno
- School of Medicine, University of California, San Francisco, California, USA
| | - Susan Chang
- School of Medicine, University of California, San Francisco, California, USA
| | - Lee M Chen
- School of Medicine, University of California, San Francisco, California, USA
| | - Bevin Cohen
- Mount Sinai Medical Center, New York, New York, USA
| | | | - Stacey A Kenfield
- School of Medicine, University of California, San Francisco, California, USA
| | - Kord M Kober
- School of Nursing, University of California, San Francisco, California, USA
| | - Jon D Levine
- School of Medicine, University of California, San Francisco, California, USA
| | - Rachel Pozzar
- Dana Farber Cancer Institute, Boston, Massachusetts, USA
| | - Kim F Rhoads
- School of Medicine, University of California, San Francisco, California, USA
| | - Erin L Van Blarigan
- School of Medicine, University of California, San Francisco, California, USA
| | - Katherine Van Loon
- School of Medicine, University of California, San Francisco, California, USA
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Bergerot CD, Philip EJ, Bergerot PG, Pal SK. Distress and Quality of Life Among Patients with Advanced Genitourinary Cancers. Eur Urol Focus 2020. [DOI: 10.1016/j.euf.2019.10.014 5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Williamson TJ, Ostroff JS, Haque N, Martin CM, Hamann HA, Banerjee SC, Shen MJ. Dispositional shame and guilt as predictors of depressive symptoms and anxiety among adults with lung cancer: The mediational role of internalized stigma. STIGMA AND HEALTH 2020; 5:425-433. [PMID: 34027060 PMCID: PMC8132596 DOI: 10.1037/sah0000214] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE The current study investigated whether dispositional tendencies to experience shame and guilt (i.e., shame- and guilt- proneness) were associated with higher levels of internalized stigma and, in turn, higher depressive symptoms and anxiety in adults with lung cancer. METHOD Participants (N = 50, 56.0% female) were men and women who received a clinical consultation for lung cancer and completed validated questionnaires. Mediation modeling using bootstrapping was used to characterize relationships between shame- and guilt-proneness, lung cancer stigma, depressive symptoms, and anxiety. RESULTS Higher guilt-proneness was associated significantly with higher anxiety (b = 0.69, SE=0.28, 95% CI [0.13, 1.26]) and higher shame-proneness was associated significantly with higher depressive symptoms (b = 0.56, SE = 0.19, 95% CI [0.18, 0.93]), beyond sociodemographic, medical, and smoking-related characteristics. Higher lung cancer stigma also significantly mediated the relationship between guilt-proneness and anxiety (indirect effect = 0.43, SE = .20, 95% CI [0.08, 0.89]) but not between shame-proneness and depressive symptoms. CONCLUSIONS Shame- and guilt-proneness are associated significantly with depressive symptoms and anxiety, respectively, and the relationship between guilt-proneness and anxiety is explained in part by internalized stigma in a sample of newly diagnosed lung cancer patients. Findings carry implications for the early identification of lung cancer patients in need of additional supportive care services and highlight internalized stigma as a target for psychosocial intervention.
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Affiliation(s)
- Timothy J. Williamson
- Department of Psychiatry & Biobehavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Jamie S. Ostroff
- Department of Psychiatry & Biobehavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Noshin Haque
- Department of Psychiatry & Biobehavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Chloe M. Martin
- Department of Psychiatry & Biobehavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY
| | | | - Smita C. Banerjee
- Department of Psychiatry & Biobehavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Megan J. Shen
- Department of Medicine, Weill Cornell Medical College, New York, NY
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Hsieh CC, Ho CC, Lin ZZ, Yu CJ, Jow GM, Huang FY, Shih JY, Hsiao FH. Trait mindfulness and depressive symptoms in non-small cell lung cancer patients: the mediating roles of quality of life and meaning in life. Psychol Health 2020; 36:1102-1114. [PMID: 32998574 DOI: 10.1080/08870446.2020.1825713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The present study examined the potential mediating influences of meaning in life and quality of life in the relationship of trait mindfulness and depressive symptoms in lung cancer patients. Design: We adopted a cross-sectional design studying a sample of patients with non-small cell lung cancer, aged 20-65 years, and receiving cancer treatments or follow-up care. Main Outcome Measures: The outcome measures included Beck Depression Inventory-II, European Organisation for Research and Treatment of Cancer Core Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and lung cancer specific complementary measure (EORTC QLQ-LC13), Five Facet Mindfulness Questionnaire, and the meaning in life questionnaire. Results: Among 116 lung cancer patients, 26.72% of them had clinically significant depressive symptoms. The presence of meaning, quality of life (QOL) functioning and symptom distress mediated the relationship of trait mindfulness and depressive symptoms. Multiple mediation analyses found that the presence of meaning in life was the main mediator. Conclusion: The reductions of depressive symptoms might be related to trait mindfulness enhancing lung cancer patients' perceptions of meaning in life. A mindfulness program has the potential to improve depressive symptoms in people with lung cancer.
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Affiliation(s)
- Chia-Chen Hsieh
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chao-Chi Ho
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Zhong-Zhe Lin
- Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Chong-Jen Yu
- College of Medicine, National Taiwan University, Taipei, Taiwan.,BioMedical Park Branch, National Taiwan University Hospital, , Hsinchu, Taiwan
| | - Guey-Mei Jow
- School of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
| | - Feng-Ying Huang
- Department of Education, National Taipei University of Education, Taipei, Taiwan
| | - Jin-Yuan Shih
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Fei-Hsiu Hsiao
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
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Park SK, Park HA, Lee J. Understanding the Public's Emotions about Cancer: Analysis of Social Media Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7160. [PMID: 33007865 PMCID: PMC7579657 DOI: 10.3390/ijerph17197160] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 09/27/2020] [Accepted: 09/29/2020] [Indexed: 01/06/2023]
Abstract
Cancer survivors suffer from emotional distress, which varies depending on several factors. However, existing emotion management programs are insufficient and do not take into consideration all of the factors. Social media provides a platform for understanding the emotions of the public. The aim of this study was to explore the relationship between the public's emotions about cancer and factors affecting emotions using social media data. We used 321,339 posts on cancer and emotions relating to cancer extracted from 22 social media channels between 1 January 2014, and 30 June 2017. The factors affecting emotions were analyzed using association rule mining and social network analysis. Hope/gratitude was the most frequently mentioned emotion group on social media followed by fear/anxiety/overwhelmed, sadness/depression/loneliness/guilt, and anger/denial. Acute survival stage, treatment method, and breast cancer were associated with hope/gratitude. Early stage, gastrointestinal problems, fatigue/pain/fever, and pancreatic cancer were associated with fear/anxiety/overwhelmed. Surgery, hair loss/skin problems, and fatigue/pain/fever were associated with sadness/depression/loneliness/guilt. Acute survival stage and hair loss/skin problems were associated with anger/denial. We found that emotions concerning cancer differed depending on the cancer type, cancer stage, survival stage, treatment, and symptoms. These findings could guide the development of tailored emotional management programs for cancer survivors that meet the public's needs more effectively.
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Affiliation(s)
- Seul Ki Park
- College of Nursing and Research Institute of Nursing Science, Seoul National University, Seoul 03080, Korea;
| | - Hyeoun-Ae Park
- College of Nursing and Research Institute of Nursing Science, Seoul National University, Seoul 03080, Korea;
| | - Jooyun Lee
- College of Nursing, Gachon University, Incheon 21936, Korea;
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Zheng W, Lei M, Liu Y, Lu X, Yu D, Zhang X. An Algorithm to Stratify the Risk of Postoperative Emotional Distress in Cancer Patients with Advanced Metastatic Spinal Disease. Psychol Res Behav Manag 2020; 13:721-731. [PMID: 32982501 PMCID: PMC7490437 DOI: 10.2147/prbm.s261613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 07/22/2020] [Indexed: 12/24/2022] Open
Abstract
Purpose We wish (1) to assess what variables are significantly associated with postoperative emotional distress in patients with the metastatic spinal disease after surgery and (2) to develop and validate an algorithm to stratify patients at risk of postoperative emotional distress. Patients and Methods We retrospectively enrolled 171 patients with the metastatic spinal disease treated with surgery. Twelve potential variables were used to analyze postoperative emotional distress. Postoperative emotional well-being was measured using the Hospital Anxiety and Depression Scales (HADS). Significant variables were included in the algorithm and assigned scores based on odds ratios (ORs) from the multiple logistic regression analysis. The predictive performance of the risk algorithm was validated on the basis of discrimination and calibration. Results Twenty-six (15.20%) patients had a HADS of 19 points or more. Of all the 12 variables, age (P=0.06), marital status (P=0.02), primary cancer types (P=0.004), and physical well-being (P=0.006) were included in the algorithm. This algorithm ranged from 0 to 24. Higher scores represented higher rates of postoperative emotional distress. Patients were stratified into three risk groups: patients in the group A had scores of 0 to 9 and the rate of postoperative emotional distress was only 1.14%, patient in the group B had scores of 10 to 15 and the rate of postoperative emotional distress was 21.31%, and patient in the group C had scores of 16 to 24 and the rate of postoperative emotional distress was up to 54.55%. The area under the receiver operating characteristic curve (AUROC) for the algorithm was 0.84, and the correct classification rate was 81.3%. Conclusion Postoperative emotional distress is common in patients with the metastatic spinal disease after surgery. We propose and validate an algorithm that can be used as a potential screening tool to identify patients at high risk of postoperative emotional distress.
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Affiliation(s)
- Wenjing Zheng
- Department of Orthopedic Surgery, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Mingxing Lei
- Department of Orthopedic Surgery, The Hainan Hospital of Chinese PLA General Hospital, Sanya, People's Republic of China
| | - Yaosheng Liu
- Department of Orthopedic Surgery, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Xin Lu
- Department of General Surgery, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Dan Yu
- Department of Neurosurgery, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China
| | - Xin Zhang
- Nursing Department, The Fifth Medical Center of Chinese PLA General Hospital, Beijing, People's Republic of China
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Qin S, Xiao Y, Chi Z, Zhu D, Cheng P, Yu T, Li H, Jiao L. Effectiveness and safety of massage in the treatment of anxiety and depression in patients with cancer: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2020; 99:e22262. [PMID: 32991424 PMCID: PMC7523760 DOI: 10.1097/md.0000000000022262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 08/20/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Anxiety and depression, complications of cancer, are prevalent but often overlooked mental illnesses. Studies have demonstrated that massage therapy is useful in relieving anxiety and depression of cancer survivors. However, the mechanism is still unclear and no systematic review has provided sufficient evidence for the treatment. Therefore, this protocol is carried out to comprehensively evaluate the reliability of cancer patients with anxiety and depression treated by massage. METHODS We will systematically search the relevant literature from PubMed, Cochrane Library, EMBASE, Web of Science, Wanfang, Chongqing VIP, CNKI and Chinese Biomedical Literature Database from the establishment of the databases to June 1, 2020. In addition, we will only include randomized controlled trials about massage for cancer survivors with anxiety and depression, regardless of language and publication status. Two experienced researchers will separately screen the literature, collect data, analyze data and synthesize data using RevMan V.5.3 software. The quality of the included trials in the study will be assessed by the Cochrane bias risk assessment tool. RESULTS The protocol for the meta-analysis will systematically evaluate the reliability of massage therapy for cancer patients with anxiety and depression. CONCLUSION This conclusion will provide an important basis for evaluating whether massage is reliable in treating cancer survivors who feel anxious and depressed. INPLASY REGISTRATION NUMBER INPLASY202060101.
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Affiliation(s)
- Siyu Qin
- College of Acupuncture-Moxibustion and Tuina, Jiangxi University of Traditional Chinese Medicine
| | - Yuanyi Xiao
- College of Acupuncture-Moxibustion and Tuina, Jiangxi University of Traditional Chinese Medicine
| | - Zhenhai Chi
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Daocheng Zhu
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
| | - Pan Cheng
- College of Acupuncture-Moxibustion and Tuina, Jiangxi University of Traditional Chinese Medicine
| | - Ting Yu
- College of Acupuncture-Moxibustion and Tuina, Jiangxi University of Traditional Chinese Medicine
| | - Haiyan Li
- College of Acupuncture-Moxibustion and Tuina, Jiangxi University of Traditional Chinese Medicine
| | - Lin Jiao
- The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, China
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van den Brekel L, van der Baan FH, Zweers D, Koldenhof JJ, Vos JBH, de Graeff A, Witteveen PO, Teunissen SCCM. Predicting Anxiety in Hospitalized Cancer Patients. J Pain Symptom Manage 2020; 60:522-530.e1. [PMID: 32305577 DOI: 10.1016/j.jpainsymman.2020.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 04/04/2020] [Accepted: 04/07/2020] [Indexed: 12/23/2022]
Abstract
CONTEXT Anxiety in patients with cancer is highly prevalent; yet it remains underestimated and inadequately assessed. Little is known about predictors for anxiety in hospitalized patients with cancer. Insight in predictors should improve recognition and enable a targeted approach. OBJECTIVES To determine the prevalence of anxiety and predictors for anxiety in hospitalized patients with cancer at different stages of disease. METHODS A cross-sectional analysis of patients with cancer admitted to the Utrecht University Medical Center in 2015-2018 was conducted. The Utrecht Symptom Diary, an adapted Dutch version of the Edmonton Symptom Assessment System, was used to assess symptom burden on a numeric rating scale (0 = no symptom and 10 = worst possible symptom). Scores ≥4 were considered clinically relevant. All patients completed the Utrecht Symptom Diary as part of routine care. The first questionnaire after admission was selected. Using multivariable linear regression, the predictive value of potential predictors on anxiety was analyzed. RESULTS In total, 2144 patients were included, of which 22% reported clinically relevant anxiety. The prevalence of anxiety was highest (36%) in patients receiving symptom-directed palliation only. In the total group, female gender, younger age, depressed mood, sleeping problems, dyspnea, and cancer of the head and neck were predictive of anxiety. Throughout all stages of disease, depressed mood was consistently the strongest predictor. CONCLUSION We found a high prevalence of anxiety in hospitalized patients with cancer. It is recommended to explore anxiety in hospitalized patients with cancer, in particular when they experience depressed mood. Structural use of a symptom diary during hospitalization facilitates the recognition of anxiety and concurrent symptoms.
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Affiliation(s)
- Lieke van den Brekel
- Department of General Practice, Center of Expertise Palliative Care-Utrecht, Julius Center for Healthcare Sciences and Primary Care, University of Utrecht, Utrecht, The Netherlands.
| | - Frederieke H van der Baan
- Department of General Practice, Center of Expertise Palliative Care-Utrecht, Julius Center for Healthcare Sciences and Primary Care, University of Utrecht, Utrecht, The Netherlands
| | - Danielle Zweers
- Department of General Practice, Center of Expertise Palliative Care-Utrecht, Julius Center for Healthcare Sciences and Primary Care, University of Utrecht, Utrecht, The Netherlands; Department of Medical Oncology, Cancer Center University Medical Center-Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - José J Koldenhof
- Department of Medical Oncology, Cancer Center University Medical Center-Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - J Bernard H Vos
- Department of Medical Oncology, Cancer Center University Medical Center-Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Alexander de Graeff
- Department of Medical Oncology, Cancer Center University Medical Center-Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Petronella O Witteveen
- Department of Medical Oncology, Cancer Center University Medical Center-Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - Saskia C C M Teunissen
- Department of General Practice, Center of Expertise Palliative Care-Utrecht, Julius Center for Healthcare Sciences and Primary Care, University of Utrecht, Utrecht, The Netherlands; Department of Medical Oncology, Cancer Center University Medical Center-Utrecht, University of Utrecht, Utrecht, The Netherlands
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Diniz ALL. Editorial Comment: Anxiety and depression associated with a positive prostate biopsy result: A comparative, prospective cohort study. Int Braz J Urol 2020; 46:1006-1009. [PMID: 32822129 PMCID: PMC7527089 DOI: 10.1590/s1677-5538.ibju.2019.0719.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- André Luiz Lima Diniz
- Departamento de Urologia, Instituto Nacional do Câncer - INCA, Rio de Janeiro, RJ, Brasil
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Andersen BL, Valentine TR, Lo SB, Carbone DP, Presley CJ, Shields PG. Newly diagnosed patients with advanced non-small cell lung cancer: A clinical description of those with moderate to severe depressive symptoms. Lung Cancer 2020; 145:195-204. [PMID: 31806360 PMCID: PMC7239743 DOI: 10.1016/j.lungcan.2019.11.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/19/2019] [Accepted: 11/20/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES The aims of this observational study were to 1) accrue newly diagnosed patients with advanced-stage non-small cell lung cancer (NSCLC) awaiting the start of first-line treatment and identify those with moderate to severe depressive symptoms and, 2) provide a clinical description of the multiple, co-occurring psychological and behavioral difficulties and physical symptoms that potentially exacerbate and maintain depressive symptoms. MATERIALS AND METHODS Patients with stage IV NSCLC (N = 186) were enrolled in an observational study (ClinicalTrials.gov Identifier: NCT03199651) and completed the American Society of Clinical Oncology-recommended screening measure for depression (Patient Health Questionnaire-9 [PHQ-9]). Individuals with none/mild (n = 119; 64 %), moderate (n = 52; 28 %), and severe (n = 15; 8 %) depressive symptoms were identified. Patients also completed measures of hopelessness, generalized anxiety disorder (GAD) symptoms, stress, illness perceptions, functional status, and symptoms. RESULTS Patients with severe depressive symptoms reported concomitant feelings of hopelessness (elevating risk for suicidal behavior), anxiety symptoms suggestive of GAD, and traumatic, cancer-specific stress. They perceived lung cancer as consequential for their lives and not controllable with treatment. Pain and multiple severe symptoms were present along with substantial functional impairment. Patients with moderate depressive symptoms had generally lower levels of disturbance, though still substantial. The most salient differences were low GAD symptom severity and fewer functional impairments for those with moderate symptoms. CONCLUSIONS Depressive symptoms of moderate to severe levels co-occur in a matrix of clinical levels of anxiety symptoms, traumatic stress, impaired functional status, and pain and other physical symptoms. All of the latter factors have been shown, individually and collectively, to contribute to the maintenance or exacerbation of depressive symptoms. As life-extending targeted and immunotherapy use expands, prompt identification of patients with moderate to severe depressive symptoms, referral for evaluation, and psychological/behavioral treatment are key to maximizing treatment outcomes and quality of life for individuals with advanced NSCLC.
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Affiliation(s)
- B L Andersen
- Department of Psychology, The Ohio State University, United States.
| | - T R Valentine
- Department of Psychology, The Ohio State University, United States
| | - S B Lo
- Department of Psychology, The Ohio State University, United States
| | - D P Carbone
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center and The James Cancer Hospital/Solove Research Institute, United States
| | - C J Presley
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center and The James Cancer Hospital/Solove Research Institute, United States
| | - P G Shields
- Department of Internal Medicine, Division of Medical Oncology, The Ohio State University Comprehensive Cancer Center and The James Cancer Hospital/Solove Research Institute, United States
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Reducing Cardiac Radiation Dose From Breast Cancer Radiation Therapy With Breath Hold Training and Cognitive Behavioral Therapy. Top Magn Reson Imaging 2020; 29:135-148. [PMID: 32568976 DOI: 10.1097/rmr.0000000000000241] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The delivery of radiation therapy shares many of the challenges encountered in imaging procedures. As in imaging, such as MRI, organ motion must be reduced to a minimum, often for lengthy time periods, to effectively target the tumor during imaging-guided therapy while reducing radiation dose to nearby normal tissues. For patients, radiation therapy is frequently a stress- and anxiety-provoking medical procedure, evoking fear from negative perceptions about irradiation, confinement from immobilization devices, claustrophobia, unease with equipment, physical discomfort, and overall cancer fear. Such stress can be a profound challenge for cancer patients' emotional coping and tolerance to treatment, and particularly interferes with advanced radiation therapy procedures where active, complex and repetitive high-level cooperation is often required from the patient.In breast cancer, the most common cancer in women worldwide, radiation therapy is an indispensable component of treatment to improve tumor control and outcome in both breast-conserving therapy for early-stage disease and in advanced-stage patients. High technological complexity and high patient cooperation is required to mitigate the known cardiac toxicity and mortality from breast cancer radiation by reducing the unintended radiation dose to the heart from left breast or left chest wall irradiation. To address this, radiation treatment in daily deep inspiration breath hold (DIBH), to create greater distance between the treatment target and the heart, is increasingly practiced. While holding the promise to decrease cardiac toxicity, DIBH procedures often augment patients' baseline stress and anxiety reaction toward radiation treatment. Patients are often overwhelmed by the physical and mental demands of daily DIBH, including the nonintuitive timed and sustained coordination of abdominal thoracic muscles for prolonged breath holding.While technologies, such as DIBH, have advanced to millimeter-precision in treatment delivery and motion tracking, the "human factor" of patients' ability to cooperate and perform has been addressed much less. Both are needed to optimally deliver advanced radiation therapy with minimized normal tissue effects, while alleviating physical and cognitive distress during this challenging phase of breast cancer therapy.This article discusses physical training and psychotherapeutic integrative health approaches, applied to radiation oncology, to leverage and augment the gains enabled by advanced technology-based high-precision radiation treatment in breast cancer. Such combinations of advanced technologies with training and cognitive integrative health interventions hold the promise to provide simple feasible and low-cost means to improve patient experience, emotional outcomes and quality of life, while optimizing patient performance for advanced imaging-guided treatment procedures - paving the way to improve cardiac outcomes in breast cancer survivors.
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Kouhestani M, Ahmadi Gharaei H, Fararouei M, Hosienpour Ghahremanloo H, Ghaiasvand R, Dianatinasab M. Global and regional geographical prevalence of depression in gastric cancer: a systematic review and meta-analysis. BMJ Support Palliat Care 2020; 12:e526-e536. [PMID: 32434923 DOI: 10.1136/bmjspcare-2019-002050] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/25/2020] [Accepted: 04/15/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND Substantial uncertainty exists about the prevalence of depression in patients with gastric cancer. We aimed to summarise the global and regional pooled prevalence of depression among patients with gastric cancer. METHOD Up to February 2020, we searched PubMed/MEDLINE, Embase, Scopus, Web of science (ISI) and PsychINFO to identify published studies on the prevalence of depression among patients with gastric cancer. The study selection procedure was in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We estimated the prevalence of depression in gastric cancer patients using a random-effect pooled estimate analysis approach with subgroup analysis based on WHO regions, and methods of depression measurement. RESULTS Totally, we retrieved 3781 studies from the previously mentioned databases, of which 18 (12 cross-sectional and 6 cohort studies in design) met the eligibility criteria, which were published from 2001 to 2017 in different regions. The total sample size of the included studied contained 4709 patients with gastric cancer, of which 1885 cases were diagnosed with depression. The pooled prevalence of depression among gastric cancer patients was 37%(95% CI: 26% to 48%). Subgroup analysis showed that the highest prevalence of depression was in Eastern Mediterranean (pooled prevalence=42%; 95% CI: 18% to 65%) followed by the Western Pacific region (pooled prevalence=40%;95% CI: 26% to 54%). The results indicated a significant heterogeneity (I 2=98.8%,P<0.05). CONCLUSION Our findings indicated that depression is high among gastric cancer patients. The findings suggest health authorities to provide specially designed social and psychological supportive care services, including screening for depression, among such patients. PROSPERO REGISTRATION NUMBER CRD42020139836.
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Affiliation(s)
- Mostafa Kouhestani
- Department of Health Management and Economics, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hasan Ahmadi Gharaei
- Department of Health, Faculty of Public Health; Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mohammad Fararouei
- Department of Epidemiology, Faculty of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Reza Ghaiasvand
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Mostafa Dianatinasab
- Department of Epidemiology, Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Sharoud, Iran
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Shunmugasundaram C, Rutherford C, Butow PN, Sundaresan P, Dhillon HM. What are the optimal measures to identify anxiety and depression in people diagnosed with head and neck cancer (HNC): a systematic review. J Patient Rep Outcomes 2020; 4:26. [PMID: 32328839 PMCID: PMC7181465 DOI: 10.1186/s41687-020-00189-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 03/12/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND A cancer diagnosis is potentially life-threatening, likely causing distress and uncertainty, which may be psychologically debilitating. Depression and anxiety are commonly underdiagnosed and undertreated in cancer patients. Head and neck cancer (HNC) patients face particular challenges that may contribute to distress. This review aims to: i) identify patient reported outcome measures (PROMs) designed to assess anxiety and depression in HNC; and ii) determine their suitability for use in research and clinical practice to screen patients. METHODS We searched five electronic databases between July 2007 to July 2019 for studies assessing anxiety and depression in HNC patients. Searches were limited to this period to account for advances in cancer treatment. Records were screened for eligibility by one reviewer and 10% cross-checked by a second across all stages of the review. In addition to the electronic searches, PROM databases were searched for additional measures of anxiety and depression. All retrieved PROMs were mapped against Diagnostic and Statistical Manual-5 criteria for anxiety and depression to assess content coverage. Then, their psychometric properties appraised against the COSMIN checklist. RESULTS Electronic searches identified 98 records, from which five anxiety and eight depression measures were retrieved. PROM database searches retrieved an additional four anxiety and four depression measures; a total of nine anxiety and 12 depression measures were appraised. Content coverage of anxiety measures ranged from 50% to 75% and depression measures from 42% to 100%. Demonstration of psychometric properties against COSMIN criteria ranged from 57% to 71% for anxiety measures (three PROMs > 70%) and from 29% to 86% for depression measures (nine PROMs > 70%). Three anxiety and seven depression measures had established clinical cut-offs in cancer populations. CONCLUSIONS The Patient Health Questionnaire-9, Zung Self-rating Depression and Zung Self-rating Anxiety Scales demonstrated good content coverage along with excellent psychometric properties, and thus were considered the most suitable PROMs to assess psychological distress in HNC populations. It is important to have PROMs assessing psychological distress that capture a comprehensive set of subjective symptoms. The identified PROMs will help researchers and health professionals in clinical-decision making, thereby potentially improving quality of life in HNC patients.
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Affiliation(s)
- Chindhu Shunmugasundaram
- University of Sydney, School of Psychology, Centre for Medical Psychology and Evidence-Based Decision-Making, Sydney, Australia
- University of Sydney, School of Psychology, Psycho-Oncology Cooperative Research Group, Sydney, Australia
| | - Claudia Rutherford
- University of Sydney, School of Psychology, Quality of Life Office, Sydney, Australia
- University of Sydney, Sydney Nursing School, Cancer Nursing Research Unit (CNRU), Sydney, Australia
| | - Phyllis N Butow
- University of Sydney, School of Psychology, Centre for Medical Psychology and Evidence-Based Decision-Making, Sydney, Australia
- University of Sydney, School of Psychology, Psycho-Oncology Cooperative Research Group, Sydney, Australia
| | - Puma Sundaresan
- Radiation Oncology Network, Western Sydney Local Health District, Sydney, Australia
- University of Sydney, Faculty of Medicine, Sydney Medical School, Sydney, Australia
| | - Haryana M Dhillon
- University of Sydney, School of Psychology, Centre for Medical Psychology and Evidence-Based Decision-Making, Sydney, Australia.
- University of Sydney, School of Psychology, Psycho-Oncology Cooperative Research Group, Sydney, Australia.
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Economos G, Lovell N, Johnston A, Higginson IJ. What is the evidence for mirtazapine in treating cancer-related symptomatology? A systematic review. Support Care Cancer 2020; 28:1597-1606. [PMID: 31858251 PMCID: PMC7036072 DOI: 10.1007/s00520-019-05229-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 12/05/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE Cancer patients often experience multiple distressing symptoms which are challenging to manage. It would therefore be helpful to find a treatment that alleviates more than one symptom, to avoid polypharmacy: mirtazapine has been used in several studies for this purpose. The objective of this study was to assess the effectiveness and safety of mirtazapine in alleviating one or more frequently encountered cancer-related symptoms. METHODS Systematic review of clinical trials in English or French. Eight databases were searched. Included studies assessed the effectiveness of mirtazapine in alleviating one or more frequently encountered cancer-related symptoms. Comparator and validated assessment tools were required. Studies were independently appraised by two investigators before data synthesis. RESULTS The search yielded 1898 references, from which we identified 12 relevant articles evaluating highly heterogeneous outcomes. These were two randomised-controlled (RCTs), three non-randomised controlled, and seven non-randomised non-controlled trials. In total, 392 participants were included and 185 were in RCTs. No study assessed the effectiveness of mirtazapine in alleviating symptoms at the same time, but some considered more than one symptom. Overall, the data was of poor quality, limited by small sample size and bias. However, mirtazapine showed effectiveness in treating depression, anxiety, sleep disorders, emesis and neuropathic pain. Across all studies, mirtazapine is safe to use, with drowsiness and dizziness the most common side-effects. CONCLUSION Study design and small sample sizes limit the ability to interpret results. Trials to assess the impact of mirtazapine or other medicines in alleviating multiple symptoms would be valuable.
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Affiliation(s)
- Guillaume Economos
- Cicely Saunders Institut, Departement Palliative Care Policy and Rehabilitation, King’s College London, 10 Cutcombe Rd, Brixton, London, SE5 9PJ UK
- Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Palliative Care, 165 chemin du Grand Revoyet, 69310 Pierre-Bénite, France
| | - Natasha Lovell
- Cicely Saunders Institut, Departement Palliative Care Policy and Rehabilitation, King’s College London, 10 Cutcombe Rd, Brixton, London, SE5 9PJ UK
| | - Anna Johnston
- Cicely Saunders Institut, Departement Palliative Care Policy and Rehabilitation, King’s College London, 10 Cutcombe Rd, Brixton, London, SE5 9PJ UK
| | - Irene J. Higginson
- Cicely Saunders Institut, Departement Palliative Care Policy and Rehabilitation, King’s College London, 10 Cutcombe Rd, Brixton, London, SE5 9PJ UK
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Hortense FTP, Bergerot CD, Domenico EBLD. Quality of life, anxiety and depression in head and neck cancer patients: a randomized clinical trial. Rev Esc Enferm USP 2020; 54:e03546. [PMID: 32236346 DOI: 10.1590/s1980-220x2018040103546] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 05/21/2019] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE To evaluate an educational program based on the principles of self-management with a conventional educational program through quality of life, anxiety and depression instruments within 12 months of starting cancer treatment. METHOD An experimental, randomized, controlled study conducted with head and neck cancer patients treated at a university hospital in the city of São Paulo, Brazil. Patients were randomly divided into two groups: the control group submitted to the conventional educational plan, and the experimental group submitted to the educational plan for self-management. Descriptive and analytical statistics were used for the analyzes using the t-test, Fischer's exact test and Repeated Measures ANOVA. RESULTS Twenty (20) patients were selected. Most participants were male, in advanced stages of disease and undergoing three therapeutic modalities. The control group showed a gradual decrease in quality of life scores during treatment, while the experimental group progressively increased. The correlation was significant between the presence of anxiety and depression symptoms and poor quality of life. Patients in the control group had a significant worsening in social/family well-being (P = 0.02) and the prevalence of additional head and neck cancer-related additional concerns (P = 0.01), while the experimental group had reduced anxiety symptoms (P = 0.001) and improved emotional well-being (P = 0.01). CONCLUSION The educational intervention based on building self-management skills favored quality of life and reduced anxiety and depression. Brazilian Registry of Clinical Trials (RBR 2q53ct).
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Han L. Prevalence, risk factors and prognostic role of anxiety and depression in surgical gastric cancer patients. Transl Cancer Res 2020; 9:1371-1383. [PMID: 35117485 PMCID: PMC8797988 DOI: 10.21037/tcr.2020.01.11] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Accepted: 12/12/2019] [Indexed: 12/24/2022]
Abstract
Background The present study was conducted to explore the prevalence, risk factors and prognostic role of anxiety and depression in surgical gastric cancer patients. Methods Totally 200 gastric cancer patients who underwent surgical resection were enrolled and their Hospital Anxiety and Depression Scale (HADS) scores were assessed before surgery. Besides, 200 healthy controls were enrolled with their HADS scores assessed at enrollment. Results The HADS-anxiety score (7.4±3.8 vs. 4.7±2.8, P<0.001), prevalence (42.5% vs. 13.5%, P<0.001) and severity (P=0.002) of anxiety were greatly increased in gastric cancer patients compared with healthy controls. And HADS-depression score (6.9±3.5 vs. 4.2±2.6, P<0.001), prevalence (33.5% vs. 10.0%, P<0.001) and severity (P=0.001) of depression were also dramatically elevated in gastric cancer patients compared with healthy controls. Regarding the factors predicting anxiety/depression risks in gastric cancer patients, gender (female) (P=0.003), diabetes (P<0.001), higher pathological grade (P=0.005), larger tumor size (P=0.044) and higher T stage (P=0.017) were independent predictive factors for higher risk of anxiety, and age (>60 years) (P=0.025), gender (female) (P=0.004), hyperlipidemia (P=0.039), diabetes (P<0.001) and higher TNM stage (P=0.003) were independent predictive factors for higher risk of depression. Most importantly, anxiety/depression and the severity of anxiety/depression were all negatively associated with disease-free survival as well as overall survival (all P<0.05) in surgical gastric cancer patients. Conclusions Anxiety/depression are common and severe, which predicts unfavorable prognosis in gastric cancer patients underwent surgery, suggesting the necessity of psychological care post-surgery.
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Affiliation(s)
- Lijuan Han
- Department of Surgery, The 2nd Affiliated Hospital of Harbin Medical University, Harbin 150001, China
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Abstract
Germline CDH1 mutation carriers are at risk for early-onset diffuse gastric cancer (DGC) and female carriers have an additional risk of lobular breast cancer. The reported literature GC risk of 70% has led to the recommendation for germline mutation carriers to undergo prophylactic total gastrectomy (PTG). The objective of this research was to examine post-surgical clinical outcomes and to identify which of the domains/symptoms from the European Organisation for Research and Treatment of Cancer QOL Questionnaire (EORTC QLQ-C30) were determinants of overall quality of life (QOL) in individuals undergoing PTG. Participants were recruited through multiple sources. Postsurgical clinical outcomes were obtained from hospital records. Participants completed validated questionnaires measuring generic and condition specific QOL (PROMIS, EORTC and SF 36v.II) at a single point in time. The mean QOL in this cohort was 70.6 (SD = 25.6), which is better than reference values from the general populations in USA and Canada Role and social function plus the symptoms anxiety, pain, taste, dyspnea and diarrhea were significant predictor variables for QOL (p < 0.05). Although this study reveals good overall QOL for individuals after PTG, attention should be given to managing symptoms as part of long term care to further enhance QOL. The function/symptom scores were associated with worse overall health and global health status and thus may mark a real need for more attentive post-surgical care.
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77
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The association of anxiety and depression with perioperative and oncologic outcomes among patients with clear cell renal cell carcinoma undergoing nephrectomy. Urol Oncol 2020; 38:41.e19-41.e27. [DOI: 10.1016/j.urolonc.2019.10.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/25/2019] [Accepted: 10/29/2019] [Indexed: 12/29/2022]
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78
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Hata K, Ono H, Ogawa Y, Suzuki SI. The mediating effect of activity restriction on the relationship between perceived physical symptoms and depression in cancer survivors. Psychooncology 2020; 29:663-670. [PMID: 31984588 PMCID: PMC7216991 DOI: 10.1002/pon.5303] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 11/07/2019] [Accepted: 11/15/2019] [Indexed: 12/20/2022]
Abstract
Purpose Several studies have explored factors causing depression in cancer survivors, including perceived physical symptoms. Another critical factor in the depression symptomatology of cancer survivors is activity restriction (AR). We investigated how AR mediate the effects of perceived pain and fatigue on depression in cancer survivors. Methods Cancer survivors (n = 61; mean age 56.16 years) that were recruited through cancer support groups in Japan participated in this study. Participants completed a battery of questionnaires comprising demographic and clinical information, the Pain Catastrophizing Scale, the Cancer Fatigue Scale, the Activity Restriction Scale for Cancer Patients, and the Hospital Anxiety and Depression Scale. Results Mediation analysis indicated that AR partially mediates the effect of pain on depression. Direct paths from pain to AR, AR to depression, and pain to depression were significant (P < .005). Moreover, indirect paths from pain to AR, AR to depression, and pain to depression were also significant at the 95% level [0.04‐0.13]. However, AR did not mediate the effect of fatigue on depression, and fatigue had a significant direct path to both AR and depression (P < .005). Conclusion This study aimed to explore the mediating effect of AR in the relationships of perceived pain and fatigue and depression in cancer survivors. We found that AR mediates perceived pain to depression, however not for perceived fatigue. In addition, because AR was experienced in the face of any survivorship period, AR may need to be treated as a long‐term effect of the cancer diagnosis
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Affiliation(s)
- Kotone Hata
- Graduate School of Human Sciences, Waseda University, Saitama, Japan.,Japan Society for the Promotion of Science, Research Fellow
| | - Haruka Ono
- Graduate School of Human Sciences, Waseda University, Saitama, Japan
| | - Yuko Ogawa
- Department of Psycho-Oncology, National Cancer Center, Tokyo, Japan
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79
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Ornstein KA, Liu B, Schwartz RM, Smith CB, Alpert N, Taioli E. Cancer in the context of aging: Health characteristics, function and caregiving needs prior to a new cancer diagnosis in a national sample of older adults. J Geriatr Oncol 2020; 11:75-81. [PMID: 30952516 PMCID: PMC6774923 DOI: 10.1016/j.jgo.2019.03.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 01/25/2019] [Accepted: 03/25/2019] [Indexed: 12/14/2022]
Abstract
INTRODUCTION As cancer trajectories change due to screening, earlier diagnoses, living longer with illnesses, and new successful treatments, cancer is increasingly a disease of older adults. While cancer diagnoses themselves are very stressful for patients and families, little is known about the health status, functional limitations, and social resources of older patients before they face a new cancer diagnosis. MATERIALS AND METHODS Using the National Health and Aging Trends Study (NHATS), a national survey of older Medicare beneficiaries linked to Medicare claims data, we examined the health characteristics, functional limitations and social and financial resources of older adults before a new diagnosis of lung, breast, prostate or colorectal cancer and how these factors vary by race/ethnicity. RESULTS We identified 274 community-dwelling older adults with incident cancer diagnoses: lung (30.6%), breast (20.3%), prostate (30.8%), and colorectal (18.3%) representing 1,202,920 older Medicare beneficiaries. The sample was 81% Non-Hispanic White, 10% Non-Hispanic Black, and 9% Hispanic/Other. Before diagnosis, patients had an average of three comorbidities and 29% of patients reported poor/fair health. Almost one-third were living alone, 13% received help with at least one activity of daily living (ADL), 11% had probable dementia and nearly one in ten already received financial help from family members. DISCUSSION Before an older adult has ever been diagnosed with a major cancer, many face significant health and financial challenges and are dependent on others for care. These needs vary based on cancer type and race/ethnicity and must be considered as clinicians develop individualized care plans for patients alongside caregivers.
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Affiliation(s)
- Katherine A Ornstein
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
| | - Bian Liu
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Division of Hematology/Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Rebecca M Schwartz
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Division of Hematology/Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Department of Occupational Medicine, Epidemiology and Prevention, Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, United States of America
| | - Cardinale B Smith
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Department of Occupational Medicine, Epidemiology and Prevention, Zucker School of Medicine at Hofstra/Northwell, Great Neck, NY, United States of America
| | - Naomi Alpert
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Emanuela Taioli
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America; Division of Hematology/Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
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Wells C, Malins S, Clarke S, Skorodzien I, Biswas S, Sweeney T, Moghaddam N, Levene J. Using smart-messaging to enhance mindfulness-based cognitive therapy for cancer patients: A mixed methods proof of concept evaluation. Psychooncology 2019; 29:212-219. [PMID: 31654533 PMCID: PMC7004102 DOI: 10.1002/pon.5256] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 09/30/2019] [Accepted: 10/02/2019] [Indexed: 11/07/2022]
Abstract
Objective Depression and anxiety lead to reduced treatment adherence, poorer quality of life, and increased care costs amongst cancer patients. Mindfulness‐based cognitive therapy (MBCT) is an effective treatment, but dropout reduces potential benefits. Smart‐message reminders can prevent dropout and improve effectiveness. However, smart‐messaging is untested for MBCT in cancer. This study evaluates smart‐messaging to reduce dropout and improve effectiveness in MBCT for cancer patients with depression or anxiety. Methods Fifty‐one cancer patients attending MBCT in a psycho‐oncology service were offered a smart‐messaging intervention, which reminded them of prescribed between‐session activities. Thirty patients accepted smart‐messaging and 21 did not. Assessments of depression and anxiety were taken at baseline, session‐by‐session, and one‐month follow‐up. Logistic regression and multilevel modelling compared the groups on treatment completion and clinical effectiveness. Fifteen post‐treatment patient interviews explored smart‐messaging use. Results The odds of programme completion were eight times greater for patients using smart‐messaging compared with non‐users, controlling for age, gender, baseline depression, and baseline anxiety (OR = 7.79, 95% CI 1.75 to 34.58, p = .007). Smart‐messaging users also reported greater improvement in depression over the programme (B = ‐2.33, SEB = .78, p = .004) when controlling for baseline severity, change over time, age, and number of sessions attended. There was no difference between groups in anxiety improvement (B = ‐1.46, SEB = .86, p = .097). In interviews, smart‐messaging was described as a motivating reminder and source of personal connection. Conclusions Smart‐messaging may be an easily integrated telehealth intervention to improve MBCT for cancer patients.
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Affiliation(s)
- Chloe Wells
- Department of PsychologyNottingham Trent UniversityNottinghamUK
| | - Sam Malins
- Institute of Mental HealthUniversity of NottinghamNottinghamUK
- Specialist ServicesNottinghamshire Healthcare NHS Foundation TrustNottinghamshireUK
| | - Simon Clarke
- Department of PsychologyNottingham Trent UniversityNottinghamUK
| | | | - Sanchia Biswas
- Specialist ServicesNottinghamshire Healthcare NHS Foundation TrustNottinghamshireUK
| | - Tim Sweeney
- Specialist ServicesNottinghamshire Healthcare NHS Foundation TrustNottinghamshireUK
| | | | - Jo Levene
- Specialist ServicesNottinghamshire Healthcare NHS Foundation TrustNottinghamshireUK
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Kedia SK, Collins A, Dillon PJ, Akkus C, Ward KD, Jackson BM. Psychosocial interventions for informal caregivers of lung cancer patients: A systematic review. Psychooncology 2019; 29:251-262. [DOI: 10.1002/pon.5271] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 10/19/2019] [Accepted: 10/20/2019] [Indexed: 01/08/2023]
Affiliation(s)
- Satish K. Kedia
- Division of Social and Behavioral Sciences, School of Public Health University of Memphis Memphis Tennessee
| | - Andy Collins
- Division of Social and Behavioral Sciences, School of Public Health University of Memphis Memphis Tennessee
| | - Patrick J. Dillon
- School of Communication Studies Kent State University at Stark North Canton Ohio
| | - Cem Akkus
- Division of Social and Behavioral Sciences, School of Public Health University of Memphis Memphis Tennessee
| | - Kenneth D. Ward
- Division of Social and Behavioral Sciences, School of Public Health University of Memphis Memphis Tennessee
| | - Bianca M. Jackson
- Multidisciplinary Thoracic Oncology Program, Baptist Cancer Center, Memphis Tennessee
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82
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Huang HM, Lai JH, Huang TW. Mediating effects of depression on anxiety and leisure constraints in patients with breast cancer. BMC WOMENS HEALTH 2019; 19:141. [PMID: 31747957 PMCID: PMC6868872 DOI: 10.1186/s12905-019-0838-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 11/07/2019] [Indexed: 12/23/2022]
Abstract
Background Patients with breast cancer often exhibit high levels of anxiety and depression and a considerable decrease in their ability to participate in leisure activities, which result in the long-term disruption of their daily lives. This study intended to explore the relationships among anxiety, leisure constraints, and depression and evaluate whether depression mediates the effects of anxiety on leisure constraints in patients with breast cancer. Method This prospective study included 106 patients with breast cancer. All the patients completed the Taiwanese version of the Hospital Anxiety and Depression Scale and Leisure constraints questionnaire. Path analysis was used to test the mediating role of depression. Results Leisure constraints, anxiety, and depression were positively interrelated and co-occurred in the patients. The accelerated bootstrapping confidence intervals of the indirect effect did not include zero (0.276–1.663). Moreover, depression completely mediated the effects of anxiety on leisure constraints in patients with earlier cancer stages but not in patients with advanced cancer stages. Conclusions Depression is a crucial mechanism underlying the relationship between anxiety and leisure constraints in patients with breast cancer. Although many patients experience minimal disruption of activities and roles during survivorship, they are unable to perform functional activities and satisfactorily play their roles. This is the first study to explore leisure constraints in patients with breast cancer and investigate the mediating role of depression that underlies the relationship between anxiety and leisure constraints. The current findings are clinically crucial because they suggest the need to consider the simultaneous management of anxiety and depression for alleviating leisure constraints.
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Affiliation(s)
- Hsiu-Mei Huang
- Department of Nursing, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan
| | - Jun-Hung Lai
- Department of Internal Medicine, Erlin Christian Hospital, ChangHua, Taiwan
| | - Tsai-Wei Huang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan. .,Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan.
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Structured multi-disciplinary psychosocial care for cancer patients and the perceived quality of care from the patient perspective: a cluster-randomized trial. J Cancer Res Clin Oncol 2019; 145:2845-2854. [DOI: 10.1007/s00432-019-03018-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 09/03/2019] [Indexed: 10/26/2022]
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Association of depression and anxiety disorder with the risk of mortality in breast cancer: A National Health Insurance Service study in Korea. Breast Cancer Res Treat 2019; 179:491-498. [PMID: 31673880 DOI: 10.1007/s10549-019-05479-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 10/15/2019] [Indexed: 01/06/2023]
Abstract
PURPOSE To examine whether depression, anxiety disorder, and their co-occurrence would increase the risk of mortality in patients with breast cancer, and whether antidepressant treatment would reduce the same. METHODS Data were retrieved from the database of the Korean National Health Insurance Service. Of 145,251 patients diagnosed with breast cancer between 2007 and 2014, 20,870 patients diagnosed with depression or anxiety disorder one year before breast cancer diagnosis were excluded. Thus, data of 124,381 patients were included in this study. RESULTS Depression and anxiety disorder were associated with an increased risk of mortality [Hazard Ratio (HR) 1.26, 95% CI 1.18-1.36; HR 1.14, 95% CI 1.08-1.22, respectively] and their co-occurrence further increased the risk (HR = 1.38, 95% CI 1.24-1.54). Antidepressant treatment was related to a reduced risk of mortality. Compared to patients without any psychiatric comorbidity with no antidepressant treatment, the mortality risk increased in patients with either psychiatric comorbidity or both, but the risk seemed to attenuate with antidepressant treatments. CONCLUSION The current findings suggest that psychiatric comorbidities are markers of increased mortality risk in patients with breast cancer, and antidepressant treatment may attenuate the risk. This underscores the need for screening and treating depression and anxiety disorders to improve survival in patients with breast cancer.
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85
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Granek L, Ben-David M, Bar-Sela G, Shapira S, Ariad S. "Please do not act violently towards the staff": Expressions and causes of anger, violence, and aggression in Israeli cancer patients and their families from the perspective of oncologists. Transcult Psychiatry 2019; 56:1011-1035. [PMID: 30051769 DOI: 10.1177/1363461518786162] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Expressions of anger within the healthcare context are a common occurrence, particularly in clinical situations where patients can experience emotional distress in the face of illness. The purpose of this study was to examine one aspect of this phenomenon by looking at expressions and causes of anger among Israeli cancer patients and their families from the perspective of oncologists who treat them. Twenty-two Israeli oncologists were interviewed from three oncology centers between March 2013 and June 2014. The grounded theory method was used to collect and analyze the data. Our study revealed that oncologists are exposed to and cope with expressions and acts of anger, aggression, and violence from some of their cancer patients and their families. The causes of this anger include physician blame, unrealistic treatment expectations, perceived errors in communication, and lack of follow up with bereaved families. Our study also revealed that the cultural context affected patient-physician interactions, including anger. This context included a culture that has open interpersonal boundaries and is family-oriented; a multicultural society that includes citizens with different cultural norms and expectations around cancer care; and a strained healthcare system that leaves oncologists limited in time and resources, including limited access to palliative care. Policy implications include reducing oncologist workload by hiring more mental health professionals, having translators available on site to help with language barriers, reducing administrative burdens, and incorporating palliative care widely to help with the psychosocial and physical care of patients and families.
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Affiliation(s)
| | | | - Gil Bar-Sela
- Rambam Health Care Campus and Rappaport Faculty of Medicine & The Technion-Israel Institute of Technology
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Abstract
PURPOSE OF REVIEW Up until the latter part of the previous century, the monoamine theory guided our understanding of psychiatric disorders, notably depressive illness in its various phenotypic manifestations. The purpose of this review is to provide an overview of newer theories that allow a deeper understanding of brain dysfunction and neuropsychiatric disease entities such as depressive illness. One such key theory is the theory of inflammation as a result of stress-induced immune system activation. RECENT FINDINGS Stress activates the hypothalamic-pituitary-adrenal axis and the sympathetic branch of the autonomic nervous system [sympathetic branch (SNS)] with a concomitant reduction in vagal tone. This homeostatic imbalance makes a simultaneous dual contribution to the resulting proinflammatory state of depression. SNS stimulation results in upregulation of proinflammatory signaling, whereas diminution in parasympathetic tone affects the body's immune response. The resulting proinflammatory status has been closely associated with multiple organ dysfunction and comorbid conditions. SUMMARY The advent of innovative theories about the pathophysiology of psychiatric disorders has ushered in a new era on the basis of the role of the immune system and inflammation in mediating depression in its multifaceted manifestations. Extensive studies have confirmed the proinflammatory status in depression and causal relationships with neurotransmitter dysregulation. Equally importantly the role the autonomic nervous system plays in this complex and multifactorial interplay of body systems is being increasingly elucidated.
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87
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Fuller-Thomson E, West KJ. Flourishing despite a cancer diagnosis: factors associated with complete mental health in a nationally-representative sample of cancer patients aged 50 years and older. Aging Ment Health 2019; 23:1263-1274. [PMID: 30130417 DOI: 10.1080/13607863.2018.1481926] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objectives: This study investigated the association between cancer and complete mental health (CMH). CMH includes optimal functioning as well as the absence of psychopathology. Methods: Secondary data analyses of the nationally representative 2012 Canadian Community Health Survey-Mental Health. This study used bivariate and logistic regression analyses to estimate the odds ratios of CMH among community dwellers aged 50 and older with current cancer (n = 438), previous cancer (n = 1,174) and no cancer history (n = 9,279). CMH had three elements: (1) absence of mental illness, addictions and suicidal thoughts in the past year; (2) almost daily happiness or life satisfaction in the past month; (3) psychosocial well-being. Control variables included socio-demographics, health behaviours, current physical health and lifetime history of mental illness and childhood maltreatment. Results: Adults aged 50 and over with current cancer had a much lower prevalence of CMH (66.1%) than those with previous cancer (77.5%) and those with no cancer history (76.8%). After adjusting for 17 variables, the odds of CMH among those with current cancer remained substantially lower (OR = 0.63; 95% CI = 0.49-0.79) than those without cancer. Among those who had ever had cancer, the odds of CMH were higher for female, white, married, and older respondents, as well as those with higher socioeconomic status, and no history of childhood physical abuse, substance abuse, depression or anxiety disorder. Conclusions: Those with former cancer have comparable odds of CMH to those with no cancer history, suggesting a high level of resilience among cancer survivors.
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Affiliation(s)
- Esme Fuller-Thomson
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada.,b Institute for Life Course & Aging, University of Toronto , Toronto , Canada.,c Department of Family & Community Medicine , University of Toronto , Toronto , Canada
| | - Keri J West
- a Factor-Inwentash Faculty of Social Work , University of Toronto , Toronto , Canada
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88
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Schwartz RM, Ornstein KA, Liu B, Alpert N, Bevilacqua KG, Taioli E. Change in Quality of Life after a Cancer Diagnosis among a Nationally Representative Cohort of Older Adults in the US. Cancer Invest 2019; 37:299-310. [PMID: 31379217 DOI: 10.1080/07357907.2019.1645160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Age-related decreases in Quality of Life (QoL) are often compounded by comorbidities, including cancer. This study aimed to examine QoL changes before and after a new cancer diagnosis using data from the National Health and Aging Trend Study (NHATS), linked to Medicare claims (N = 136). There was a significant increase in the relative odds of fair/poor self-reported health and needing help with Activities of Daily Living. There was also a marginal increase in depression, but no change in anxiety or pain scores. Results underscore importance of considering pre-cancer QoL when making treatment decisions for older adult cancer patients.
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Affiliation(s)
- Rebecca M Schwartz
- Northwell Health, Occupational Medicine, Epidemiology and Prevention , Great Neck , NY , USA.,Institute for Translational Epidemiology, Department of Population Health Science and Policy, The Icahn School of Medicine at Mount Sinai , New York , NY , USA.,Tisch Cancer Institute, The Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Katherine A Ornstein
- Institute for Translational Epidemiology, Department of Population Health Science and Policy, The Icahn School of Medicine at Mount Sinai , New York , NY , USA.,Brookdale Department of Geriatrics and Palliative Medicine, The Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Bian Liu
- Institute for Translational Epidemiology, Department of Population Health Science and Policy, The Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Naomi Alpert
- Brookdale Department of Geriatrics and Palliative Medicine, The Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Kristin G Bevilacqua
- Northwell Health, Occupational Medicine, Epidemiology and Prevention , Great Neck , NY , USA
| | - Emanuela Taioli
- Institute for Translational Epidemiology, Department of Population Health Science and Policy, The Icahn School of Medicine at Mount Sinai , New York , NY , USA
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Robbertz AS, Weiss DM, Awan FT, Byrd JC, Rogers KA, Woyach JA. Identifying risk factors for depression and anxiety symptoms in patients with chronic lymphocytic leukemia. Support Care Cancer 2019; 28:1799-1807. [PMID: 31332513 DOI: 10.1007/s00520-019-04991-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 07/11/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE This study assessed whether empirically supported risk factors can identify future depression and anxiety symptoms in a specific cancer type, chronic lymphocytic leukemia (CLL). METHODS Patients enrolled in a CLL treatment clinical trial (N = 106) participated at baseline following informed consent and prior to treatment initiation. Risk factors with empirical support (personal or family psychiatric history, recurrent, advanced or progressive disease, low socioeconomic status, gender, medical comorbidities, and single marital status) and additional risk factors (cancer-specific stress, social contacts, negative life events, absolute lymphocyte counts, treatment group, and fatigue) were measured at baseline to predict depression and anxiety symptoms at 12 months. RESULTS Data show 14% (n = 15) and 12% (n = 13) of patients experienced moderate-severe depression and anxiety symptoms, respectively. Multiple linear regression analyses found medical comorbidities predicted 12-month anxiety symptoms (p < 0.05). Also, negative life events predicted depression and anxiety symptoms and fatigue predicted depression symptoms (p < 0.05). CONCLUSION Empirically supported risk factors associated with depression and anxiety symptoms are limited in predicting future depression and anxiety symptoms beyond initial screening in patients with CLL. In addition to levels of depression and anxiety symptoms at baseline, negative life events, higher levels of fatigue, and greater medical comorbidities were associated with future depression or anxiety symptoms in patients with CLL.
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Affiliation(s)
- Abigail S Robbertz
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA.
| | - David M Weiss
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
| | - Farrukh T Awan
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
| | - John C Byrd
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
| | - Kerry A Rogers
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
| | - Jennifer A Woyach
- Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA
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Perry LM, Hoerger M, Sartor O, Robinson WR. Distress among African American and White adults with cancer in Louisiana. J Psychosoc Oncol 2019; 38:63-72. [PMID: 31322062 DOI: 10.1080/07347332.2019.1634176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose/Objectives: Screening for distress is a key priority in cancer care, and African American patients may experience increased distress compared to White patients. However, this question has not yet been addressed in Louisiana. The purpose of the present study was to examine the relationship between African American race and distress at a cancer center in Louisiana.Design/Methods: This was a retrospective study of 1,544 patients who were treated at an academic cancer center in 2015. Extracted data included patient self-reports of distress using the single-item Distress Thermometer (DT) and demographic and clinical characteristics. Hypotheses were tested using logistic regression.Findings: Distress was present in 19.7% of the sample. In univariate analyses, African American patients were more likely than White patients to experience distress (OR = 1.38, p = .013). However, race was no longer associated with distress in a multivariate analysis that adjusted for the covariates of age, gender, cancer site, presence of metastases, and number of distress screenings (OR = 1.07, p = .670). Distress was more common in patients who were younger (OR = 2.26, p < .001), diagnosed with lung/bronchus cancer (OR = 5.28, p < .001), or screened more often (OR = 5.20, p < .001). Distress was less common among patients with female breast cancer (OR = 0.39, p = .015).Conclusions/Implications: This study suggests that African American individuals with cancer in Louisiana are at increased risk for distress, but that this can be attributed to African American patients being younger, more likely to have lung cancer, and screened more frequently. Implications include careful consideration of patient race, age, and cancer site during distress management in cancer care.
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Affiliation(s)
- Laura M Perry
- Department of Psychology, Tulane University, New Orleans, Louisiana, USA
| | - Michael Hoerger
- Department of Psychology, Tulane University, New Orleans, Louisiana, USA.,Tulane Cancer Center, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Oliver Sartor
- Tulane Cancer Center, Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - William R Robinson
- Tulane Cancer Center, Tulane University School of Medicine, New Orleans, Louisiana, USA
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91
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Cheng HH, Kamarck TW, Gianaros PJ, Roecklein KA, Vanegas Y, Tsung A, Geller DA, Marsh JW, Ahmed NS, Steel JL. Socioeconomic disparities of depressive symptoms and cytokines in hepatocellular carcinoma. Psychooncology 2019; 28:1624-1632. [PMID: 31119824 DOI: 10.1002/pon.5127] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 04/12/2019] [Accepted: 04/18/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To examine the associations among socioeconomic factors, depressive symptoms, and cytokines in patients diagnosed with hepatocellular carcinoma (HCC). METHODS A total of 266 patients diagnosed with HCC were administered a battery of questionnaires including a sociodemographic questionnaire and the Center for Epidemiologic StudiesDepression (CES-D) scale. Blood samples were collected to assess serum levels of cytokines using Luminex. Descriptive statistics, Mann-Whitney U, Kruskal-Wallis, linear regression, and Bonferroni corrections were performed to test the hypotheses. RESULTS Of the 266 patients, 24% reported depressive symptoms in the clinical range (CES-D ≥ 22). Females had higher CES-D score than males (Mann-Whitney U = 7135, P = .014, Padj = .028). Being unemployed/disabled (Kruskal-Wallis = 14.732, P = .001, Padj = .005) was found to be associated with higher depressive symptoms in males but not in females. Serum level of IL-2 (Kruskal-Wallis = 17.261, P = .001, Padj = .005) were found to be negatively associated with education level. Gender (β = .177, P = .035), income (β = -.252, P = .004), whether the patient's income met their basic needs (β = .180, P = .035), and IL-1β (β = -.165, P = .045) independently predicted depressive symptoms and together explained 19.4% of variance associated with depressive symptoms. CONCLUSIONS Sociodemographic and socioeconomic factors were predictive of inflammation and depressive symptoms. Recommendations include the development of gender-targeted interventions for patients diagnosed with HCC who have low socioeconomic status (SES) and may suffer from depressive symptoms.
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Affiliation(s)
- Hoyee H Cheng
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Thomas W Kamarck
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Peter J Gianaros
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kathryn A Roecklein
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Yanet Vanegas
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Allan Tsung
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - David A Geller
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - James W Marsh
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Surgery, West Virginia University, Morgantown, West Virginia
| | - Nadia S Ahmed
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jennifer L Steel
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
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92
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The Relationships Among Symptom Distress, Posttraumatic Stress Symptoms, and Depression in Patients With Female-specific Cancers. Cancer Nurs 2019; 41:181-188. [PMID: 28151832 DOI: 10.1097/ncc.0000000000000479] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Previous studies have demonstrated that posttraumatic stress symptoms (PTSS) affect women with breast cancer. However, few studies have explored the relationships among PTSS, symptom distress, and depression in association with cancers specific to women in Taiwan. OBJECTIVE The aim of this study was to explore the relationships among symptom distress, PTSS, and depression in women given a diagnosis of female-specific cancers. METHODS A cross-sectional design was used, and 220 women given a diagnosis of female-specific cancer were recruited from a general hospital in southern Taiwan. The outcome measures included the subjects' scores on a symptom distress scale, the Chinese Davidson Trauma Scale, and the Center for Epidemiologic Studies-Depressive Scale; their personal characteristics; and disease-related variables. RESULTS There were significant positive relationships among the frequency of PTSS, the severity of PTSS, symptom distress, and depressive symptoms. Logistic regression analysis demonstrated that educational level, symptom distress, and the frequency of PTSS were significant predictors of depression. CONCLUSIONS The study demonstrated a high prevalence of depression in women with female-specific cancer, and the results confirm the relationship between PTSS and depression. In addition, educational level and physical distress were also found to be predictors of depression. IMPLICATIONS FOR PRACTICE Screening for depressive symptoms should be a component of routine screening in women with female-specific cancer. Oncology nurses should be aware of the distress symptoms experienced by these women and recognize PTSS in patients who are given a diagnosis of female-specific cancer. Awareness will reduce the multiple risks of posttraumatic stress disorder and depression and decrease the depressive symptoms of women after surviving cancer.
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93
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Parpa E, Kostopoulou S, Tsilika E, Galanos A, Mystakidou K. Depression as a Mediator or Moderator Between Preparatory Grief and Sense of Dignity in Patients With Advanced Cancer. Am J Hosp Palliat Care 2019; 36:1063-1067. [PMID: 31014076 DOI: 10.1177/1049909119844783] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objectives of the study were to evaluate the relationship between depression, preparatory grief, and loss of dignity in patients with advanced cancer and whether depression has a mediator and/or a mediator role between preparatory grief and dignity. The participants were 120 patients with advanced cancer who completed the Greek version of the Patient Dignity Inventory, the Greek Hospital Anxiety and Depression Scale, and the Preparatory Grief in Advanced Cancer Patients questionnaire. Depression was highly correlated with preparatory grief and loss of dignity. Additionally, strong relationship was found between preparatory grief and loss of dignity. Mediation analyses revealed that preparatory grief influenced loss of dignity as well as indirectly by its effect on depression. However, there was not any affect of depression as moderator. The effect of depression on preparatory grief in patients with advanced cancer and dignity emphasizing the need for further research to confirm the current relationship as well as the need for treatment of depression.
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Affiliation(s)
- Efi Parpa
- 1 Departmet of Radiology, Pain Relief and Palliative Care Unit, Areteion Hospital, National & Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Sotiria Kostopoulou
- 1 Departmet of Radiology, Pain Relief and Palliative Care Unit, Areteion Hospital, National & Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Eleni Tsilika
- 1 Departmet of Radiology, Pain Relief and Palliative Care Unit, Areteion Hospital, National & Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Antonis Galanos
- 1 Departmet of Radiology, Pain Relief and Palliative Care Unit, Areteion Hospital, National & Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Kyriaki Mystakidou
- 1 Departmet of Radiology, Pain Relief and Palliative Care Unit, Areteion Hospital, National & Kapodistrian University of Athens, School of Medicine, Athens, Greece
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94
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Saracino RM, Nelson CJ. Identification and treatment of depressive disorders in older adults with cancer. J Geriatr Oncol 2019; 10:680-684. [PMID: 30797709 DOI: 10.1016/j.jgo.2019.02.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 12/04/2018] [Accepted: 02/11/2019] [Indexed: 01/07/2023]
Abstract
The increasing number of older adults living with cancer will inevitably include vulnerable subgroups who experience a range of depressive symptoms throughout the care continuum. It is well established that depression can lead to decreased quality of life, poor treatment adherence, increased length of hospital stay and health service utilization, and in severe cases, suicide. Thus, clinicians working in oncology must be able to identify, conceptualize, and treat (or connect to services) the mental health concerns of their older patients. This brief review describes the unique etiologies, features, and treatments for depressive syndromes among older adults in the oncology setting, drawing on the literature and prevailing depression management guidelines from both psycho-oncology and geriatric depression research.
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Affiliation(s)
- Rebecca M Saracino
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America.
| | - Christian J Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America.
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95
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Shyu IL, Hu LY, Chen YJ, Wang PH, Huang BS. Risk factors for developing depression in women with cervical cancer: a nationwide population-based study in Taiwan. Int J Womens Health 2019; 11:135-141. [PMID: 30804687 PMCID: PMC6371941 DOI: 10.2147/ijwh.s193003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Introduction Depression might affect women with cervical cancer and can deteriorate their quality of life or even their compliance with cancer treatments. The aim of this study was to investigate the incidence of depression and risk factors for developing depression among women with cervical cancer in Taiwan. Patients and methods This study enrolled patients with newly diagnosed cervical cancer from the National Health Insurance Research Database in Taiwan. From a population of 21,400,826 residents, each cervical cancer patient was matched with one subject without cervical cancer according to sex, age, and comorbidities with the same diagnostic index. The International Classification of Diseases, Ninth Revision, code 180.9 was used to identify patients with cervical cancer, and 296.0X–296.1X, 296.4X–296.8X, 296.2X–296.3X, 300.4, and 311.X codes were used to identify those with depressive disorders. Results In total, 19,316 newly diagnosed cervical cancer patients were enrolled from January 2000 to December 2005, and the median follow-up period was 5.23 years (1.75–8.48 years). The prevalence of depressive disorder was 4.21% (813 of 19,316) in the cervical cancer cohort, and it was 3.85% (744 of 19,316) in the control cohort. The incidence risk ratio of depressive disorders was 1.35 (95% CI =1.22–1.49, P<0.001) among these cervical cancer patients. Cervical cancer, as an independent risk factor, was associated with developing subsequent depressive disorder. In addition, being older (≥65 years old) and the comorbidities of diabetes mellitus, ischemic heart disease, and cerebrovascular disease were also risk factors for predicting depressive disorder in cervical cancer patients. Discussion Cervical cancer is a prominent risk factor for the development of depression in women with cervical cancer in Taiwan. The patients with comorbidities, including diabetes mellitus, ischemic heart disease, and cerebrovascular disease, have higher risks of developing depression. However, there were no significant differences among the cervical cancer treatment modalities. In conclusion, these patients require early psychological support and intervention.
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Affiliation(s)
- Ing-Luen Shyu
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, .,Department of Obstetrics and Gynecology, Chi-Mei Hospital, Tainan City, Taiwan
| | - Li-Yu Hu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Jen Chen
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, .,Department of Obstetrics and Gynecology, School of Medicine, Taipei, Taiwan, .,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan,
| | - Peng-Hui Wang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, .,Department of Obstetrics and Gynecology, School of Medicine, Taipei, Taiwan, .,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan,
| | - Ben-Shian Huang
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan, .,Department of Obstetrics and Gynecology, School of Medicine, Taipei, Taiwan, .,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan,
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96
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McFarland DC. New lung cancer treatments (immunotherapy and targeted therapies) and their associations with depression and other psychological side effects as compared to chemotherapy. Gen Hosp Psychiatry 2019; 60:148-155. [PMID: 31056371 PMCID: PMC7238762 DOI: 10.1016/j.genhosppsych.2019.04.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Revised: 03/15/2019] [Accepted: 04/01/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Lung cancer carries a high prevalence of distress, anxiety and depression. New treatments, targeted therapy and immunotherapy have changed the disease course for subsets of patients and confer longer survival, but their psychological associations and possible mechanisms (e.g., inflammation and physical symptoms) are not well described. METHOD Patients with metastatic lung cancer undergoing systemic treatment (n = 109) were evaluated for distress, self-endorsed problems using the Distress Thermometer and Problem List, and depression and anxiety using the Hospital Anxiety and Depression Scale. Demography, cancer-related information, and inflammation were evaluated for their associations with chemotherapy, targeted therapy, and immunotherapy. Inflammation was measured by C-reactive protein, albumin, and neutrophil to lymphocyte ratio. RESULTS Chemotherapies were given most often followed by immunotherapy and targeted therapies. Depression and anxiety were endorsed by 23.9%, respectively, and 41.1% had significant distress. Chemotherapy was associated with depression (p = .006) and inflammation (p < .001). Physical symptoms were the same among treatment types. Targeted therapy and immunotherapy predicted for less depression (p = .04, p = .04 respectively) than chemotherapy when controlling for age, sex, and performance status however these predictors where not significant when controlled for inflammation. CONCLUSION New immunotherapy and targeted therapies are associated with less depression and inflammation among patients who are living longer while their physical symptoms are the same.
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Affiliation(s)
- Daniel C. McFarland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
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97
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Looijmans M, van Manen AS, Traa MJ, Kloover JS, Kessels BLJ, de Vries J. Psychosocial consequences of diagnosis and treatment of lung cancer and evaluation of the need for a lung cancer specific instrument using focus group methodology. Support Care Cancer 2018; 26:4177-4185. [PMID: 29948393 PMCID: PMC6209000 DOI: 10.1007/s00520-018-4291-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Accepted: 05/23/2018] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Patients with lung cancer (LC) have high rates of psychosocial symptoms and international guidelines recommend regular psychosocial screening during treatment. This study evaluates psychosocial consequences of diagnosis and treatment of LC in a qualitative way and evaluates the need for a LC specific screening instrument. METHODS Focus group meetings with LC patients were divided by treatment type. Patients discussed psychological and social consequences of diagnosis and treatment. Major themes were identified using content analysis. Themes were re-evaluated in a subsequent focus group, in accordance with the European Organization for Research and Treatment of Cancer (EORTC) guidelines. RESULTS Patients reported a range of psychosocial consequences, such as frustration due to physical limitations, fear of recurrence, sadness of leaving behind partner and children, and disappointing social support. Patients treated with palliative intent specifically indicated insecurities about the future. Patients from all treatment modalities indicated a need for family support during treatment. No themes specific to LC arose. CONCLUSIONS Patients with LC are coping with a range of psychosocial consequences, independent of the type of treatment they receive. Fear of recurrence/metastasis and insecurity about the future were more prominent in patients receiving palliative chemotherapy. Themes were not specific to LC; therefore, a screening instrument specific for the LC population does not seem required. However, the current standard for screening is considered insufficiently sensitive and a stepped screening approach with specific screening tools and a clinical interview is suggested as usual care.
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Affiliation(s)
- Milou Looijmans
- CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000, Tilburg, LE, The Netherlands
| | - Annick S van Manen
- CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000, Tilburg, LE, The Netherlands
| | - Marjan J Traa
- CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000, Tilburg, LE, The Netherlands
- Department of Medical Psychology, Elisabeth Tweesteden Hospital, Tilburg, The Netherlands
| | - Jeroen S Kloover
- Department of Respiratory Diseases, Elisabeth Tweesteden Hospital, Tilburg, The Netherlands
| | - Bart L J Kessels
- Department of Respiratory Diseases, Elisabeth Tweesteden Hospital, Tilburg, The Netherlands
| | - Jolanda de Vries
- CoRPS - Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000, Tilburg, LE, The Netherlands.
- Department of Medical Psychology, Elisabeth Tweesteden Hospital, Tilburg, The Netherlands.
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98
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Hedman C, Djärv T, Strang P, Lundgren CI. Fear of Recurrence and View of Life Affect Health-Related Quality of Life in Patients with Differentiated Thyroid Carcinoma: A Prospective Swedish Population-Based Study. Thyroid 2018; 28:1609-1617. [PMID: 30244657 DOI: 10.1089/thy.2018.0388] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Differentiated thyroid cancer (DTC) has a good prognosis but a remaining risk of recurrence and need for lifelong follow-up. The aim was to study changes in health-related quality of life (HRQoL) from diagnosis to one year of follow-up. METHODS In this prospective population-based study, patients were identified from all the Swedish departments of oncology treating DTC. In total, 487 patients diagnosed with DTC between 2012 and 2017 were invited to answer the Swedish version of the Short Form-36 Health Survey (SF-36) and a study-specific questionnaire at diagnosis and after one year. RESULTS In total, 349 (72%) patients responded. Of these, 235 (67%) had reached one year of follow-up and also answered the questionnaire after one year. Of those, 23% had a negative view of life, and 75% had a fear of recurrence at diagnosis. These patients had a significantly lower HRQoL on eight and five of the SF-36 domains, respectively (p < 0.05). A negative view of life and a fear of recurrence also affected HRQoL negatively after one year of follow-up, with a significantly lower HRQoL on seven SF-36 domains for those reporting a negative view of life or fear of recurrence often (p < 0.05). Thyrotropin suppression did not affect HRQoL negatively. In regression models, HRQoL at diagnosis was the most important predictive factor for HRQoL at the one-year follow-up. CONCLUSIONS Despite a good prognosis, HRQoL was substantially affected at the time of diagnosis, with some improvements after one year. As fear of recurrence and a negative view of life substantially affect HRQoL, these patients should be given additional attention.
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Affiliation(s)
- Christel Hedman
- 1 Department of Molecular Medicine and Surgery, Solna, Karolinska Institutet , Stockholm, Sweden
- 2 Stockholms Sjukhem Foundation's R&D Department , Stockholm, Sweden
| | - Therese Djärv
- 3 Department of Medicine, Solna, Karolinska Institutet , Stockholm, Sweden
- 4 Karolinska University Hospital , Stockholm, Sweden
| | - Peter Strang
- 2 Stockholms Sjukhem Foundation's R&D Department , Stockholm, Sweden
- 5 Department of Oncology-Pathology, and Solna, Karolinska Institutet , Stockholm, Sweden
| | - Catharina Ihre Lundgren
- 1 Department of Molecular Medicine and Surgery, Solna, Karolinska Institutet , Stockholm, Sweden
- 4 Karolinska University Hospital , Stockholm, Sweden
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99
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Bergerot CD, Battle D, Staehler MD, Pal SK. Distress in patients with renal cell carcinoma: a curious gap in knowledge. BJU Int 2018; 123:208-209. [DOI: 10.1111/bju.14564] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Cristiane Decat Bergerot
- Department of Medical Oncology and Experimental Therapeutics; City of Hope Comprehensive Cancer Center; Duarte CA USA
| | - Dena Battle
- Kidney Cancer Research Alliance (KCCure); Alexandria VA USA
| | | | - Sumanta Kumar Pal
- Department of Medical Oncology and Experimental Therapeutics; City of Hope Comprehensive Cancer Center; Duarte CA USA
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100
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Neuroimmunomodulation in Major Depressive Disorder: Focus on Caspase 1, Inducible Nitric Oxide Synthase, and Interferon-Gamma. Mol Neurobiol 2018; 56:4288-4305. [PMID: 30306457 PMCID: PMC6505498 DOI: 10.1007/s12035-018-1359-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 09/19/2018] [Indexed: 12/13/2022]
Abstract
Major depressive disorder (MDD) is one of the leading causes of disability worldwide, and its incidence is expected to increase. Despite tremendous efforts to understand its underlying biological mechanisms, MDD pathophysiology remains elusive and pharmacotherapy outcomes are still far from ideal. Low-grade chronic inflammation seems to play a key role in mediating the interface between psychological stress, depressive symptomatology, altered intestinal microbiology, and MDD onset. We review the available pre-clinical and clinical evidence of an involvement of pro-inflammatory pathways in the pathogenesis, treatment, and remission of MDD. We focus on caspase 1, inducible nitric oxide synthase, and interferon gamma, three inflammatory systems dysregulated in MDD. Treatment strategies aiming at targeting such pathways alone or in combination with classical therapies could prove valuable in MDD. Further studies are needed to assess the safety and efficacy of immune modulation in MDD and other psychiatric disorders with neuroinflammatory components.
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