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Predictors of Psychological Distress After Diagnosis in Breast Cancer Patients and Patients with Benign Breast Problems. PSYCHOSOMATICS 2011; 52:56-64. [DOI: 10.1016/j.psym.2010.11.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2009] [Revised: 10/05/2009] [Accepted: 10/14/2009] [Indexed: 11/18/2022]
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102
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Manoudi F, Chagh R, Asri F, Tarwate M, Tazi I, Tahiri A, Bouras N. Les troubles dépressifs chez les patients atteints de cancer. Une étude marocaine. PSYCHO-ONCOLOGIE 2010. [DOI: 10.1007/s11839-010-0253-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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103
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Thomas KS, Bower J, Hoyt MA, Sepah S. Disrupted sleep in breast and prostate cancer patients undergoing radiation therapy: the role of coping processes. Psychooncology 2010; 19:767-76. [PMID: 19885853 DOI: 10.1002/pon.1639] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Sleep problems are a common complaint in cancer patients that have been understudied. METHODS This study examined changes in sleep in 33 breast cancer (BC) patients and 23 prostate cancer (PC) patients during radiation therapy and over a 6-month followup. Coping processes were examined as predictors of sleep. Self-reported sleep was assessed at eight time-points before, during, and after treatment using the Medical Outcomes Study-Sleep Scale. The COPE Scale was used to assess coping processes before treatment onset. RESULTS Mixed effects linear modeling analyses revealed that both BC and PC patients reported the most sleep problems prior to and during the early weeks of treatment. Coping strategies predicted sleep trajectories in both groups. In particular, approach coping predicted better sleep in PC patients, whereas avoidance coping predicted worst sleep in both PC and BC patients (p's<0.05). CONCLUSION These findings highlight the importance of evaluating sleep in patients as they undergo treatment for cancer. Additionally, they suggest that interventions aimed at increasing the use of approach-oriented coping strategies may improve sleep and quality of life in these patients.
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Affiliation(s)
- Kamala S Thomas
- Department of Psychology, Pitzer College, Claremont, CA 91711, USA.
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104
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Vehling S, Lehmann C, Oechsle K, Bokemeyer C, Krüll A, Koch U, Mehnert A. Is advanced cancer associated with demoralization and lower global meaning? The role of tumor stage and physical problems in explaining existential distress in cancer patients. Psychooncology 2010; 21:54-63. [DOI: 10.1002/pon.1866] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Revised: 07/29/2010] [Accepted: 09/13/2010] [Indexed: 11/10/2022]
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105
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Friedman LC, Barber CR, Chang J, Tham YL, Kalidas M, Rimawi MF, Dulay MF, Elledge R. Self-blame, self-forgiveness, and spirituality in breast cancer survivors in a public sector setting. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2010; 25:343-348. [PMID: 20186521 DOI: 10.1007/s13187-010-0048-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2009] [Accepted: 01/08/2010] [Indexed: 05/28/2023]
Abstract
Cognitive appraisal affects adjustment to breast cancer. A self-forgiving attitude and spirituality may benefit breast cancer survivors who blame themselves for their cancer. One hundred and eight women with early breast cancers completed questionnaires assessing self-blame, self-forgiveness, spirituality, mood and quality of life (QoL) in an outpatient breast clinic. Women who blamed themselves reported more mood disturbance (p < 0.01) and poorer QoL (p < 0.01). Women who were more self-forgiving and more spiritual reported less mood disturbance and better QoL (p's < 0.01). Interventions that reduce self-blame and facilitate self-forgiveness and spirituality could promote better adjustment to breast cancer.
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Affiliation(s)
- Lois C Friedman
- Department of Psychiatry, Ireland Cancer Center, University Hospitals Case Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
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106
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Jones JM, Cheng T, Jackman M, Rodin G, Walton T, Catton P. Self-efficacy, perceived preparedness, and psychological distress in women completing primary treatment for breast cancer. J Psychosoc Oncol 2010; 28:269-90. [PMID: 20432117 DOI: 10.1080/07347331003678352] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The present analyses were conducted to examine demographic and clinical variables associated with mood and health-related distress in a sample of 440 women completing primary treatment for early-stage breast cancer. The authors' aim was to test the hypothesis that higher levels of self-efficacy and perceived preparedness for the end of treatment--the reentry phase--are associated with better mood and lower health-related distress in this sample. Women who had received chemotherapy and who were younger (<50 years) had significantly higher mood disturbance and health-related distress scores. Younger age, preparedness, and self-efficacy predicted 36% of the variance in mood disturbance scores. Self-efficacy and age predicted 26% of the variance in health-related distress. Although further research is needed, our findings suggest that self-efficacy and perceived preparedness represent important constructs to target in the development of interventions for women at the reentry transition.
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Affiliation(s)
- Jennifer M Jones
- Department of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, University Health Network, Toronto, Ontario, Canada.
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107
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Talley A, Molix L, Schlegel RJ, Bettencourt A. The influence of breast cancer survivors' perceived partner social support and need satisfaction on depressive symptoms: a longitudinal analysis. Psychol Health 2010; 25:433-49. [PMID: 20397295 DOI: 10.1080/08870440802582682] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The present study examines the ways in which breast cancer survivors' perceptions of emotional and instrumental social support from an intimate partner and need satisfaction in their partner role influence depression during and after breast cancer treatment. Our sample was comprised of 163 women who were an average of 57 years old, mostly White/Caucasian, and diagnosed primarily with early-stage breast cancer. Longitudinal data were analysed using both multilevel and structural equation modelling. Results reveal that (a) greater perceived partner emotional support is associated with lowered levels of depression at each wave, (b) partner-role need satisfaction mediates the relationship between perceived partner emotional support and depression at each wave, (c) perceived partner emotional support predicts subsequent changes in depression by way of need satisfaction and (d) depression prospectively predicts lowered perceptions of partner emotional and instrumental support. The findings confirm that basic need satisfaction, within intimate relationships, is an important predictor of lowered depression among breast cancer survivors.
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Affiliation(s)
- Amelia Talley
- Department of Psychological Sciences, University of Missouri, Columbia, SC, USA.
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108
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Shapiro JP, McCue K, Heyman EN, Dey T, Haller HS. A naturalistic evaluation of psychosocial interventions for cancer patients in a community setting. J Psychosoc Oncol 2010; 28:23-42. [PMID: 20391064 DOI: 10.1080/07347330903438891] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
We used a naturalistic methodology to examine associations between change in cancer patients' emotional functioning and their use of interventions in a community organization. One-hundred ninety-two patients completed measures at baseline and 6 months later. During this time, they utilized the organization's various interventions as they wished. Attendance at educational events was associated with decreased well-being. Use of art therapy groups was not associated with decreases in negative emotion but was consistently associated with increases in positive emotion. Improved functioning on some measures was associated with use of psychoeducational groups, expressive/supportive groups, movement classes, healing arts, and a buddy-matching service.
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109
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Tuinman MA, Hoekstra HJ, Vidrine DJ, Gritz ER, Sleijfer DT, Fleer J, Hoekstra-Weebers JEHM. Sexual function, depressive symptoms and marital status in nonseminoma testicular cancer patients: a longitudinal study. Psychooncology 2010; 19:238-47. [PMID: 19319832 DOI: 10.1002/pon.1560] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
GOAL To longitudinally investigate sexual functioning in testicular cancer patients during the first year, and examine the effect of relationship status (with a partner or single) and depressive symptoms on sexual functioning. PATIENTS AND METHODS 93 testicular cancer patients (39% single) treated in two large referral centers for testicular cancer filled in the International Index of Erectile Function (IIEF) and CES-D after orchiectomy (T1) and 3 (T2) and 12 (T3) months later. RESULTS Orgasmic functioning, overall satisfaction and total sexual functioning decreased between T1 and T2 and increased to an above T1 level at T3. Levels of erectile functioning and intercourse satisfaction were higher at T3 than at T1 and T2. Desire remained stable. Type of treatment did not affect sexual functioning. Singles reported worse sexual functioning at all measurement times than committed patients, and comparable desire. One year after surgery, singles also reported worse sexual functioning on three domains when compared with norms. Depressive symptoms were highest and significantly but weakly related to one domain of sexual functioning at T1, to three domains at T2, and to none at T3. Early depressive symptoms had small to moderate predictive power on sexual functioning at T2, but not at T3. CONCLUSION Sexual functioning, but not desire, fluctuates during the first year after testicular cancer. Type of treatment and depressive symptoms were no risk factors for sexual dysfunction in the longer term. Singles reported more sexual problems than patients in a relationship and norms, they may need more information and guidance concerning their sexuality.
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Affiliation(s)
- Marrit A Tuinman
- Department of Surgical Oncology, University of Groningen and University Medical Center Groningen, Groningen, The Netherlands
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110
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Härtl K, Schennach R, Müller M, Engel J, Reinecker H, Sommer H, Friese K. Quality of Life, Anxiety, and Oncological Factors: A Follow-Up Study of Breast Cancer Patients. PSYCHOSOMATICS 2010. [DOI: 10.1016/s0033-3182(10)70671-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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111
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Depressive symptoms among young breast cancer survivors: the importance of reproductive concerns. Breast Cancer Res Treat 2010; 123:477-85. [PMID: 20130979 DOI: 10.1007/s10549-010-0768-4] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2009] [Accepted: 01/22/2010] [Indexed: 10/19/2022]
Abstract
Breast cancer diagnosis and treatment can negatively impact fertility in premenopausal women and influence reproductive planning. This study investigates whether concerns about reproduction after breast cancer treatment were associated with long-term depressive symptoms. Participants include 131 women diagnosed with early-stage breast cancer at age 40 or younger participating in the Women's Healthy Eating and Living (WHEL) Survivorship Study. Participants were enrolled an average of 1.5 years postdiagnosis and depressive symptoms were monitored 6 times throughout the average additional 10 year follow-up period. Detailed recall of reproductive concerns after treatment was collected an average of 12 years postdiagnosis. Multilevel regression was used to evaluate whether mean long-term depressive symptoms differed as a function of reproductive concerns and significant covariates. Multilevel regression identified greater recalled reproductive concerns as an independent predictor of consistent depressive symptoms after controlling for both social support and physical health (B = 0.02, SE = 0.01, P = 0.04). In bivariate analyses, being nulliparous at diagnosis and reporting treatment-related ovarian damage were both strongly associated with higher reproductive concerns and with depressive symptoms. Reported reproductive concerns after breast cancer treatment were a significant contributor to consistent depressive symptoms. Younger survivors would benefit from additional information and support related to reproductive issues.
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112
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Härtl K, Engel J, Herschbach P, Reinecker H, Sommer H, Friese K. Personality traits and psychosocial stress: quality of life over 2 years following breast cancer diagnosis and psychological impact factors. Psychooncology 2010; 19:160-9. [DOI: 10.1002/pon.1536] [Citation(s) in RCA: 111] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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113
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Siedentopf F, Marten-Mittag B, Utz-Billing I, Schoenegg W, Kentenich H, Dinkel A. Experiences with a specific screening instrument to identify psychosocial support needs in breast cancer patients. Eur J Obstet Gynecol Reprod Biol 2010; 148:166-71. [DOI: 10.1016/j.ejogrb.2009.10.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Revised: 08/31/2009] [Accepted: 10/14/2009] [Indexed: 10/20/2022]
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114
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Schmid-Büchi S, Halfens RJG, Dassen T, van den Borne B. Psychosocial problems and needs of posttreatment patients with breast cancer and their relatives. Eur J Oncol Nurs 2010; 15:260-6. [PMID: 20089447 DOI: 10.1016/j.ejon.2009.11.001] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2009] [Revised: 11/20/2009] [Accepted: 11/24/2009] [Indexed: 11/18/2022]
Abstract
PURPOSE The study assessed and compared the psychosocial needs of patients with breast cancer and of their relatives, the patients' and relatives' burden of illness, anxiety, depression and distress and assessed the patients' cancer treatment-related symptoms and identified relevant factors influencing patients' and relatives' needs. METHOD Seventy-two patients (n=72) participated with a relative in a cross-sectional mail-survey, 1-22 months after cancer treatment. RESULTS The patients reported needing help with psychological and sexual issues. They suffered from treatment-related symptoms. More treatment-related symptoms and depression were related to the patients' needs for supportive care. Their relatives' needs primarily concerned access to information and communication with health care professionals. Relatives had higher levels of anxiety (25.0% vs. 22.2%), depression (12.5% vs. 8.3%) and distress (40% vs. 34%) than patients. Higher levels of depression, younger age and having a disease themselves were associated with relatives' need for help. CONCLUSION Patients' and relatives' substantial needs and psychological problems require professional support even after completion of the patients' treatment. Continued assessment of the patients' and their relatives' needs and of the patients' symptoms provide the basis for purposeful counselling and education. Rehabilitation programs for patients and their relatives should be developed and implemented in clinical practice.
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115
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Shapiro JP, McCue K, Heyman EN, Dey T, Haller HS. Coping-Related Variables Associated with Individual Differences in Adjustment to Cancer. J Psychosoc Oncol 2010; 28:1-22. [DOI: 10.1080/07347330903438883] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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116
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Chen X, Lu W, Zheng Y, Gu K, Chen Z, Zheng W, Shu XO. Exercise, tea consumption, and depression among breast cancer survivors. J Clin Oncol 2010; 28:991-8. [PMID: 20048185 DOI: 10.1200/jco.2009.23.0565] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To examine the association of lifestyle factors and supplement use with depression among breast cancer survivors. PATIENTS AND METHODS In a population-based cohort study conducted between April 2002 and December 2006 in Shanghai, China, a total of 1,399 women who were diagnosed with stage 0 to III breast cancer completed 6-month and 18-month postdiagnosis, in-person interviews. Information on sociodemographic, clinical, and lifestyle factors were collected through the interviews and through review of medical charts at approximately 6 months postdiagnosis. A metabolic equivalent (MET) score was calculated from reported exercise activities. Quality of life (QOL) was evaluated by the Medical Outcomes Short Form-36 Health Survey at 6 months postdiagnosis. Depressive symptoms were measured by using a 20-item Center for Epidemiological Studies-Depression Scale at approximately 18 months postdiagnosis. Results Overall, 26% of women reported depressive symptoms and 13% met the criteria of clinical depression at 18 months postdiagnosis. Women with a higher exercise level (ie, >/= 8.3 MET h/wk) were less likely to have depression than nonexercisers; the multivariate adjusted odds ratios (ORs) were 0.71 (95% CI, 0.47 to 1.07) for mild depression and 0.56 (95% CI, 0.35 to 0.88) for clinical depression in analyses controlled for sociodemographic and clinical factors and baseline QOL. Women who increased their exercise level had lower risk for depression. Regular tea consumption (ie, > 100 g dried tea leaves/mo) was inversely associated with overall depression (OR, 0.39; 95% CI, 0.19 to 0.84). No associations were found for dietary intake or supplement use with depression. CONCLUSION Regular exercise participation and tea consumption may play an important role in the prevention of depression among breast cancer survivors.
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Affiliation(s)
- Xiaoli Chen
- Vanderbilt Epidemiology Center, 2525 West End Ave, Suite 600, Nashville, TN 37203-1738, USA
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117
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Hopwood P, Sumo G, Mills J, Haviland J, Bliss JM. The course of anxiety and depression over 5 years of follow-up and risk factors in women with early breast cancer: results from the UK Standardisation of Radiotherapy Trials (START). Breast 2009; 19:84-91. [PMID: 20042336 DOI: 10.1016/j.breast.2009.11.007] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2009] [Revised: 09/01/2009] [Accepted: 11/19/2009] [Indexed: 11/12/2022] Open
Abstract
Prospective data are limited on the course of anxiety and depression and their determinants in women with early breast cancer. These parameters were assessed before adjuvant radiotherapy (RT) and over 5 years follow-up. Of 2208 women recruited to the START QOL study, 35% reported clinically relevant levels of anxiety and/or depression pre-RT; there was no significant change in these proportions over time. However, 75% women with high baseline anxiety recorded further high scores over time whilst one in six had high scores at every follow-up point. Depression showed a similar pattern with lower frequencies at all time points; very few with initial normal scores developed clinically relevant anxiety or depression over time. Lower educational level predicted worse anxiety and depression over time; younger age predicted worse anxiety and chemotherapy predicted worse depression. Scores in the borderline or case range for anxiety or depression at baseline were both significantly associated with worse mood states over 5 years. These findings indicate the course of anxiety and depression in women with specific risk factors. This subgroup of patients requires greater clinical attention.
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Affiliation(s)
- Penelope Hopwood
- ICR Clinical Trials and Statistics Unit (ICR-CTSU), Section of Clinical Trials, The Institute of Cancer Research, Sir Richard Doll Building, Cotswold Road, Sutton, Surrey SM2 5NG, UK
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118
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Chen X, Zheng Y, Zheng W, Gu K, Chen Z, Lu W, Shu XO. Prevalence of depression and its related factors among Chinese women with breast cancer. Acta Oncol 2009; 48:1128-36. [PMID: 19863220 DOI: 10.3109/02841860903188650] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND. Little information is available regarding depression among Asian breast cancer survivors. METHODS. We estimated the prevalence of depression and its correlates among 1400 participants of a population-based cohort study of women with stage 0-IV breast cancer in Shanghai, China. Through in-person interviews conducted at 6 months and 18 months post-diagnosis and review of medical charts, information on sociodemographic and clinical factors and quality of life (QOL) was collected. Depression was measured by the 20-item Center for Epidemiologic Studies Depression Scale at 18 months post-diagnosis. RESULTS. Approximately 26% of participants had mild to severe depression and 13% fulfilled the criteria of clinical depression at 18 months post-diagnosis. Women with lower income were more likely to have depression than women with higher income (prevalence: 16.6% vs. 6.9% for mild depression and 17.1% vs. 5.5% for clinical depression, respectively). Depression was more common among women who were widowed (18.9%) or divorced/separated/single (16.4%) than among women who were married (11.8%). Women with comorbidity were more likely to have clinical depression (17.3% vs 11.2%). Multivariate analysis showed that low income, marital status, comorbidity, and low QOL scores were independent predictors for depression. We did not find that prevalence of depression differed by menopausal status, estrogen or progesterone receptor status, disease stage, or cancer-related treatments. CONCLUSION. Depression is common among Asian women with breast cancer. Routine screening and prevention of depression are warranted among women with breast cancer.
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Affiliation(s)
- Xiaoli Chen
- Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, 2525 West End Avenue, Suite 600, Nashville, TN, 37203, USA
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119
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Den Oudsten BL, Van Heck GL, Van der Steeg AFW, Roukema JA, De Vries J. Predictors of depressive symptoms 12 months after surgical treatment of early-stage breast cancer. Psychooncology 2009; 18:1230-7. [PMID: 19142843 DOI: 10.1002/pon.1518] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Brenda L Den Oudsten
- CoRPS-Center of Research on Psychology in Somatic Diseases, Department of Medical Psychology, Tilburg University, 5000 LE Tilburg, The Netherlands
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120
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The psychological responses of outpatient breast cancer patients before and during first medical consultation. Palliat Support Care 2009; 7:307-14. [DOI: 10.1017/s147895150999023x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObjective:The purpose of this study was to qualitatively examine the content of the psychological responses in interviews with breast cancer outpatients receiving initial medical consultation.Method:The participants were 180 people who visited the breast cancer outpatient clinic at Kitasato University Hospital between November 2004 and August 2005. The remaining 176 participants (39 breast cancer patients and 137 benign tumor patients; average age ± SD: 50.7 ± 12.4 years) were analyzed. Two clinical psychologists carried out the interview, asking the participants to speak freely about their anxieties, worries, thoughts, and feelings up until the medical examination. This study used a content analysis of interviews to chronologically examine psychological response of cancer patients seeking medical consultation at three points in time.Results:Patients at the time of their first outpatient breast cancer consultation experience negative feelings before the examination, directly influenced by the suspicion of cancer. These include anxiety and worries, fear, evasion, depression, and impatience. These tendencies do not change at the time of consultation. However, in addition to negative feelings, some people also possess positive feelings, either simultaneously or at a different point in time. Further, many patients tend to talk at length about psychological responses before seeking treatment, understanding the process they went through to come to seek treatment as an important event.Significance of results:It is important for medical workers to bear in mind the psychological conflicts that patients may undergo before seeking treatment and ensure that sufficient communication takes place.
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121
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Brothers BM, Andersen BL. Hopelessness as a predictor of depressive symptoms for breast cancer patients coping with recurrence. Psychooncology 2009; 18:267-75. [PMID: 18702065 DOI: 10.1002/pon.1394] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The Hopelessness Theory of Depression provides the framework to test feelings of hopelessness and social support as predictors of depressive symptoms in women recently diagnosed with a recurrence of breast cancer. METHODS Patients (N=67) were assessed within weeks of receiving their recurrence diagnosis (initial) and again 4 months later (follow-up). RESULTS Controlling for their current physical and depressive symptoms, hopelessness at diagnosis was a significant predictor of the maintenance of depressive symptoms among patients. A corollary of the theory was also confirmed: social support (i.e. the presence/absence of a romantic partner) interacted with hopelessness. CONCLUSIONS Women who reported feelings of hopelessness and who were alone (i.e. without a partner) were especially vulnerable to later depressive symptoms. The data provide support for the Hopelessness Theory and suggest factors conferring risk for depressive symptoms for those coping with a worsened cancer prognosis.
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Affiliation(s)
- Brittany M Brothers
- Department of Psychology, The Ohio State University, Columbus, OH 43210-1222, USA
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122
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Siassi M, Weiss M, Hohenberger W, Lösel F, Matzel K. Personality rather than clinical variables determines quality of life after major colorectal surgery. Dis Colon Rectum 2009; 52:662-8. [PMID: 19404072 DOI: 10.1007/dcr.0b013e31819ecf2e] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE Clinical factors, especially the presence of a stoma, have been presumed to be the major determinants of quality of life after colorectal surgery. We investigated the relative influence of other variables, e.g., patient's personality, sense of coherence, and coping strategies, to determine the validity of this long-held assumption. METHODS We investigated 79 patients undergoing major colorectal surgery. Quality of Life was assessed with the Short Form-36 and Gastrointestinal Quality of Life Index questionnaires at three and 12 months postsurgery. Additionally, baseline psychologic data on personality and sense of coherence were assessed. The results were analyzed in both a bivariate manner and by multivariate hierarchical regression analysis. RESULTS In the bivariate analysis, clinical parameters had a small and temporary effect on quality of life, if any. In the multivariate model the character of the underlying disease and the presence of a stoma did not affect quality of life significantly. In contrast, emotional lability, extraversion, and sense of coherence had a strong and lasting influence, accounting for 49 percent of variance (Delta R2) for emotional quality of life, 22 percent for physical and 32 percent for disease-specific Quality of Life. CONCLUSION Personality exerts a strong and lasting effect on quality of life after colorectal surgery. This effect by far exceeds the influence of common clinical variables.
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Affiliation(s)
- Michael Siassi
- University Hospital of Erlangen, Department of General Surgery, Erlangen, Germany.
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123
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Psychological characteristics and subjective symptoms as determinants of psychological distress in patients prior to breast cancer diagnosis. Support Care Cancer 2009; 17:1361-70. [DOI: 10.1007/s00520-009-0593-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2008] [Accepted: 01/26/2009] [Indexed: 11/27/2022]
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124
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Henselmans I, Sanderman R, Baas PC, Smink A, Ranchor AV. Personal control after a breast cancer diagnosis: stability and adaptive value. Psychooncology 2009; 18:104-8. [DOI: 10.1002/pon.1333] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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125
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Course of Distress in Breast Cancer Patients, Their Partners, and Matched Control Couples. Ann Behav Med 2008; 36:141-8. [DOI: 10.1007/s12160-008-9061-8] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2007] [Indexed: 10/21/2022] Open
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126
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Patterns of objective physical functioning and perception of mood and fatigue in posttreatment breast cancer patients and healthy controls: an ambulatory psychophysiological investigation. Psychosom Med 2008; 70:819-28. [PMID: 18725433 DOI: 10.1097/psy.0b013e31818106f1] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To monitor objective physiological and self-report measures among apparently disease-free breast cancer patients (n = 33) in the first 2 years of posttreatment recovery, using a cross-sectional design, and compare findings with women without histories of cancer or other serious disorders (n =33). Time-since-treatment also served as an independent variable. Few studies have examined adjustment of breast cancer patients after primary treatment or objectively characterized posttreatment, everyday patterns of functioning. METHODS A 24-hour ambulatory minute-by-minute cardiorespiratory functioning and accelerometry activity were measured during one day, together with multiple repeated assessments of mood and fatigue. Traditional retrospective measures of well-being were also evaluated. Our ambulatory methodology permitted estimation of physiological rhythms of cardiorespiratory and accelerometry activity. RESULTS Patients reported lower ambulatory levels of energy and poorer mood during the daytime than controls. Time-since-treatment was related directly to both momentary mood and energy as well as to objective measures of activity and respiratory parameters. Retrospective self-reports of impaired mood and symptoms persisted in patients, independently of time-since-treatment and of ambulatory physical or physiological activity. Ambulatory self-report data were associated with concurrent respiratory measures. Chemotherapy-related elevation of heart rate was found but was unrelated to self-report measures. CONCLUSIONS Impaired sense of well being based on retrospective measures is not associated with pattern of physical or physiological functioning after treatment for breast cancer. However, ambulatory, momentary levels of mood and fatigue seem to be related to concurrent ventilatory activity and time-since-treatment. This is the first investigation that relates ambulatory and retrospective measures of affect and fatigue to concurrent, real-life physical functioning.
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The Effect of Psychological Intervention on Personality Change, Coping, and Psychological Distress of Japanese Primary Breast Cancer Patients. Cancer Nurs 2008; 31:E27-35. [DOI: 10.1097/01.ncc.0000305746.49205.f8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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128
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Kim SH, Son BH, Hwang SY, Han W, Yang JH, Lee S, Yun YH. Fatigue and depression in disease-free breast cancer survivors: prevalence, correlates, and association with quality of life. J Pain Symptom Manage 2008; 35:644-55. [PMID: 18358687 DOI: 10.1016/j.jpainsymman.2007.08.012] [Citation(s) in RCA: 179] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2007] [Revised: 07/21/2007] [Accepted: 08/08/2007] [Indexed: 11/26/2022]
Abstract
We performed this study to examine the prevalence and correlates of fatigue and depression, and their relevance to health-related quality of life in disease-free breast cancer survivors. A total of 1,933 breast cancer survivors recruited from five large hospitals in Korea completed a mailed survey, which included the Brief Fatigue Inventory, Beck Depression Inventory, European Organization for Research and Treatment of Cancer QLQ-C30, and QLQ-BR23. With a framework that included sociodemographic, clinical, and symptom characteristics, multivariate logistic regression models were used to identify factors associated with fatigue and depression. Among breast cancer survivors, 66.1% reported moderate to severe fatigue and 24.9% reported moderate to severe depression. Risk factors common to both fatigue and depression were lower income, dyspnea, insomnia, appetite loss, constipation, and arm symptoms. Risk factors for fatigue only included younger age, employment, presence of gastrointestinal disease, and pain. Having a musculoskeletal disease was identified as a risk factor for depression only. Both fatigue and depression were influenced by sociodemographic factors, comorbidity and symptom characteristics rather than cancer or treatment-related factors. Both fatigue and depression were negatively associated with survivors' health-related quality of life. However, the patterns of differences in health-related quality of life according to severity of fatigue or depression were similar. This concurrent examination of risk factors for fatigue and depression may be helpful in the development of clinical management strategies in disease-free breast cancer survivors.
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Affiliation(s)
- Soo Hyun Kim
- National Cancer Control Research Institute and Hospital, National Cancer Center, Goyang, Gyeonggi, Korea
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129
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Bardwell WA, Profant J, Casden DR, Dimsdale JE, Ancoli-Israel S, Natarajan L, Rock CL, Pierce JP. The relative importance of specific risk factors for insomnia in women treated for early-stage breast cancer. Psychooncology 2008; 17:9-18. [PMID: 17428006 PMCID: PMC2575103 DOI: 10.1002/pon.1192] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Many individual risk factors for insomnia have been identified for women with a history of breast cancer. We assessed the relative importance of a wide range of risk factors for insomnia in this population. METHODS Two thousand six hundred and forty-five women < or =4 years post-treatment for Stage I (> or =1 cm)-IIIA breast cancer provided data on cancer-related variables, personal characteristics, health behaviors, physical health/symptoms, psychosocial variables, and the Women's Health Initiative-Insomnia Rating Scale (WHI-IRS; scores > or =9 indicate clinically significant insomnia). RESULTS Thirty-nine per cent had elevated WHI-IRS scores. In binary logistic regression, the variance in high/low insomnia group status accounted for by each risk factor category was: cancer-specific variables, 0.4% (n.s.); personal characteristics, 0.9% (n.s.); health behaviors, 0.6% (n.s.); physical health/symptoms, 13.4% (p<0.001); and, psychosocial factors, 11.4% (p<0.001). Insomnia was associated with worse depressive (OR = 1.32) and vasomotor symptoms (particularly night sweats) (OR = 1.57). CONCLUSION Various cancer-specific, demographic, health behavior, physical health, and psychosocial factors have been previously reported as risk factors for insomnia in breast cancer. In our study (which was powered for simultaneous examination of a variety of variables), cancer-specific, health behavior, and other patient variables were not significant risk factors when in the presence of physical health and psychosocial variables. Only worse depressive and vasomotor symptoms were meaningful predictors.
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Affiliation(s)
- Wayne A Bardwell
- Rebecca & John Moores Cancer Center, University of California, San Diego, CA 92093, USA.
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130
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Von Ah D, Kang DH. Correlates of mood disturbance in women with breast cancer: patterns over time. J Adv Nurs 2008; 61:676-89. [DOI: 10.1111/j.1365-2648.2007.04563.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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131
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Christensen S, Zachariae R, Jensen AB, Vaeth M, Møller S, Ravnsbaek J, von der Maase H. Prevalence and risk of depressive symptoms 3-4 months post-surgery in a nationwide cohort study of Danish women treated for early stage breast-cancer. Breast Cancer Res Treat 2008; 113:339-55. [PMID: 18278553 DOI: 10.1007/s10549-008-9920-9] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2008] [Accepted: 01/28/2008] [Indexed: 11/28/2022]
Abstract
BACKGROUND Elevated levels of depressive symptoms are generally found among cancer patients, but results from existing studies vary considerably with respect to prevalence and proposed risk factors. PURPOSE To study the prevalence of depressive symptoms and major depression 3-4 months following surgery for breast cancer, and to identify clinical risk factors while adjusting for pre-cancer sociodemographic factors, comorbidity, and psychiatric history. PATIENTS AND METHODS The study cohort consists of 4917 Danish women, aged 18-70 years, receiving standardized treatment for early stage invasive breast cancer during the 2 1/2 year study period. Of these, 3343 women (68%) participated in a questionnaire study 12-16 weeks following surgery. Depressive symptoms (Beck's Depression Inventory II) and health-related behaviors were assessed by questionnaire. The Danish Breast Cancer Cooperative Group (DBCG) and the surgical departments provided disease-, treatment-, and comorbidity data for the study cohort. Information concerning sociodemographics and psychiatric history were obtained from national longitudinal registries. RESULTS The results indicated an increased prevalence of depressive symptoms and major depression (13.7%) compared to population-based samples. The pre-cancer variables: Social status, net-wealth, ethnicity, comorbidity, psychiatric history, and age were all independent risk factors for depressive symptoms. Of the clinical variables, only nodal status carried additional prognostic information. Physical functioning, smoking, alcohol use, and BMI were also independently associated with depressive symptoms. CONCLUSION Risk factors for depressive symptoms were primarily restricted to pre-cancer conditions rather than disease-specific conditions. Special attention should be given to socio-economically deprived women with a history of somatic- and psychiatric disease and poor health behaviors.
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Affiliation(s)
- Søren Christensen
- Psychooncology Reseach Unit, Aarhus University Hospital, Nobelparken, Bygn. 1483, 8000, Aarhus C, Denmark.
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132
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Abstract
Behavioral symptoms are a common adverse effect of breast cancer diagnosis and treatment and include disturbances in energy, sleep, mood, and cognition. These symptoms cause serious disruption in patients' quality of life and may persist for years after treatment. Patients need accurate information about the occurrence of these adverse effects as well as assistance with symptom management. This review considers four of the most common behavioral sequelae of breast cancer, namely fatigue, sleep disturbance, depression, and cognitive impairment. Research on the prevalence, mechanisms, and treatment of each symptom is described, concluding with recommendations for future studies.
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Affiliation(s)
- Julienne E Bower
- University of California, Los Angeles, Department of Psychology, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA.
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133
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Gazendam-Donofrio S, Hoekstra H, van der Graaf W, van de Wiel H, Visser A, Huizinga G, Hoekstra-Weebers J. Family functioning and adolescents' emotional and behavioral problems: when a parent has cancer. Ann Oncol 2007; 18:1951-6. [DOI: 10.1093/annonc/mdm373] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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134
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Arving C, Glimelius B, Brandberg Y. Four weeks of daily assessments of anxiety, depression and activity compared to a point assessment with the Hospital Anxiety and Depression Scale. Qual Life Res 2007; 17:95-104. [PMID: 18026852 DOI: 10.1007/s11136-007-9275-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2007] [Accepted: 10/27/2007] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To explore to what extent the daily reporting of anxiety, depression and activity in a diary mirrors scores on point assessments with the Hospital Anxiety and Depression scale (HADS). METHODS In a randomized intervention study consecutive breast cancer patients (n = 179) about to start adjuvant therapy were included. The HADS questionnaires were sent to patients 3 and 12 months after inclusion. Daily reporting of anxiety, depression and activity on Visual Analogue Scales (VAS) were completed during 4 weeks surrounding the HADS assessments. RESULTS The results showed moderate correlations (r = -0.36 to -0.67, P < 0.01) at both assessments. The daily reports were consistent over 4 weeks and did not differ between assessments. Mean scores on the HAD-Anxiety were 4.00 at the 3 months and 5.07 at the 12 months assessment. For the HAD-Depression the mean scores at the same assessment points were 3.61 and 3.23, respectively. The daily reports put more strain on the respondents and produced a larger attrition rate than the HADS. CONCLUSION A point assessment with the HADS captures the situation of breast cancer patients' equivalent to 4 weeks assessment in a diary, but is easier to complete and is therefore preferable to the diary.
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Affiliation(s)
- Cecilia Arving
- Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, 751 83, Uppsala, Sweden.
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135
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Scheier MF, Helgeson VS, Schulz R, Colvin S, Berga SL, Knapp J, Gerszten K. Moderators of interventions designed to enhance physical and psychological functioning among younger women with early-stage breast cancer. J Clin Oncol 2007; 25:5710-4. [PMID: 17998547 DOI: 10.1200/jco.2007.11.7093] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To identify factors that condition or moderate the impact of a previously described set of interventions on psychological and physical adjustment after diagnosis and treatment for early-stage breast cancer. PATIENTS AND METHODS Younger women (age < 51 years, N = 252) with early-stage breast cancer within 2 months of having completed active nonhormonal adjuvant therapy were randomly assigned to a three-arm clinical trial, consisting of a control arm, an education arm, and a nutrition arm. Primary end points, assessed before random assignment and 4 and 13 months later, included mental functioning, physical functioning, and depressive symptoms. Four types of moderator variables were identified, including two sets reflecting psychosocial resources, specifically personality factors and factors related to the person's social environment, a set reflecting demographic variables, and a set reflecting treatment and disease variables (including comorbidities). RESULTS Psychosocial factors were more likely to moderate treatment effects than were demographic and disease-related factors, but the moderating effects of these psychosocial factors were limited to patients receiving the nutrition intervention. Patients with lower psychosocial resources benefited from the nutrition intervention, whereas patients with a greater amount of psychosocial resources did not. CONCLUSION Future trials of this type should stratify by or select for the moderating variables identified here (ie, dispositional pessimism, unmitigated communion, and negative social interaction) to establish more firmly their role in responses to psychosocial interventions. Effort should also be made to collect data to inform the delivery of interventions to those who might benefit the most.
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Affiliation(s)
- Michael F Scheier
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA 15213, USA.
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136
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Jeon HJ, Shim EJ, Shin YW, Oh DY, Im SA, Heo DS, Hahm BJ. Discrepancies in performance status scores as determined by cancer patients and oncologists: are they influenced by depression? Gen Hosp Psychiatry 2007; 29:555-61. [PMID: 18022049 DOI: 10.1016/j.genhosppsych.2007.08.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2007] [Revised: 08/15/2007] [Accepted: 08/15/2007] [Indexed: 11/19/2022]
Abstract
OBJECTIVE In previous research studies, performance status as determined by cancer patients themselves frequently did not agree with that determined by their oncologists. However, only a few studies have evaluated the reasons for this discrepancy. METHODS One hundred eleven cancer patients attending the Comprehensive Cancer Center of Seoul National University Hospital were asked to complete a questionnaire that included questions on sociodemographic and medical status, Eastern Cooperative Oncology Group (ECOG) performance status score and the Hospital Anxiety and Depression Scale (HADS). Medical oncology records were reviewed to obtain information and oncologist-assessed ECOG performance status scores. RESULTS Patients and oncologists agreed in 59 cases (53.2%; weighted kappa=0.17). There were no statistically significant gender-, cancer-type- or cancer-stage-related differences in agreement rates. Hierarchical logistic regression analyses showed that HADS depression subscale was the only variable that significantly contributed to patient-assessed performance status scores (beta=0.50, P=.0005), whereas cancer stage was the only variable that significantly contributed to oncologist-assessed performance status scores (beta=0.34, P=.0004). The mean of HADS depression subscale and the depression rates were highest in patients who rated themselves as most impaired on ECOG performance. CONCLUSIONS Depression was found to be significantly associated with patients who rated their performance status as more impaired than with the oncologist-assessed score.
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Affiliation(s)
- Hong Jin Jeon
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, 28 Yeongeon-dong, Chongno-gu, Seoul 110-744, South Korea
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137
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Schlich-Bakker KJ, Ausems MGEM, Schipper M, Ten Kroode HFJ, Wárlám-Rodenhuis CC, van den Bout J. BRCA1/2 mutation testing in breast cancer patients: a prospective study of the long-term psychological impact of approach during adjuvant radiotherapy. Breast Cancer Res Treat 2007; 109:507-14. [PMID: 17674198 PMCID: PMC2668630 DOI: 10.1007/s10549-007-9680-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2007] [Accepted: 07/09/2007] [Indexed: 11/23/2022]
Abstract
This study assessed psychological distress during the first year after diagnosis in breast cancer patients approached for genetic counseling at the start of adjuvant radiotherapy and identified those vulnerable to long-term high distress. Of the approached patients some chose to receive a DNA test result (n = 58), some were approached but did not fulfill criteria for referral (n = 118) and some declined counseling and/or testing (n = 44). The comparative group consisted of patients not eligible for genetic counseling (n = 182) and was therefore not approached. Patients actively approached for genetic counseling showed no more long-term distress than patients not eligible for such counseling. There were no differences between the subgroups of approached patients. Predictors for long-term high distress or an increase in distress over time were pre-existing high distress and a low quality of life, having children, and having no family members with breast cancer. It is concluded that breast cancer patients can be systematically screened and approached for genetic counseling during adjuvant radiotherapy without imposing extra psychological burden. Patients vulnerable to long-term high distress already displayed high distress shortly after diagnosis with no influence of their medical treatment on their level of distress at long-term.
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Affiliation(s)
- Kathryn J Schlich-Bakker
- Department of Medical Oncology, University Medical Centre Utrecht, P.O. Box 85060, Utrecht, 3508 AB, The Netherlands.
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138
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Friedman LC, Romero C, Elledge R, Chang J, Kalidas M, Dulay MF, Lynch GR, Osborne CK. Attribution of blame, self-forgiving attitude and psychological adjustment in women with breast cancer. J Behav Med 2007. [PMID: 17497216 DOI: 10.1007/s10865‐007‐9108‐5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to examine relationships among self-blame for developing breast cancer, a self-forgiving attitude, mood, and quality of life among women with breast cancer. In this cross-sectional study, 123 women with Stages 0-III breast cancer completed questionnaires measuring demographic and medical characteristics, self-blame, self-forgiveness, mood, and quality of life. Women who blamed themselves reported more mood disturbance (p <or= .001) and poorer quality of life (p < .001) than those who did not blame themselves. Mediational analyses revealed that self-blame for cancer partially mediated the relationships between a self-forgiving attitude and both mood disturbance and quality of life (Z = -2.72, p = .006 and Z = -2.89, p = .004, respectively). Patients may benefit from a discussion with their oncologists and other healthcare providers about self-forgiveness and the potential benefits of reducing self-blame to facilitate adjustment to breast cancer.
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Affiliation(s)
- Lois C Friedman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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139
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Friedman LC, Romero C, Elledge R, Chang J, Kalidas M, Dulay MF, Lynch GR, Osborne CK. Attribution of blame, self-forgiving attitude and psychological adjustment in women with breast cancer. J Behav Med 2007. [PMID: 17497216 DOI: 10.1007/s10865–007-9108–5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
The purpose of this study was to examine relationships among self-blame for developing breast cancer, a self-forgiving attitude, mood, and quality of life among women with breast cancer. In this cross-sectional study, 123 women with Stages 0-III breast cancer completed questionnaires measuring demographic and medical characteristics, self-blame, self-forgiveness, mood, and quality of life. Women who blamed themselves reported more mood disturbance (p <or= .001) and poorer quality of life (p < .001) than those who did not blame themselves. Mediational analyses revealed that self-blame for cancer partially mediated the relationships between a self-forgiving attitude and both mood disturbance and quality of life (Z = -2.72, p = .006 and Z = -2.89, p = .004, respectively). Patients may benefit from a discussion with their oncologists and other healthcare providers about self-forgiveness and the potential benefits of reducing self-blame to facilitate adjustment to breast cancer.
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Affiliation(s)
- Lois C Friedman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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140
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Friedman LC, Romero C, Elledge R, Chang J, Kalidas M, Dulay MF, Lynch GR, Osborne CK. Attribution of Blame, Self-forgiving Attitude and Psychological Adjustment in Women with Breast Cancer. J Behav Med 2007; 30:351-7. [PMID: 17497216 DOI: 10.1007/s10865-007-9108-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2006] [Accepted: 04/09/2007] [Indexed: 10/23/2022]
Abstract
The purpose of this study was to examine relationships among self-blame for developing breast cancer, a self-forgiving attitude, mood, and quality of life among women with breast cancer. In this cross-sectional study, 123 women with Stages 0-III breast cancer completed questionnaires measuring demographic and medical characteristics, self-blame, self-forgiveness, mood, and quality of life. Women who blamed themselves reported more mood disturbance (p <or= .001) and poorer quality of life (p < .001) than those who did not blame themselves. Mediational analyses revealed that self-blame for cancer partially mediated the relationships between a self-forgiving attitude and both mood disturbance and quality of life (Z = -2.72, p = .006 and Z = -2.89, p = .004, respectively). Patients may benefit from a discussion with their oncologists and other healthcare providers about self-forgiveness and the potential benefits of reducing self-blame to facilitate adjustment to breast cancer.
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Affiliation(s)
- Lois C Friedman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
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141
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Pasquini M, Biondi M. Depression in cancer patients: a critical review. Clin Pract Epidemiol Ment Health 2007; 3:2. [PMID: 17288583 PMCID: PMC1797173 DOI: 10.1186/1745-0179-3-2] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2006] [Accepted: 02/08/2007] [Indexed: 12/04/2022]
Abstract
Cancer patients experience several stressors and emotional upheavals. Fear of death, interruption of life plans, changes in body image and self-esteem, changes in social role and lifestyle are all important issues to be faced. Moreover, Depressive Disorders may impact the course of the disease and compliance. The cost and prevalence, the impairment caused, and the diagnostic and therapeutic uncertainty surrounding depressive symptoms among cancer patients make these conditions a priority for research. In this article we discuss recent data, focusing on detection of Depressive Disorders, biological correlates, treatments and unmet needs of depressed cancer patients.
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Affiliation(s)
- Massimo Pasquini
- Department of Psychiatry and Psychological Medicine, University "La Sapienza" of Rome, Italy
- Dipartimento di Scienze Psichiatriche e Medicina Psicologica. Viale dell'Università 30 – Roma, 00185, Italia
| | - Massimo Biondi
- Department of Psychiatry and Psychological Medicine, University "La Sapienza" of Rome, Italy
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142
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Graves KD, Arnold SM, Love CL, Kirsh KL, Moore PG, Passik SD. Distress screening in a multidisciplinary lung cancer clinic: prevalence and predictors of clinically significant distress. Lung Cancer 2006; 55:215-24. [PMID: 17084483 PMCID: PMC1857305 DOI: 10.1016/j.lungcan.2006.10.001] [Citation(s) in RCA: 247] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2006] [Revised: 09/29/2006] [Accepted: 10/03/2006] [Indexed: 10/23/2022]
Abstract
Screening for distress in cancer patients is recommended by the National Comprehensive Cancer Network, and a Distress Thermometer has previously been developed and empirically validated for this purpose. The present study sought to determine the rates and predictors of distress in a sample of patients being seen in a multidisciplinary lung cancer clinic. Consecutive patients (N=333) were recruited from an outpatient multidisciplinary lung cancer clinic to complete the Distress Thermometer, an associated Problem Symptom List, and two questions about interest in receiving help for symptoms. Over half (61.6%) of patients reported distress at a clinically significant level, and 22.5% of patients indicated interest in receiving help with their distress and/or symptoms. Problems in the areas of family relationships, emotional functioning, lack of information about diagnosis/treatment, physical functioning, and cognitive functioning were associated with higher reports of distress. Specific symptoms of depression, anxiety, pain and fatigue were most predictive of distress. Younger age was also associated with higher levels of distress. Distress was not associated with other clinical variables, including stage of illness or medical treatment approach. Similar results were obtained when individuals who had not yet received a definitive diagnosis of lung cancer (n=134) were excluded from analyses; however, family problems and anxiety were no longer predictive of distress. Screening for distress in a multidisciplinary lung cancer clinic is feasible and a significant number of patients can be expected to meet clinical criteria for distress. Results also highlight younger age and specific physical and psychosocial symptoms as predictive of clinically significant distress. Identification of the presence and predictors of distress are the first steps toward appropriate referral and treatment of symptoms and problems that contribute to cancer patients' distress.
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Affiliation(s)
- Kristi D Graves
- Cancer Control Program, Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC 20007, USA.
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143
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Scheier MF, Helgeson VS. Really, disease doesn't matter? A commentary on correlates of depressive symptoms in women treated for early-stage breast cancer. J Clin Oncol 2006; 24:2407-8. [PMID: 16651643 DOI: 10.1200/jco.2005.05.5244] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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