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He Y, Cheng S, Yang L, Ding L, Chen Y, Lu J, Zheng R. Associations between plasma markers and symptoms of anxiety and depression in patients with breast cancer. BMC Psychiatry 2024; 24:678. [PMID: 39394561 DOI: 10.1186/s12888-024-06143-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 10/07/2024] [Indexed: 10/13/2024] Open
Abstract
BACKGROUND AND PURPOSE Among patients with solid tumors, those with breast cancer (BC) experience the most severe psychological issues, exhibiting a high global prevalence of depression that negatively impacts prognosis. Depression can be easily missed, and clinical markers for its diagnosis are lacking. Therefore, this study in order to investigate the diagnostic markers for BC patients with depression and anxiety and explore the specific changes of metabolism. METHOD AND RESULTS Thirty-eight BC patients and thirty-six matched healthy controls were included in the study. The anxiety and depression symptoms of the participants were evaluated by the 17-item Hamilton Depression Scale (HAMD-17) and Hamilton Anxiety Scale (HAMA). Plasma levels of glial fibrillary acidic protein (GFAP) and lipocalin-2 (LCN2) were evaluated using enzyme linked immunosorbent assay, and plasma lactate levels and metabolic characteristics were analyzed. CONCLUSION This study revealed that GFAP and LCN2 may be good diagnostic markers for anxiety or depression in patients with BC and that plasma lactate levels are also a good diagnostic marker for anxiety. In addition, specific changes in metabolism in patients with BC were preliminarily explored.
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Affiliation(s)
- Yibo He
- Department of Oncology, Hangzhou Cancer Hospital, Hangzhou, 310002, China
| | - Shangping Cheng
- School of Life Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Lingrong Yang
- Department of Hangzhou Cancer Institution, Hangzhou Cancer Hospital, Hangzhou, 310002, China
| | - Lingyu Ding
- Department of Oncology, Hangzhou Cancer Hospital, Hangzhou, 310002, China
| | - Yidan Chen
- Department of Hangzhou Cancer Institution, Hangzhou Cancer Hospital, Hangzhou, 310002, China
| | - Jing Lu
- School of Life Sciences, Zhejiang Chinese Medical University, Hangzhou, China.
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310003, China.
- Zhejiang Key Laboratory of Precision Psychiatry, Hangzhou, 310003, China.
| | - Ruzhen Zheng
- Department of Oncology, Hangzhou Cancer Hospital, Hangzhou, 310002, China.
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van Buchem MM, de Hond AAH, Fanconi C, Shah V, Schuessler M, Kant IMJ, Steyerberg EW, Hernandez-Boussard T. Applying natural language processing to patient messages to identify depression concerns in cancer patients. J Am Med Inform Assoc 2024; 31:2255-2262. [PMID: 39018490 DOI: 10.1093/jamia/ocae188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Revised: 06/03/2024] [Accepted: 07/09/2024] [Indexed: 07/19/2024] Open
Abstract
OBJECTIVE This study aims to explore and develop tools for early identification of depression concerns among cancer patients by leveraging the novel data source of messages sent through a secure patient portal. MATERIALS AND METHODS We developed classifiers based on logistic regression (LR), support vector machines (SVMs), and 2 Bidirectional Encoder Representations from Transformers (BERT) models (original and Reddit-pretrained) on 6600 patient messages from a cancer center (2009-2022), annotated by a panel of healthcare professionals. Performance was compared using AUROC scores, and model fairness and explainability were examined. We also examined correlations between model predictions and depression diagnosis and treatment. RESULTS BERT and RedditBERT attained AUROC scores of 0.88 and 0.86, respectively, compared to 0.79 for LR and 0.83 for SVM. BERT showed bigger differences in performance across sex, race, and ethnicity than RedditBERT. Patients who sent messages classified as concerning had a higher chance of receiving a depression diagnosis, a prescription for antidepressants, or a referral to the psycho-oncologist. Explanations from BERT and RedditBERT differed, with no clear preference from annotators. DISCUSSION We show the potential of BERT and RedditBERT in identifying depression concerns in messages from cancer patients. Performance disparities across demographic groups highlight the need for careful consideration of potential biases. Further research is needed to address biases, evaluate real-world impacts, and ensure responsible integration into clinical settings. CONCLUSION This work represents a significant methodological advancement in the early identification of depression concerns among cancer patients. Our work contributes to a route to reduce clinical burden while enhancing overall patient care, leveraging BERT-based models.
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Affiliation(s)
- Marieke M van Buchem
- Department of Medicine (Biomedical Informatics), Stanford University, Stanford, CA 94305, United States
- Clinical Artificial Intelligence Implementation and Research Lab (CAIRELab), Leiden University Medical Center, Leiden 2333ZN, The Netherlands
| | - Anne A H de Hond
- Department of Medicine (Biomedical Informatics), Stanford University, Stanford, CA 94305, United States
- Julius Centre for Health Sciences and Primary Care, University Medical Center, Utrecht 3584CX, The Netherlands
| | - Claudio Fanconi
- Department of Medicine (Biomedical Informatics), Stanford University, Stanford, CA 94305, United States
- Department of Information Technology and Electrical Engineering, ETH Zürich, Zürich 8092, Switzerland
| | - Vaibhavi Shah
- Department of Medicine (Biomedical Informatics), Stanford University, Stanford, CA 94305, United States
| | - Max Schuessler
- Department of Biomedical Data Science, Stanford University, Stanford, CA 94305, United States
| | - Ilse M J Kant
- Department of Digital Health, University Medical Center Utrecht, Utrecht 3584CX, The Netherlands
| | - Ewout W Steyerberg
- Clinical Artificial Intelligence Implementation and Research Lab (CAIRELab), Leiden University Medical Center, Leiden 2333ZN, The Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden 2333ZN, The Netherlands
| | - Tina Hernandez-Boussard
- Department of Medicine (Biomedical Informatics), Stanford University, Stanford, CA 94305, United States
- Department of Biomedical Data Science, Stanford University, Stanford, CA 94305, United States
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Cella D, Kuharic M, Peipert JD, Bedjeti K, Garcia SF, Yanez B, Hirschhorn LR, Coughlin A, Morken V, O'Connor M, Linder JA, Jordan N, Ackermann RT, Amagai S, Kircher S, Mohindra N, Aggarwal V, Weitzel M, Nelson EC, Elwyn G, Van Citters AD, Barnard C. Shared decision-making and disease management in advanced cancer and chronic kidney disease using patient-reported outcome dashboards. J Am Med Inform Assoc 2024; 31:2190-2201. [PMID: 39093939 DOI: 10.1093/jamia/ocae180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 06/22/2024] [Accepted: 07/04/2024] [Indexed: 08/04/2024] Open
Abstract
OBJECTIVES To assess the use of a co-designed patient-reported outcome (PRO) clinical dashboard and estimate its impact on shared decision-making (SDM) and symptomatology in adults with advanced cancer or chronic kidney disease (CKD). MATERIALS AND METHODS We developed a clinical PRO dashboard within the Northwestern Medicine Patient-Reported Outcomes system, enhanced through co-design involving 20 diverse constituents. Using a single-group, pretest-posttest design, we evaluated the dashboard's use among patients with advanced cancer or CKD between June 2020 and January 2022. Eligible patients had a visit with a participating clinician, completed at least two dashboard-eligible visits, and consented to follow-up surveys. PROs were collected 72 h prior to visits, including measures for chronic condition management self-efficacy, health-related quality of life (PROMIS measures), and SDM (collaboRATE). Responses were integrated into the EHR dashboard and accessible to clinicians and patients. RESULTS We recruited 157 participants: 66 with advanced cancer and 91 with CKD. There were significant improvements in SDM from baseline, as assessed by collaboRATE scores. The proportion of participants reporting the highest level of SDM on every collaboRATE item increased by 15 percentage points from baseline to 3 months, and 17 points between baseline and 6-month follow-up. Additionally, there was a clinically meaningful decrease in anxiety levels over study period (T-score baseline: 53; 3-month: 52; 6-month: 50; P < .001), with a standardized response mean (SRM) of -0.38 at 6 months. DISCUSSION PRO clinical dashboards, developed and shared with patients, may enhance SDM and reduce anxiety among patients with advanced cancer and CKD.
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Affiliation(s)
- David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Robert H Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - Maja Kuharic
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - John Devin Peipert
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - Katy Bedjeti
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - Sofia F Garcia
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Robert H Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - Betina Yanez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Robert H Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - Lisa R Hirschhorn
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Robert J Havey, MD Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - Ava Coughlin
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - Victoria Morken
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - Mary O'Connor
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - Jeffrey A Linder
- Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - Neil Jordan
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Center of Innovation for Complex Chronic Healthcare, Hines VA Hospital, Hines, IL 60141, United States
| | - Ronald T Ackermann
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - Saki Amagai
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - Sheetal Kircher
- Robert H Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Northwestern Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - Nisha Mohindra
- Robert H Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Northwestern Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - Vikram Aggarwal
- Northwestern Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Division of Nephrology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - Melissa Weitzel
- Northwestern Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Division of Nephrology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
| | - Eugene C Nelson
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, United States
| | - Glyn Elwyn
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, United States
| | - Aricca D Van Citters
- The Dartmouth Institute for Health Policy & Clinical Practice, Geisel School of Medicine, Dartmouth College, Hanover, NH 03755, United States
| | - Cynthia Barnard
- Division of General Internal Medicine, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
- Northwestern Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, United States
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Zhao X, Zhang L, Sáenz AA, Zhang X, Sun J, Zhong Q, Cheng Y, Jia Y. Prevalence of subthreshold depression in older adults: A systematic review and meta-analysis. Asian J Psychiatr 2024; 102:104253. [PMID: 39388746 DOI: 10.1016/j.ajp.2024.104253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Revised: 09/17/2024] [Accepted: 09/25/2024] [Indexed: 10/12/2024]
Abstract
BACKGROUND The prevalence of subthreshold depression (StD) in older adults shows considerable variation across studies. This study aimed to determine the prevalence of subthreshold depression in elderly people. METHODS We conducted a thorough literature search across multiple databases, including PubMed, Web of Science, Medline, Cochrane Library, SinoMed, Wan Fang Data, CNKI, and VIP. Statistical analyses were carried out using STATA version 16.0. Our study was prospectively registered with PROSPERO (CRD42023494210). RESULTS Seventy-seven studies involving 225,232 individuals were included in this meta-analysis. The overall prevalence of subthreshold depression was 18.6 % (95 % CI: 16.0 %-21.2 %, I2 =99.8 %, p<0.001. Subgroup analyses showed the prevalence of StD in older adults varied depending on the screening tools used and the continent of the study. Funnel plots and Egger's test did not reveal any significant publication bias (Egger's test: p = 0.057). CONCLUSION The prevalence of subthreshold depression in older adults is high, suggesting attention needs to be paid to the mental health of the elderly. To prevent a larger public health issue, it is imperative to implement timely and effective preventive measures and interventions, focusing on early detection and intervention.
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Affiliation(s)
- Xiaoyan Zhao
- School of Nursing, Jilin University, Changchun 130012, China.
| | - Li Zhang
- Department of Nursing, Second Hospital, Jilin University, Changchun 130022, China.
| | | | - Xinyue Zhang
- Department of Nursing, Second Hospital, Jilin University, Changchun 130022, China.
| | - Jia Sun
- Department of Nursing, Second Hospital, Jilin University, Changchun 130022, China.
| | - Qiqing Zhong
- School of Nursing, Jilin University, Changchun 130012, China.
| | - Yuanjuan Cheng
- Department of Nursing, Second Hospital, Jilin University, Changchun 130022, China.
| | - Yong Jia
- School of Nursing, Jilin University, Changchun 130012, China; Department of Psychiatry, University of Cambridge, Cambridge CB2 0AH, United Kingdom.
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5
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Forbes H, Carreira H, Funston G, Andresen K, Bhatia U, Strongman H, Abrol E, Bowen L, Giles C, Bhaskaran K. Early, medium and long-term mental health in cancer survivors compared with cancer-free comparators: matched cohort study using linked UK electronic health records. EClinicalMedicine 2024; 76:102826. [PMID: 39318789 PMCID: PMC11421364 DOI: 10.1016/j.eclinm.2024.102826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 08/20/2024] [Accepted: 08/27/2024] [Indexed: 09/26/2024] Open
Abstract
Background We aimed to compare the risk of incident depression, anxiety, non-fatal self-harm and completed suicide in survivors from a wide range of cancers versus cancer-free individuals. Methods We used electronic health records from the United Kingdom Clinical Practice Research Datalink linked to cancer registry data, hospital admissions data and death records between 1998 and 2021. Adult survivors of the 20 most common cancers were matched (age, sex, general practice) 1:10 to cancer-free individuals. Cox regression models, adjusted for shared risk factors, were used to estimate associations between cancer survivorship and mental health outcomes. Findings 853,177 adults with cancer diagnosed in 1998-2018 were matched to 8,106,643 cancer-free individuals. Survivors of all 20 cancer types under study had a higher risk of experiencing a new episode of anxiety and depression during follow-up compared with cancer-free individuals; there was also evidence of raised risks of non-fatal self-harm in 17/20 cancers and completed suicide in 8/20 cancers. Effect sizes were greatest in cancers with poorer 5-year survival: hazard ratios (HRs) for anxiety and depression of 1.1-1.2 were seen for malignant melanoma survivors, while HRs for both outcomes were >2.5 for lung and oesophageal cancer survivors. HRs were highest in the first year from cancer diagnosis, reducing over time since diagnosis. However, 5-year cancer survivors still experienced elevated risks of a subsequent new episode of anxiety or depression, in 18/20 cancers. Interpretation Survivors of the 20 most common cancers were at increased risk of experiencing depression and anxiety, and these increased risks persisted in medium-to long-term cancer survivors. Substantially raised risks of non-fatal self-harm and completed suicide were also seen for several types of cancer. The risks of all mental health outcomes were generally higher in survivors of cancers with poorer prognosis. Our findings suggest a need for improved psychological support for all patients with cancer. Funding Wellcome Trust.
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Affiliation(s)
- Harriet Forbes
- Department of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Helena Carreira
- Department of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Garth Funston
- Wolfson Institute of Population Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kirsty Andresen
- Department of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Urvita Bhatia
- Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
- UK Addictions and Related-Research Group, Sangath, India
| | - Helen Strongman
- Department of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Esha Abrol
- Division of Psychiatry, University College London, UK
| | - Liza Bowen
- Population Health Research Institute, St George's, University of London, London, UK
| | | | - Krishnan Bhaskaran
- Department of Non-Communicable Diseases Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
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Najib J. The role of psilocybin in depressive disorders. Curr Med Res Opin 2024; 40:1793-1808. [PMID: 39177339 DOI: 10.1080/03007995.2024.2396536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/19/2024] [Accepted: 08/20/2024] [Indexed: 08/24/2024]
Abstract
Depression is a serious psychiatric disorder with a high incidence of morbidity and mortality and psilocybin with psychotherapy has emerged as a promising potential in the treatment of depressive disorders. A review of psilocybin use in patients with depressive disorders is presented.A search was conducted investigating the use of psilocybin in patients with depressive disorders and treatment resistant depression via PubMed/MEDLINE, EMBASE, and Google Scholar in October 2023; all publication types were permitted and limited for English-language. Keyword search terms included: "psilocybin" or "psychedelics" and "depression", or "major depressive disorder", or "treatment-resistant depression". Controlled and uncontrolled clinical trials utilizing psilocybin with psychological support for major depressive disorder and treatment-resistant depression, as well as in patients with depression and cancer related anxiety have demonstrated immediate and sustained antidepressant and anxiolytic effects. Psilocybin has a favorable safety profile and was well-tolerated in clinical trials. Psilocybin's abuse potential is low and clinical research suggests the potential of psilocybin to produce rapid and lasting antidepressant effects up to 12 months post-treatment. Psilocybin may offer a valuable contribution as an option to the currently available pharmacological and psychotherapeutic agents for patients with major depressive disorders, treatment-resistant depression as well as for patients with depression and comorbid terminal cancer. Future studies are needed to demonstrate these findings and any synergistic interaction between psilocybin and the psychological support offered to patients during sessions.
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Affiliation(s)
- Jadwiga Najib
- LIU, Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Brooklyn, New York, USA
- Zucker Hillside Hospital of Northwell Health, Glen Oaks, New York, USA
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7
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Mitchell RJ, Delaney GP, Arnolda G, Liauw W, Lystad RP, Braithwaite J. Three-year hospital service use trajectories of people diagnosed with cancer: A retrospective cohort study. Cancer Epidemiol 2024; 93:102676. [PMID: 39303658 DOI: 10.1016/j.canep.2024.102676] [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: 07/01/2024] [Revised: 08/27/2024] [Accepted: 09/14/2024] [Indexed: 09/22/2024]
Abstract
BACKGROUND Information regarding hospital service use by people newly diagnosed with cancer can inform patterns of healthcare utilisation and resource demands. This study aims to identify characteristics of group-based trajectories of hospital service use three years after an individual was diagnosed with cancer; and determine factors predictive of trajectory group membership. METHOD A group-based trajectory analysis of hospital service use of people aged ≥30 years who had a new diagnosis of cancer during 2018 in New South Wales, Australia was conducted. Linked cancer registry, hospital and mortality data were examined for a three-year period after diagnosis. Group-based trajectory models were derived based on number of hospital admissions. Multinominal logistic regression examined predictors of trajectory group membership. RESULTS Of the 44,577 new cancer diagnosis patients, 29,085 (65.2 %) were hospitalised at least once since their cancer diagnosis. Four distinct trajectory groups of hospital users were identified: Low (68.4 %), Very-Low (25.1 %), Moderate-Chronic (2.2 %), and Early-High (4.2 %). Key predictors of trajectory group membership were age group, cancer type, degree of cancer spread, prior history of cancer, receiving chemotherapy, and presence of comorbidities, including renal disease, moderate/serious liver disease, or anxiety. CONCLUSIONS Comorbidities should be considered in cancer treatment and management decision making. Caring for people diagnosed with cancer with multimorbidity requires multidisciplinary shared care.
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Affiliation(s)
- Rebecca J Mitchell
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia.
| | - Geoffrey P Delaney
- Maridulu Budyari Gumal - Sydney Partnership for Health, Education, Research and Enterprise (SPHERE), University of New South Wales, Sydney, Australia; Cancer Therapy Centre, Liverpool Hospital, Sydney, Australia; Collaboration for Cancer Outcomes Research and Evaluation, South-Western Sydney Clinical School, University of New South Wales, Sydney, Australia; University of New South Wales School of Clinical Medicine, Sydney, Australia
| | - Gaston Arnolda
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Winston Liauw
- University of New South Wales School of Clinical Medicine, Sydney, Australia; Cancer Care Centre, St George Hospital, Kogarah, Australia
| | - Reidar P Lystad
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Jeffrey Braithwaite
- Australian Institute of Health Innovation, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
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8
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Schipper S, Nigam K, Schmid Y, Piechotta V, Ljuslin M, Beaussant Y, Schwarzer G, Boehlke C. Psychedelic-assisted therapy for treating anxiety, depression, and existential distress in people with life-threatening diseases. Cochrane Database Syst Rev 2024; 9:CD015383. [PMID: 39260823 PMCID: PMC11390284 DOI: 10.1002/14651858.cd015383.pub2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
BACKGROUND Psychedelic-assisted therapy refers to a group of therapeutic practices involving psychedelics taken under therapeutic supervision from physicians, psychologists, and others. It has been hypothesised that psychedelic-assisted therapy may reduce symptoms of anxiety, depression, and existential distress in patients facing life-threatening diseases (e.g. cancer). However, these substances are illegal in most countries and have been associated with potential risks. OBJECTIVES To assess the benefits and harms of psychedelic-assisted therapy compared to placebo or active comparators (e.g. antidepressants) for treatment of anxiety, depression, and existential distress in people with life-threatening diseases. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, and two trial registers on 30 March 2024. In addition, we undertook reference checking, citation searching, and contact with study authors to identify additional studies. We used no language or date restrictions. SELECTION CRITERIA We included randomised controlled trials (RCTs), with no restrictions regarding comorbidity, sex, or ethnicity. Interventions comprised a substance-induced psychedelic experience preceded by preparatory therapeutic sessions and followed by integrative therapeutic sessions. DATA COLLECTION AND ANALYSIS We used the standard methodological procedures expected by Cochrane. MAIN RESULTS We included six studies in the review, which evaluated two different interventions: psychedelic-assisted therapy with classical psychedelics (psilocybin ('magic mushrooms') and lysergic acid diethylamide (LSD)), and psychedelic-assisted therapy with 3,4-methylenedioxymethamphetamine (MDMA or 'Ecstasy'). The studies randomised 149 participants with life-threatening diseases and analysed data for 140 of them. The age range of participants was 36 to 64 years. The studies lasted between 6 and 12 months, and were conducted in outpatient settings in the USA and in Switzerland. Drug companies were not involved in study funding, but funding was provided by organisations that promote psychedelic-assisted therapy. Primary outcomes (at 1 to 12 weeks) Anxiety Psychedelic-assisted therapy using classical psychedelics (psilocybin, LSD) may result in a reduction in anxiety when compared to active placebo (or low-dose psychedelic): State Trait Anxiety Inventory (STAI-Trait, scale 20 to 80) mean difference (MD) -8.41, 95% CI -12.92 to -3.89; STAI-State (scale 20 to 80) MD -9.04, 95% CI -13.87 to -4.21; 5 studies, 122 participants; low-certainty evidence. The effect of psychedelic-assisted therapy using MDMA on anxiety, compared to placebo, is very uncertain: STAI-T MD -14.70, 95% CI -29.45 to 0.05; STAI-S MD -16.10, 95% CI -33.03 to 0.83; 1 study, 18 participants; very low certainty evidence. Depression Psychedelic-assisted therapy using classical psychedelics (psilocybin, LSD) may result in a reduction in depression when compared to active placebo (or low-dose psychedelic): Beck Depression Inventory (BDI, scale 0 to 63) MD -4.92, 95% CI -8.97 to -0.87; 4 studies, 112 participants; standardised mean difference (SMD) -0.43, 95% CI -0.79 to -0.06; 5 studies, 122 participants; low-certainty evidence. The effect of psychedelic-assisted therapy using MDMA on depression, compared to placebo, is very uncertain: BDI-II (scale: 0 to 63) MD -6.30, 95% CI -16.93 to 4.33; 1 study, 18 participants; very low certainty evidence. Existential distress Psychedelic-assisted therapy using classical psychedelics (psilocybin, LSD) compared to active placebo (or low-dose psychedelic) may result in a reduction in demoralisation, one of the most common measures of existential distress, but the evidence is very uncertain (Demoralisation Scale, 1 study, 28 participants): post treatment scores, placebo group 39.6 (SEM 3.4), psilocybin group 18.8 (3.6), P ≤ 0.01). Evidence from other measures of existential distress was mixed. Existential distress was not measured in people receiving psychedelic-assisted therapy with MDMA. Secondary outcomes (at 1 to 12 weeks) Quality of life When classical psychedelics were used, one study had inconclusive results and two reported improved quality of life, but the evidence is very uncertain. MDMA did not improve quality of life measures, but the evidence is also very uncertain. Spirituality Participants receiving psychedelic-assisted therapy with classical psychedelics rated their experience as being spiritually significant (2 studies), but the evidence is very uncertain. Spirituality was not assessed in participants receiving MDMA. Adverse events No treatment-related serious adverse events or adverse events grade 3/4 were reported. Common minor to moderate adverse events for classical psychedelics were elevated blood pressure, nausea, anxiety, emotional distress, and psychotic-like symptoms (e.g. pseudo-hallucination where the participant is aware they are hallucinating); for MDMA, common minor to moderate adverse events were anxiety, dry mouth, jaw clenching, and headaches. Symptoms subsided when drug effects wore off or up to one week later. Certainty of the evidence Although all six studies had intended to blind participants, personnel, and assessors, blinding could not be achieved as this is very difficult in studies investigating psychedelics. Using GRADE criteria, we judged the certainty of evidence to be low to very low, mainly due to high risk of bias and imprecision (small sample size). AUTHORS' CONCLUSIONS Implications for practice Psychedelic-assisted therapy with classical psychedelics (psilocybin, LSD) may be effective for treating anxiety, depression, and possibly existential distress, in people facing a life-threatening disease. Psychedelic-assisted therapy seemed to be well tolerated, with no treatment-emergent serious adverse events reported in the studies included in this review. However, the certainty of evidence is low to very low, which means that we cannot be sure about these results, and they might be changed by future research. At the time of this review (2024), psychedelic drugs are illegal in many countries. Implications for research The risk of bias due to 'unblinding' (participants being aware of which intervention they are receiving) could be reduced by measuring expectation bias, checking blinding has been maintained before cross-over, and using active placebos. More studies with larger sample sizes are needed to reduce imprecision. As the US Drug Enforcement Administration (DEA) currently classifies psychedelics as Schedule I substances (i.e. having no accepted medical use and a high potential for abuse), research involving these drugs is restricted, but is steadily increasing.
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Affiliation(s)
- Sivan Schipper
- Department of Medicine, Spital Uster, Uster, Switzerland
| | - Kabir Nigam
- Department of Psychiatry, Brigham and Women's Hospital, Boston, USA
| | - Yasmin Schmid
- Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Vanessa Piechotta
- Department for Infectious Disease Epidemiology, Robert Koch Institute, Berlin, Germany
| | - Michael Ljuslin
- Palliative Medicine Division, Department of Rehabilitation and Geriatrics, Geneva University Hospitals, Geneva, Switzerland
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, USA
- Harvard Medical School, Boston, USA
| | - Yvan Beaussant
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, USA
- Harvard Medical School, Boston, USA
| | - Guido Schwarzer
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Christopher Boehlke
- Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
- Palliative Care Center Basel, Basel, Switzerland
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9
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Köditz AK, Mehnert-Theuerkauf A, Ernst J. [Partnership Status And Prevalence Of Mental Disorders In Women And Men With Cancer]. Psychother Psychosom Med Psychol 2024. [PMID: 39260378 DOI: 10.1055/a-2390-1951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/13/2024]
Abstract
BACKGROUND Patients facing the diagnosis of cancer are confronted with high stress levels, which increase the risk of developing a mental disorder. Being in a relationship moderates patients' mental health and can have a risk-reducing effect. We aim to describe the influence of partnership status on the 4-week-prevalence of mental disorders in cancer patients and how it varies by gender. METHODS As part of the secondary data analysis of a multicenter cross-sectional study, 1857 patients with cancer (51,6% women, age 18-75 years, Ø age 57 years, 79,7% in a partnership) were assessed using a written questionnaire and, for the diagnosis of psychological disorders (4-week prevalence), the CIDI-O interview. Frequency calculations and binary logistic analyses were carried out. RESULTS In the univariate analyses, the frequency of the presence of at least one mental disorder is significantly lower in patients who are in a relationship (25,4% vs. 35,3%, p<0,001). They are also less likely to simultaneously suffer from multiple mental disorders. These differences are also evident for individual classes of disorders. The multivariate gender-differentiated analysis confirms this trend. In addition to age and income as significant predictors, only men experience a significant protective effect of their relationship against the occurrence of a mental disorder (OR=2,5, p<0,001). DISCUSSION There has been very limited research on the links between partnership status, gender, and mental disorders in cancer patients. The results found in our analyses should be further explored, particularly regarding the protective role of partnership against developing mental disorders. CONCLUSION In the context of psycho-oncological care the status of living alone should be considered as a possible risk factor for developing mental disorders, especially in men.
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Affiliation(s)
- Anne-Kathrin Köditz
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig
| | - Anja Mehnert-Theuerkauf
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig
| | - Jochen Ernst
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig
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10
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Mehnert-Theuerkauf A, Springer F. [Psycho-oncology-psychosocial distress and supportive care needs]. UROLOGIE (HEIDELBERG, GERMANY) 2024; 63:878-885. [PMID: 38995422 DOI: 10.1007/s00120-024-02395-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 07/13/2024]
Abstract
The number of patients living with or after cancer is constantly increasing due to improved diagnostics and care as well as the ageing society. This is particularly true for the group of older cancer survivors with complex health and supportive care needs. For many of those affected and their relatives, the disease and its treatment are accompanied by high levels of emotional stress, an impaired quality of life, and a variety of psychosocial challenges. Psychosocial distress, such as depression and anxiety, sometimes persists for years after treatment has ended. The most common unmet supportive care needs of patients include psychological and emotional needs as well as information needs. Therefore, it is essential to implement effective psychosocial screening and low-threshold needs-based referral to evidence-based psycho-oncological support services. Around a third of all cancer patients express a desire for professional psycho-oncological support. Although there is compelling evidence that psycho-oncological interventions can reduce psychosocial distress and improve quality of life, there is a need for further research into the design and effectiveness of intervention services for specific subgroups, such as prostate cancer patients.
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Affiliation(s)
- Anja Mehnert-Theuerkauf
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Deutschland.
| | - Franziska Springer
- Abteilung für Medizinische Psychologie und Medizinische Soziologie, Universitätsklinikum Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Deutschland
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11
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Ikeda H, Yamagishi A, Yonemochi N, Yamamoto S, Shimizu T, Muto A, Waddington JL, Kamei J. Keratinocyte-Derived Cytokine in the Hippocampus Disrupts Extinction of Conditioned Fear Memory in Tumor-Bearing Mice. Mol Neurobiol 2024; 61:6454-6468. [PMID: 38308664 DOI: 10.1007/s12035-024-03992-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 01/27/2024] [Indexed: 02/05/2024]
Abstract
While patients with cancer show a higher prevalence of psychiatric disorders than the general population, the mechanism underlying this interaction remains unclear. The present study examined whether tumor-bearing (TB) mice show psychological changes using the conditioned fear paradigm and the role of cytokines in these changes. TB mice were established by transplantation with mouse osteosarcoma AXT cells. These TB mice were then found to exhibit disruption in extinction of conditioned fear memory. Eighteen cytokines in serum were increased in TB mice, among which i.c.v. injection of interleukin (IL)-1β and IL-6 strengthened fear memory in normal mice. Contents of IL-17 and keratinocyte-derived cytokine (KC) in the amygdala and KC in the hippocampus were increased in TB mice. KC mRNA in both the amygdala and hippocampus was also increased in TB mice, and i.c.v. injection of KC dose-dependently strengthened fear memory in normal mice. In addition, injection of IL-1β, but not IL-6, increased KC mRNA in the amygdala and hippocampus. In TB mice KC mRNA was increased in both astrocytes and microglia of the amygdala and hippocampus. The microglia inhibitor minocycline, but not the astrocyte inhibitor fluorocitrate, alleviated disruption in extinction of conditioned fear memory in TB mice. Microinjection of KC into the hippocampus, but not into the amygdala, increased fear memory in normal mice. These findings indicate that TB mice show an increase in serum cytokines, including IL-1β, that increases KC production in microglia of the hippocampus, which then disrupts extinction of fear memory.
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Affiliation(s)
- Hiroko Ikeda
- Department of Pathophysiology and Therapeutics, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo, 142-8501, Japan.
| | - Aimi Yamagishi
- Department of Pathophysiology and Therapeutics, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo, 142-8501, Japan
| | - Naomi Yonemochi
- Department of Pathophysiology and Therapeutics, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo, 142-8501, Japan
| | - Shogo Yamamoto
- Department of Pathophysiology and Therapeutics, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo, 142-8501, Japan
| | - Takatsune Shimizu
- Department of Pathophysiology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo, 142-8501, Japan
| | - Akihiro Muto
- Department of Pathophysiology, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo, 142-8501, Japan
| | - John L Waddington
- School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, 111 St Stephen's Green, Dublin 2, Ireland
| | - Junzo Kamei
- Department of Pathophysiology and Therapeutics, Hoshi University School of Pharmacy and Pharmaceutical Sciences, 2-4-41 Ebara, Shinagawa-ku, Tokyo, 142-8501, Japan
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12
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Zh. Zhelev K, Conev NV, Zahariev ZI, Mihaylova IS, Tonev ID, Sht. Donev I. Time estimation is associated with the levels of distress in patients prior to starting radiotherapy. Tech Innov Patient Support Radiat Oncol 2024; 31:100258. [PMID: 39070541 PMCID: PMC11278554 DOI: 10.1016/j.tipsro.2024.100258] [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: 03/14/2024] [Revised: 06/02/2024] [Accepted: 06/24/2024] [Indexed: 07/30/2024] Open
Abstract
Purpose or Objective The aim of this study was to explore the potential relationship between the time estimation and psychological distress in patients with solid tumors prior to starting radiotherapy. Materials and Methods In this multicenter study were included a total of 344 patients with solid tumors (197 with and 147 without metastatic disease). The time estimation was assessed by evaluating each subjects prospective estimation of how fast 1 min passed compared to the actual time. The median value (35sec) of subjective perception of time was used to group cases into two categories for experience of time. We used the National Comprehensive Cancer Network Distress Thermometer at the beginning of treatment to determine the levels of distress, where it measures distress on a scale from 0 to 10. Patients scoring 4 or above (73.5 %) were regarded as having high levels of distress. Results The time estimation distributions significantly changed according to the level of distress. ROC analysis revealed that at the optimal cut off value of time estimation, patients with low and high distress levels can be discriminated with an AUC = 0.80 (95 % CI: 0.75- 0.85, p < 0.001) and with a sensitivity of 77.8 % and specificity of 73.3 %. In a multivariate logistic regression model, fast time estimation was an independent predictor of high levels of distress (OR 0.136; 95 % CI, 0.072---0.256, p < 0.001). Conclusion Time estimation is a novel potent indicator of high levels of distress in cancer patients prior starting of radiotherapy.
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Affiliation(s)
- Kiril Zh. Zhelev
- Department of Radiotherapy and Radiosurgery, “Heart and Brain Center of Clinical Excellence”, Pleven, Bulgaria, Pierre Curie, str., 2, Postal Code 5800
| | - Nikolay V. Conev
- Clinic of Medical Oncology, UMHAT “St. Marina, Varna, Bulgaria, Hristo Smirnenski, str. 1, Postal Code 9000
| | - Zahari I. Zahariev
- Department of Radiotherapy, Uni Hospital, Panagyurishte, Bulgaria, Georgi Benkovski, str.100, Postal Code 4500
| | - Iglika S. Mihaylova
- Department of Radiotherapy, USHAT in Oncology, Sofia, Bulgaria, Plovdivsko pole, str. 6, Postal Code 1000
| | - Ivan D. Tonev
- Department of Medical Oncology, Complex Cancer Center, Plovdiv, 2A, Alexander Stamboliiski, Blvd, Code 4000
| | - Ivan Sht. Donev
- Clinic of Medical Oncology, MHAT “Nadezhda”, Sofia, Bulgaria, Blaga Vest, str.2, Postal Code 1000
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13
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Zhou J, Liu X, Liang X, Wei S. Association between depressive symptoms and second primary cancer in cancer survivors: Insights from a nationally representative study. Gen Hosp Psychiatry 2024; 90:150-156. [PMID: 39197229 DOI: 10.1016/j.genhosppsych.2024.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 08/11/2024] [Accepted: 08/12/2024] [Indexed: 09/01/2024]
Abstract
OBJECTIVE The purpose of this study was to investigate the association between depressive symptoms and second primary cancer (SPC) in U.S. cancer survivors. METHODS Cancer survivors from the 2005-2018 National Health and Nutrition Examination Survey (NHANES) were included in this cross-sectional study, and depressive symptoms were defined by the Patient Health Questionnaire 9 (PHQ-9). The association between depressive symptoms and SPC was assessed via multiple logistic regression, restricted cubic spline (RCS), sensitivity, and subgroup analyses. RESULTS This study involved 2315 participants representing >15 million noninstitutionalized U.S. residents. Multivariate logistic regression fully adjusted for confounders revealed that cancer survivors with a PHQ-9 score ≥ 10 had a greater risk of developing SPC than those with a PHQ-9 score of 0-4 ([OR] = 1.88, 95% [CI] = 1.20-2.89, p = 0.005). The RCS showed a linear positive correlation between the PHQ-9 score and SPC (p for overall = 0.017). The robustness of this association was subsequently confirmed via multiple interpolation of missing data and different cluster-level methods (namely weighted linear regression) as sensitivity analyses. Furthermore, subgroup analyses confirmed this correlation was stronger in participants with sleep duration <7 h (p for interaction = 0.036). CONCLUSION Moderate to severe depressive symptoms in cancer survivors were associated with an increased risk of developing SPC, especially at <7 h of sleep.
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Affiliation(s)
- Jie Zhou
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Wuhan, Wuhan 430079, Hubei, China
| | - Xiaoxin Liu
- Department of Nephrology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430077, Hubei, China
| | - Xinjun Liang
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Wuhan, Wuhan 430079, Hubei, China; Department of Abdominal Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei, China.
| | - Shaozhong Wei
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Wuhan, Wuhan 430079, Hubei, China.
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14
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Zhang T, Meng C, He W, Xu T, Yang Y, Tu C, Zhang L, Sun X, Zhu C, Dang X, Wang K, Chen C, Yan X, Xu H, Huang L, Jiang E, Xia F, Zhou X, Zhou S, Zang W, Li X, Zhang J, Zheng J, Xin J, Huang B, Zhu G, Zhu J, Liang J. Characteristics and patient-reported outcomes of long-term cancer survivors after apatinib-based therapy: an online survey. BMC Cancer 2024; 24:1077. [PMID: 39217302 PMCID: PMC11366127 DOI: 10.1186/s12885-024-12832-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 08/20/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Data on long-term cancer survivors treated with apatinib are lacking. This study aimed to describe the characteristics of long-term cancer survivors after apatinib-based therapy, and to know about their satisfaction degree with apatinib and severity of depression and insomnia. METHODS Patients with solid tumors who had received apatinib-based therapy for at least 5 years were invited to complete an online questionnaire. Characteristics of patients and treatment, knowledge of apatinib, satisfaction degree, and severity of depression and insomnia assessed by Patient Health Questionnaire-9 and Insomnia Severity Index were collected. RESULTS Between December 8, 2023 and March 1, 2024, a total of 436 patients completed the online questionnaire. Most patients were satisfied with the efficacy (96.6%) and safety (93.1%) of apatinib, were willing to continue apatinib treatment (99.5%), and would recommend apatinib to other patients (93.3%). Continuous apatinib treatment resulted in significant negative impact on daily life, work, or study in only two (0.5%) patients. Almost all patients currently had no or mild depression (97.0%) and insomnia (97.9%) problems. The most common patient-reported adverse events were hand-foot syndrome (21.3%) and hypertension (18.3%). CONCLUSIONS Our survey showed a high satisfaction degree with apatinib in long-term cancer survivors. Long-term apatinib treatment resulted in almost no negative impact on patient's quality of life.
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Affiliation(s)
- Tingting Zhang
- Department of Oncology, Peking University International Hospital, 1 Life Park Road, Life Science Park of Zhongguancun, Changping District, Beijing, 102206, China
| | - Chao Meng
- Department of Oncology, Peking University International Hospital, 1 Life Park Road, Life Science Park of Zhongguancun, Changping District, Beijing, 102206, China
| | - Wei He
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Tao Xu
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital, Jinan, China
| | - Yi Yang
- Department of Interventional Radiology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Chongqi Tu
- Department of Orthopedics, West China Hospital of Sichuan University, Chengdu, China
| | - Ling Zhang
- Department of Hepatobiliary Surgery, Henan Cancer Hospital, Zhengzhou, China
| | - Xiaofeng Sun
- Department of Internal Medicine, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | - Chunrong Zhu
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xueyi Dang
- Department of Hepatobiliary Surgery, Shanxi Cancer hospital, Taiyuan, China
| | - Ke Wang
- Department of Gynecologic Oncology, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China
| | - Chuan Chen
- Department of Oncology, Army Medical Center (Daping Hospital), Chongqing, China
| | - Xiong Yan
- Department of Hepatobiliary, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Huiting Xu
- Department of Abdominal Oncology, Hubei Cancer Hospital, Wuhan, China
| | - Le Huang
- Department of Gastrointestinal Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Enlai Jiang
- Department of General Surgery, The Second Affiliated Hospital of Army Medical University, Chongqing, China
| | - Feng Xia
- Department of Hepatobiliary, The Southwest Hospital of AMU, Chongqing, China
| | - Xinming Zhou
- Department of Gastroenterology, Xijing Hospital, Xian, China
| | - Shunkai Zhou
- Department of Thoracic Surgery, The 900 Hospital of the Joint Service Support Force of the People's Liberation Army of China, Fuzhou, China
| | - Weidong Zang
- Department of Gastrointestinal Surgery, Fujian Cancer Hospital, Fuzhou, China
| | - Xifeng Li
- Department of Hepatic Surgery, The Third Affiliated Hospital of the Second Military Medical University, Shanghai, China
| | - Jin Zhang
- Department of Hepatic Surgery, The Third Affiliated Hospital of the Second Military Medical University, Shanghai, China
| | - Jiaping Zheng
- Department of Interventional Radiology, Zhejiang Cancer Hospital, Hangzhou, China
| | - Jianjun Xin
- Department of Gastrointestinal Surgery, Qingdao Central Medical Group, Qingdao, China
| | - Bin Huang
- Department of Interventional Radiology, The Affiliated Cancer Hospital of Xiangya School of Medicine, Hunan Cancer Hospital, Central South University, Changsha, China
| | - Guopei Zhu
- Department of Radiation Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiexiang Zhu
- Department of Medical Affairs, Jiangsu Hengrui Pharmaceuticals Co., Ltd, Shanghai, China
| | - Jun Liang
- Department of Oncology, Peking University International Hospital, 1 Life Park Road, Life Science Park of Zhongguancun, Changping District, Beijing, 102206, China.
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15
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de La Perrière C, Lemogne C, Dauchy S. Psychiatric assessment for patients who decline cancer treatment: perspectives from medical residents. Support Care Cancer 2024; 32:614. [PMID: 39190138 DOI: 10.1007/s00520-024-08806-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 08/13/2024] [Indexed: 08/28/2024]
Abstract
PURPOSE Among patients with cancer, a comorbid mental disorder is associated with higher mortality. This could be partially attributed to reduced access to oncological care, sometimes due to treatment refusal. Recommendations were issued in 2018 by the French and Francophone Society of Psycho-Oncology concerning the management of oncological treatment refusal. This study aimed to examine oncology residents' view on psychiatric assessment in this context. METHODS In February 2021, we conducted a descriptive, observational, cross-sectional pilot study among French residents involved in oncology regarding their management of cancer treatment refusal and the importance they assign to psychiatric assessment, using an online questionnaire with 12 multiple-choice questions. RESULTS Among 87 respondents, only 35.6% systematically explore the history of mental disorders when facing cancer treatment refusal. Even in cases with a known history of mental disorders, only 42.5% systematically refer the patient to a psychiatrist. 96.5% of them were unaware of the 2018 recommendations. CONCLUSION The importance given to psychiatric assessment in cases of oncological treatment refusal remains insufficient. Qualitative studies are needed to understand the underlying reasons for this refusal. The development of psychiatric consultation-liaison interventions in oncology centers is necessary to improve the management of these cases and provide appropriate training.
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Affiliation(s)
- Claire de La Perrière
- Service de Psychiatrie et Addictologie de l'adulte et du sujet âgé, AP-HP, Hôpital Européen Georges Pompidou, 75015, Paris, France.
| | - Cédric Lemogne
- Inserm, INRAE, Center for Research in Epidemiology and StatisticS (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, 75004, Paris, France
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, 75004, Paris, France
| | - Sarah Dauchy
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, 75004, Paris, France
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16
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Shen YZ, Chen F, Yu JW, Zhang Y, Lu LX, Huo YL, Chu ST, Cao B, Tang LW. Review of Baduanjin and resistance exercise for the mental health of patients with hematologic malignancies. World J Psychiatry 2024; 14:1165-1173. [PMID: 39165558 PMCID: PMC11331390 DOI: 10.5498/wjp.v14.i8.1165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 06/29/2024] [Accepted: 07/15/2024] [Indexed: 08/12/2024] Open
Abstract
Patients with hematological tumors experience physical and psychological stress, and negative psychological states. Baduanjin, an emerging psychological rehabilitation method combined with resistance exercise, has received widespread attention. This study reviews the current status of the application of Baduanjin combined with resistance exercise in improving the negative psychological state of patients with hematological tumors and discusses its problems and prospects. Through a literature review and comprehensive analysis, the application of Baduanjin and resistance exercise in the psychological rehabilitation of patients with hematological tumors was identified and evaluated. The results showed that Baduanjin with resistance exercise had a positive effect on improving negative psychological states of patients with hematological tumors, which can alleviate anxiety, depression, and other adverse emotions, and improve quality of life. However, there is a lack of unified and standardized exercise intervention programs for practical application, and patient participation and compliance must be improved. Baduanjin combined with resistance exercise can potentially improve the negative psychological status of patients with hematological tumors; however, it is still necessary to further standardize and improve the exercise program improving patient participation and compliance. Future studies should strengthen theoretical exploration and empirical research, providing more effective psychological rehabilitation strategies for patients with hematological tumors.
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Affiliation(s)
- Ya-Zhou Shen
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
| | - Feng Chen
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
| | - Jia-Wen Yu
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
| | - Yan Zhang
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
| | - Ling-Xiang Lu
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
| | - Yong-Li Huo
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
| | - Si-Ting Chu
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
| | - Bing Cao
- Department of Nursing, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
| | - Lei-Wen Tang
- Department of Nursing, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310000, Zhejiang Province, China
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Melink Z, Lustberg MB, Schnell PM, Mezzanotte-Sharpe J, Orchard TS. Effect of minocycline on changes in affective behaviors, cognitive function, and inflammation in breast cancer survivors undergoing chemotherapy: a pilot randomized controlled trial. Breast Cancer Res Treat 2024:10.1007/s10549-024-07457-w. [PMID: 39143391 DOI: 10.1007/s10549-024-07457-w] [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: 02/20/2024] [Accepted: 08/02/2024] [Indexed: 08/16/2024]
Abstract
PURPOSE Minocycline suppresses chemotherapy-induced neuroinflammation in preclinical models, but its effects in cancer survivors are unknown. This study evaluated the longitudinal effects of minocycline on affective behaviors, cognitive functions, and inflammation in women with breast cancer (BC) undergoing chemotherapy. METHODS This is a pilot, double-blind, randomized controlled trial of oral minocycline (100 mg BID) versus placebo for chemotherapy-induced affective disorders in women initiating chemotherapy for stage I-III BC. Participants received minocycline or placebo up to one week before chemotherapy, continuing through cycle 4 (C4). Epidemiologic Studies Depression Scale (CES-D) and State-Trait Anxiety Inventory (STAI) were assessed at baseline, each cycle of chemotherapy (C1-C4), 2-3-week post-chemotherapy (end of chemotherapy), and 6-month post-chemotherapy (6 M) as the primary outcomes. Sub-group analysis of CES-D and STAI based on the severity of symptoms was also performed. Changes in self-reported cognition and serum inflammatory markers were also evaluated. RESULTS Fifty-seven women enrolled and 55 completed the study. Except for Interleukin-8 (p ≤ 0.03), changes in inflammatory markers, cognitive function, CES-D, and STAI were not significantly different between groups from baseline to any cycle or post-chemotherapy time point (all p > 0.05), adjusting for baseline scores. Increases in serum Interleukin-8 from baseline to C4 and 6 M were ameliorated by minocycline (p < 0.05). The sub-group symptomatic for depression (CES-D > = 16 at baseline) treated with minocycline had a greater reduction in CES-D score compared to placebo from baseline to 6 M (p = 0.01). CONCLUSION Despite attenuation of IL-8, minocycline did not alter self-reported affective symptoms or cognition in this cohort of BC survivors undergoing chemotherapy. The effect of minocycline on BC survivors symptomatic for depression before chemotherapy warrants further investigation.
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Affiliation(s)
- Zihan Melink
- Department of Human Sciences, The Ohio State University, Columbus, OH, 43210, USA
| | - Maryam B Lustberg
- Yale School of Medicine, Center for Breast Cancer, New Haven, CT, 06511, USA
| | - Patrick M Schnell
- Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, 43210, USA
| | - Jessica Mezzanotte-Sharpe
- Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Tonya S Orchard
- Department of Human Sciences, The Ohio State University, Columbus, OH, 43210, USA.
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Al-Hussaini M, Abdel-Razeq H, Shamieh O, Al-Ani A, Hammouri M, Mansour A. Assessment of psycho-oncology in the Middle East and North Africa region: a systematic review and meta-analysis. Oncologist 2024:oyae193. [PMID: 39137150 DOI: 10.1093/oncolo/oyae193] [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: 02/05/2024] [Accepted: 05/23/2024] [Indexed: 08/15/2024] Open
Abstract
BACKGROUND The Middle East and North Africa (MENA) region is expected to witness a significant increase in the burden of cancer. Contrary to Western literature, the burden of psycho-oncology is yet to be established within the MENA region. This study reviews all available evidence characterizing the psychological burden among patients with cancer across the MENA region. METHODS We systematically explored the PubMed/MEDLINE, Cochrane/CENTRAL, and Web of Science (WoS) databases for reports on the psychiatric burden among patients with cancer residing within the MENA region from January 2000 until January 2023. Raw proportion were extracted and analyzed using a random-effects model. FINDINGS Eighty-three studies comprised of 16 810 participants, representing 14 countries, met our inclusion criteria. Across the MENA region, the prevalence of depression, anxiety, and distress were 44% (95% CI, 39%-50%), 47% (95% CI, 40%-54%), and 43% (95% CI, 30%-56%), respectively. Prevalence of depression was significantly different across countries, with Palestine (73%; 95% CI, 42%-91%) reporting the highest rate while Morocco (23%; 95% CI, 7%-56%) reported the lowest. Similarly, anxiety significantly differed across MENA nations ranging from 64% (95% CI, 3%-99%) in Morocco to 28% (95% CI, 18%-42%) in Tunisia. Rates of depression and anxiety were significantly different across measurement tools but not between Arabic-speaking versus Persian/Farsi-speaking countries. Meta-regression models showed that neither publication year nor age affected the prevalence of both anxiety and depression (P = .374 and .091 for depression and P = .627, and .546 for anxiety, respectively). INTERPRETATION We report an abnormally high rate of psychiatric burden among patients with cancer in the MENA region. Thus, establishing appropriate psycho-oncologic interventions within the MENA region is of utmost importance.
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Affiliation(s)
- Maysa Al-Hussaini
- Department of Cell Therapy and Applied Genomics, King Hussein Cancer Center, Amman 11941, Jordan
- Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman 11941, Jordan
| | - Hikmat Abdel-Razeq
- Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan
| | - Omar Shamieh
- Centre for Palliative and Cancer Care in Conflict, Department of Palliative Care, King Hussein Cancer Center, Amman 11941, Jordan
| | - Abdallah Al-Ani
- Office of Scientific Affairs and Research, King Hussein Cancer Center, Amman 11941, Jordan
| | | | - Asem Mansour
- Office of Director General, King Hussein Cancer Center, Amman 11941, Jordan
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19
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Gomes M, Silva ER, Salgado J. Focusing with colorectal cancer patients: a pilot study of a brief online group intervention. Front Psychol 2024; 15:1339823. [PMID: 39176044 PMCID: PMC11339957 DOI: 10.3389/fpsyg.2024.1339823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 07/22/2024] [Indexed: 08/24/2024] Open
Abstract
Introduction Focusing-Oriented Psychotherapy has had a long history and influence on the field of psychotherapy. By "clearing a space" and "focusing," individuals can enhance their emotional awareness and improve their ability to self-regulate. These tasks are particularly relevant in the context of Psycho-Oncology, although the research on their potential benefits for cancer patients is limited. Furthermore, the application of these tasks in a group or online setting has not been thoroughly explored. Methods This study aimed to examine the effectiveness of a two-session online intervention based on Focusing for cancer-diagnosed participants and its impact on their mental health and wellbeing. The study involved three participants with a diagnosis of colorectal cancer who were undergoing palliative treatment. We used both qualitative and quantitative methods. PFC-2 was used to assess participants' accomplishment of the task; FMS was used to assess the change in the focusing attitude, while CORE-OM, and PWBS-RV were used as mental health distress and psychological wellbeing measures; participant feedback was collected through questionnaires and a semi-structured interview. Results The results suggest that the tasks led to greater self-awareness, heightened self-reflection, and a sense of relief for the participants. Discussion These findings suggest that the group intervention protocol based on online Focusing sessions is potentially useful for broader applications.
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Affiliation(s)
- Marta Gomes
- Department of Social and Behavioural Sciences, University of Maia, Maia, Portugal
- Center for Psychology, University of Porto, Porto, Portugal
| | - Eunice R. Silva
- Portuguese Institute of Oncology of Porto Francisco Gentil, EPE, Porto, Portugal
| | - João Salgado
- Department of Social and Behavioural Sciences, University of Maia, Maia, Portugal
- Center for Psychology, University of Porto, Porto, Portugal
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20
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Suskin JA, Paul SM, Stuckey AR, Conley YP, Levine JD, Hammer MJ, Miaskowski C, Dunn LB. Trajectories of Depressive Symptoms Among Patients Undergoing Chemotherapy for Breast, Gastrointestinal, Gynecological, or Lung Cancer. Cancer Nurs 2024:00002820-990000000-00278. [PMID: 39106444 DOI: 10.1097/ncc.0000000000001380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2024]
Abstract
BACKGROUND Individuals who undergo chemotherapy for cancer are at elevated risk of developing depressive symptoms, yet substantial interindividual variation exists in trajectories of these symptoms. OBJECTIVE To examine interindividual variations in trajectories of depressive symptoms during 2 cycles of chemotherapy and to evaluate associations between demographic and clinical characteristics, symptom severity scores, psychological adjustment characteristics (eg, stress and coping), and initial levels and trajectories of depressive symptoms. METHODS Patients (n = 1323) diagnosed with breast, gynecologic, lung, or gastrointestinal cancer completed the Center for Epidemiological Studies-Depression Scale 6 times, over 2 cycles of chemotherapy. At enrollment, patients provided demographic information and completed a broad range of symptom, stress, and coping measures. Hierarchical linear modeling was used to identify characteristics associated with initial levels and trajectories of depressive symptoms. RESULTS Interindividual differences in initial levels of depressive symptoms were associated with marital status, functional status, level of comorbidity, chemotherapy toxicity, sleep disturbance, morning fatigue, cognitive function, global and cancer-related stress, and coping characteristics (ie, sense of coherence, venting, behavioral disengagement, and self-blame). Interindividual differences in depression trajectories were associated with education, cancer type, chemotherapy toxicity, sleep disturbance, evening energy, evening fatigue, cognitive function, global and cancer-related stress, and self-blame. CONCLUSIONS We present new findings concerning the trajectories and predictors of depressive symptoms during chemotherapy. IMPLICATIONS FOR PRACTICE Modifiable risk factors (eg, stress and coping) are important targets for intervening to address depressive symptoms in oncology patients.
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Affiliation(s)
- Johanna A Suskin
- Author Affiliations: Mount Sinai-West, Icahn School of Medicine at Mount Sinai, New York (Dr Suskin); University of California, San Francisco (Drs Paul, Levine, and Miaskowski); Brown University, The Warren Alpert Medical School, Providence, Rhode Island (Dr Stuckey); University of Pittsburgh, School of Nursing, Pennsylvania (Dr Conley); Dana-Farber Cancer Institute, Boston, Massachusetts (Dr Hammer); University of Arkansas for Medical Sciences, Little Rock (Dr Dunn)
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21
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Yang Y, Huang Y, Dong N, Zhang L, Zhang S. Effect of telehealth interventions on anxiety and depression in cancer patients: A systematic review and meta-analysis of randomized controlled trials. J Telemed Telecare 2024; 30:1053-1064. [PMID: 36062618 DOI: 10.1177/1357633x221122727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Cancer patients not only experience a variety of problems associated with the treatment of their disease but also a range of psychological problems such as anxiety and depression, which may lead to reduced adherence to treatment and a lower quality of life for cancer patients. Telehealth interventions are widely used for cancer patients, and their effectiveness in improving anxiety and depression in cancer patients is variable and still contradictory. METHODS Embase, Pubmed, Web of Science, PsycINFO, CINAHL Complete, and the Cochrane Central Register of Controlled Trials were searched from inception to 19 April 2022. Data synthesis was conducted using STATA 15.0, and scores for anxiety and depression were calculated using standardized mean differences and 95% confidence intervals. RESULTS A total of 13125 cancer patients from 68 randomized controlled trials were included in the systematic evaluation. The meta-analysis showed that the telehealth intervention had a significant effect on anxiety (standardized mean differences = -0.40, 95% confidence intervals: -0.6 to 0.2, p < 0.001) and depression (standardized mean differences = -0.48, 95% confidence intervals: -0.67 to 0.28, p < 0.001) in patients with cancer. DISCUSSION Telehealth interventions significantly improved anxiety and depression levels in cancer patients compared to traditional care interventions. Breast cancer patients most often received telehealth interventions; electronic device-based and application-based telehealth interventions were more effective than online interventions; short-term interventions were more effective than medium-term and long-term interventions, and different outcome measurement tools led to different intervention outcomes. More high-quality research is needed to explore the effects of telehealth interventions.
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Affiliation(s)
- Yufan Yang
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yingying Huang
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ning Dong
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Liping Zhang
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shuanghong Zhang
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
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22
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Pfeifer VA, Weihs KL, Lai VT. Narratives about Cancer: What Metaphors can tell us about Depressive Symptoms in Breast Cancer Patients. HEALTH COMMUNICATION 2024; 39:1888-1898. [PMID: 37559183 PMCID: PMC10853478 DOI: 10.1080/10410236.2023.2245989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/11/2023]
Abstract
Metaphors are pervasive in cancer discourse. However, little is known about how metaphor use develops over time within the same patient, and how metaphor use and its content relate to the mental health of the patient. Here, we analyzed metaphor use in personal essays written by breast cancer patients shortly after the time of diagnosis and nine months later, in relation to their depressive symptoms at both time points. Results show that metaphor use can provide important insight into a patient's current mental state. Specifically, patients who had no change in their depressive symptom levels used metaphors more densely after nine months. In addition, metaphor valence in the later essay was associated with depressive symptoms at study entry and nine months after. Lastly, we observed a shift in metaphor reference pattern for different symptom trajectories, such that those who recovered from initially elevated depressive symptoms used fewer self-referencing metaphors and more cancer-referencing metaphors in their later essay. Our work suggests that metaphor use reflects how a patient is coping with their diagnosis.
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Affiliation(s)
| | - Karen L. Weihs
- Psychiatry, University of Arizona Cancer Center, Tucson, AZ
| | - Vicky T. Lai
- Psychology Department, University of Arizona, Tucson, AZ
- Cognitive Science Program, University of Arizona, Tucson, AZ
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23
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Goerling U, Ernst J, Esser P, Haering C, Hermann M, Hornemann B, Hövel P, Keilholz U, Kissane D, von dem Knesebeck O, Lordick F, Springer F, Zingler H, Zimmermann T, Engel C, Mehnert-Theuerkauf A. Estimating the prevalence of mental disorders in patients with newly diagnosed cancer in relation to socioeconomic status: a multicenter prospective observational study. ESMO Open 2024; 9:103655. [PMID: 39088984 PMCID: PMC11345380 DOI: 10.1016/j.esmoop.2024.103655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/25/2024] [Accepted: 07/01/2024] [Indexed: 08/03/2024] Open
Abstract
BACKGROUND The purpose of this study was to provide the 4-week prevalence estimates of mental disorders in newly diagnosed cancer patients in relation to socioeconomic status (SES). PATIENTS AND METHODS We enrolled newly diagnosed patients with a confirmed solid tumor within 2 months of diagnosis. We calculated patients' SES on the basis of their educational level, professional qualification, income and occupational status. We used the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition-Clinical Version (SCID-5-CV) to assess the 4-week prevalence of mental disorders in addition to a comorbidity questionnaire to assess the level of physical impairment. RESULTS We identified a total of 1702 patients with mixed cancers after reviewing their medical records and contacting them in person or by post due to coronavirus pandemic patient safety restrictions. 1030 patients (53.2% men, mean age 60.2 years) had completed SCID-5-CV. When weighted according to the SES distribution to account for over- and under-sampling of SES groups, 20.9% [95% confidence interval (CI) 18.1% to 23.6%] of patients were diagnosed with any mental disorder. The most prevalent were depressive disorders (9.9%, 95% CI 7.9% to 11.9%), trauma and stress-related disorders (6.3%, 95% CI 4.7% to 7.9%) and anxiety disorders (4.2%, 95% CI 2.9% to 5.6%). We found no difference in any mental disorder between patients with high, medium or low SES. Multivariate logistic regression analyses revealed higher proportion of patients with any mental disorder in patients younger than 60 years [odds ratio (OR) 0.42; P < 0.001], in patients without a partner (OR 1.84; P < 0.001), in women with tumor in female genital organs (OR 2.45; P < 0.002) and in those with a higher level of impairment (OR 1.05, 95% CI 1.03-1.07; P < 0.001). CONCLUSIONS SES had no significant influence on mental comorbidity in early cancer survivorship.
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Affiliation(s)
- U Goerling
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Comprehensive Cancer Center, Berlin
| | - J Ernst
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig
| | - P Esser
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig
| | - C Haering
- Comprehensive Cancer Center, University Clinic Centre Dresden, Dresden, Germany
| | - M Hermann
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Comprehensive Cancer Center, Berlin
| | - B Hornemann
- Comprehensive Cancer Center, University Clinic Centre Dresden, Dresden, Germany
| | - P Hövel
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig
| | - U Keilholz
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Comprehensive Cancer Center, Berlin
| | - D Kissane
- School of Medicine, University of Notre Dame Australia, Sydney; Departments of Palliative Care, Cabrini Health, Melbourne; Department of Palliative Care, St Vincent's Hospital Sydney, Sydney; School of Clinical Sciences, Monash Health and Monash University, Melbourne, Australia
| | - O von dem Knesebeck
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg
| | - F Lordick
- Department of Medicine II (Oncology, Gastroenterology, Hepatology, and Pulmonology), Comprehensive Cancer Center Central Germany (CCCG), University of Leipzig Medical Center, Leipzig
| | - F Springer
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig
| | - H Zingler
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover
| | - T Zimmermann
- Department of Psychosomatic Medicine and Psychotherapy, Hannover Medical School, Hannover
| | - C Engel
- Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Leipzig, Germany
| | - A Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, Comprehensive Cancer Center Central Germany (CCCG), University Medical Center Leipzig, Leipzig.
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24
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Lai Q, Li W, He X, Wang H, He Q, Hao C, Deng Z. Leisure-time physical activity is associated with depressive symptoms in cancer patients: Data from the NHANES 2007-2018. J Affect Disord 2024; 358:35-41. [PMID: 38705529 DOI: 10.1016/j.jad.2024.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 04/08/2024] [Accepted: 05/02/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Cancer patients have a higher risk of depression and are associated with severe adverse prognosis. The relationship between leisure-time physical activity (LTPA) and depressive symptoms in cancer patients is currently unclear. Therefore, our study mainly explores the potential association between LTPA and the weekly cumulative time of LTPA with depressive symptoms in cancer patients. METHODS We included and analyzed 3368 cancer patients (aged >20 years) from the National Health and Nutrition Examination Survey (NHANES) of the United States from 1999 to 2018. The LTPA score was evaluated through a self-report questionnaire, while depressive symptoms were evaluated through the Health Questionnaire-9 (PHQ-9). Multiple logistic regression analysis was used to explore the relationship between LTPA duration and the occurrence of cancer-related depressiive symptoms. Linear correlation was studied using the restricted cubic spline method. RESULTS According to a fully adjusted multivariate logistic regression model with confounding variables, the odds ratio (OR) between LTPA and depressive symptoms in cancer patients in this study was 0.59 (95 % confidence interval = 0.39, 0.92; P = 0.02). When the LTPA level was ≥300 min/week, the incidence of depressive symptoms was reduced by 59 % (OR = 0.41, 95 % CI = 0.21, 0.83). In addition, the cubic spline method was used to obtain a linear negative correlation between LTPA duration and tumor depressive symptoms. CONCLUSION LTPA was negatively correlated with cancer-related depressive symptoms, and the cumulative time of LTPA/week was linearly correlated with depressive symptoms. The slope of the benefit curve changed significantly when the cumulative time of LTPA reached 600 min per week, suggesting that appropriately increasing LTPA had significant benefits on mental health of cancer patients.
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Affiliation(s)
- Qun Lai
- Department of Hematology and Oncology, Third People's Hospital of Zigong, Zigong, Sichuan 643000, China
| | - Wenqiang Li
- Department of Pulmonary and Critical Care Medicine, First People's Hospital of Zigong, 42 Shangyihao Yizhi Street, Zigong, Sichuan 643000, China
| | - Xiaoyu He
- Department of Pulmonary and Critical Care Medicine, First People's Hospital of Zigong, 42 Shangyihao Yizhi Street, Zigong, Sichuan 643000, China; North Sichuan Medical College, Nanchong, Sichuan 637100, China
| | - Hongping Wang
- Department of Neurosurgery, Fourth People's Hospital of Zigong, Zigong, Sichuan 643000, China
| | - Qian He
- Department of Obstetrics and Gynecology, West China Second Hospital of Sichuan University, Chengdu, Sichuan 610000, China
| | - Chengluo Hao
- Department of Hematology and Oncology, Third People's Hospital of Zigong, Zigong, Sichuan 643000, China.
| | - Zhiping Deng
- Department of Pulmonary and Critical Care Medicine, First People's Hospital of Zigong, 42 Shangyihao Yizhi Street, Zigong, Sichuan 643000, China.
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25
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Sun F, Li L, Wen X, Xue Y, Yin J. The effect of Tai Chi/Qigong on depression and anxiety symptoms in adults with Cancer: A systematic review and meta-regression. Complement Ther Clin Pract 2024; 56:101850. [PMID: 38626582 DOI: 10.1016/j.ctcp.2024.101850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/18/2024] [Accepted: 04/03/2024] [Indexed: 04/18/2024]
Abstract
OBJECTIVE We expand on prior systematic reviews of Tai chi/Qigong (TCQ) practice on depression or anxiety symptoms in adults with cancer to estimate the mean effect of TCQ on depression and anxiety in randomized controlled trials. Additionally, we perform moderator analysis to examine whether effects vary based on patient features, TCQ stimuli properties, or characteristics of research design. METHODS Guided by PRISMA guidelines, we located articles published before August 31, 2023 using a combination of electronic database search and a complementary manual search through reference lists of articles and published reviews. Two separate multilevel meta-analyses with random-effects model were employed to estimate the overall effect of TCQ on depression and anxiety respectively. Further, multilevel meta-regression analysis was utilized to examine moderating effects based on moderators derived from patient features, TCQ stimuli properties, or characteristics associated with research design. Meta-analyses were performed in R4.0.0 and certainty of evidence with GRADEpro software. RESULTS The TCQ intervention yielded a standardized mean effect size of 0.29 (95% CI, 0.18 to 0.40) for anxiety, indicating homogeneity among the included studies. Conversely, for depression, the standardized mean effect size was 0.35 (95% CI, 0.14 to 0.55), signifying heterogeneity: reductions were larger when the trial primary outcome, predominantly function-related outcomes, changed significantly between the TCQ and control group. CONCLUSIONS TCQ practice exhibits small-to-moderate efficacy in alleviating depression and anxiety symptoms among cancer patients and survivors. Moreover, patients with depressive symptoms for whom TCQ intervention coupled with improvements in function-related outcomes manifested greater antidepressant effect.
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Affiliation(s)
- Fengqin Sun
- Anji County Experimental Junior Middle School, Huzhou City, Zhejiang Province, China
| | - Li Li
- Institue for Sport and Health, Harbin Sport University, Harbin, Heilongjiang Province, China
| | - Xiaodong Wen
- School of Sport and Physical Education, Shanghai Normal University, Shanghai, Shanghai, China
| | - Yuan Xue
- School of Sport and Physical Education, Shanghai Normal University, Shanghai, Shanghai, China
| | - Jianchun Yin
- School of Sport and Physical Education, Shanghai Normal University, Shanghai, Shanghai, China.
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von Humboldt S, Ilyas N, Leal I. Wolf in Sheep's Clothing? Violent, Abusive, and Harmful Behavior by the Older Person Toward Their Family Caregivers: A Qualitative Study. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241263589. [PMID: 39066570 DOI: 10.1177/08862605241263589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
Violent, abusive, and harmful behavior enacted by older adults upon their caregivers represents a distressing and frequently disregarded facet within the domain of caregiving. This qualitative study aims to (a) explore family caregivers' experiences of violent, abusive, and harmful behavior by the older person and (b) explore how violent, abusive, and harmful behavior by the older person affects family caregivers' mental health. This qualitative study encompassed 393 participants, with a diverse age range spanning from 40 to 72 years. All the interviews went through the process of content analysis. For the first objective, findings indicated six emerging themes: Frequent and extreme verbal violence (77.3%); feeling manipulated and controlled by older adults (74.7%); experiencing unpredictable illegal circumstances provoked by older adults (62.1%); experiencing damaging financial issues provoked by older adults (43.1%); experiencing physical violence (34.2.%); and experiencing sexual violence (31.1%). The second objective highlighted four themes: depression and anxiety (89.9 %), anger (81.2%), feeling morally isolated (78.3%), and emotional outbursts (65.1%). Brazilian participants mainly experienced frequent and extreme verbal violence (62.4%). Moreover, depression and anxiety were mainly verbalized by English participants (84.3%). These findings underscore the significant toll that older individuals' violent, abusive, and harmful behavior can have on the mental well-being of family caregivers. This study sheds light on the complex experiences faced by family caregivers and emphasizes the urgent need for targeted interventions to foster healthier caregiving environments. Older individuals' violent, abusive, and harmful behavior toward their caregivers has received limited attention in research and public discourse. The findings of this study call attention to the pressing need of addressing this issue, given its detrimental impact on the mental health of family carers. Recognizing the significance of this topic demands a comprehensive and targeted approach to ensure the well-being and safety of caregivers and older adults.
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Affiliation(s)
- Sofia von Humboldt
- William James Center for Research, ISPA-Instituto Universitário, Lisbon, Portugal
| | - Namrah Ilyas
- Center for Clinical Psychology, University of the Punjab, Lahore, Pakistan
| | - Isabel Leal
- William James Center for Research, ISPA-Instituto Universitário, Lisbon, Portugal
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Trendowski MR, Ruterbusch JJ, Baird TE, Wenzlaff AS, Pandolfi SS, Hastert TA, Schwartz AG, Beebe-Dimmer JL. Correlates of health-related quality of life in African Americans diagnosed with cancer: a review of survivorship studies and the Detroit research on cancer survivors cohort. Cancer Metastasis Rev 2024:10.1007/s10555-024-10200-y. [PMID: 39033236 DOI: 10.1007/s10555-024-10200-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 07/12/2024] [Indexed: 07/23/2024]
Abstract
Advances in cancer screening and treatment have improved survival after a diagnosis of cancer. As the number of cancer survivors as well as their overall life-expectancy increases, investigations of health-related quality of life (HRQOL) are critical in understanding the factors that promote the optimal experience over the course of survivorship. However, there is a dearth of information on determinants of HRQOL for African American cancer survivors as the vast majority of cohorts have been conducted predominantly among non-Hispanic Whites. In this review, we provide a review of the literature related to HRQOL in cancer survivors including those in African Americans. We then present a summary of published work from the Detroit Research on Cancer Survivors (ROCS) cohort, a population-based cohort of more than 5000 African American cancer survivors. Overall, Detroit ROCS has markedly advanced our understanding of the unique factors contributing to poorer HRQOL among African Americans with cancer. This work and future studies will help inform potential interventions to improve the long-term health of this patient population.
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Affiliation(s)
- Matthew R Trendowski
- Karmanos Cancer Institute, Wayne State University School of Medicine, 4100 John R, Mailcode: MM04EP, Detroit, MI, 48201, USA.
| | - Julie J Ruterbusch
- Karmanos Cancer Institute, Wayne State University School of Medicine, 4100 John R, Mailcode: MM04EP, Detroit, MI, 48201, USA
| | - Tara E Baird
- Karmanos Cancer Institute, Wayne State University School of Medicine, 4100 John R, Mailcode: MM04EP, Detroit, MI, 48201, USA
| | - Angela S Wenzlaff
- Karmanos Cancer Institute, Wayne State University School of Medicine, 4100 John R, Mailcode: MM04EP, Detroit, MI, 48201, USA
| | - Stephanie S Pandolfi
- Karmanos Cancer Institute, Wayne State University School of Medicine, 4100 John R, Mailcode: MM04EP, Detroit, MI, 48201, USA
| | - Theresa A Hastert
- Karmanos Cancer Institute, Wayne State University School of Medicine, 4100 John R, Mailcode: MM04EP, Detroit, MI, 48201, USA
| | - Ann G Schwartz
- Karmanos Cancer Institute, Wayne State University School of Medicine, 4100 John R, Mailcode: MM04EP, Detroit, MI, 48201, USA
| | - Jennifer L Beebe-Dimmer
- Karmanos Cancer Institute, Wayne State University School of Medicine, 4100 John R, Mailcode: MM04EP, Detroit, MI, 48201, USA
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Badger T, Segrin C, Crane TE, Chalasani P, Arslan W, Hadeed M, Given CW, Sikorskii A. A sequential multiple assignment randomized trial of symptom management for cancer survivors during treatment and their informal caregivers. Support Care Cancer 2024; 32:523. [PMID: 39023547 DOI: 10.1007/s00520-024-08734-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 07/11/2024] [Indexed: 07/20/2024]
Abstract
CONTEXT Many cancer survivors and their informal caregivers experience multiple symptoms during the survivor's treatment. OBJECTIVE Test relative effectiveness and optimal sequencing of two evidence-based interventions for symptom management. METHODS In this sequential multiple assignment randomized trial (SMART), survivors of solid tumors with elevated depression or anxiety and their caregivers as dyads were initially randomized after baseline assessment in a 3:1 ratio to the Symptom Management and Survivorship Handbook (SMSH, N = 277 dyads) intervention or SMSH plus 8 weeks of telephone interpersonal counseling (TIPC, N = 97 dyads). After 4 weeks, survivors who were not responding (no improvement or worsening score on depression and/or anxiety item) to SMSH only and their caregivers were re-randomized to continue with SMSH alone (N = 44 dyads) to give it more time or to SMSH + TIPC (N = 44 dyads). Mixed effects and generalized linear models compared severity of depression, anxiety, and a summed index of 16 other symptoms over weeks 1-13 and week 17 between randomized groups and among three dynamic treatment regimes (DTRs). Dyads received SMSH only for 12 weeks (DTR1); SMSH for 12 weeks with 8 weeks of TIPC added from week 1 (DTR2); and SMSH for 4 weeks followed by the combined SMSH + TIPC for 8 weeks if no response at 4 weeks (DTR3). RESULTS Survivors randomized initially to SMSH alone had significantly lower anxiety over weeks 1-13 compared to those randomized to the combined SMSH + TIPC. In comparing DTRs, survivor's anxiety was significantly lower at week 13 for DTR1 compared to DTR2 with no other main effects for survivors or caregivers. Exploratory moderation analyses indicated a potential benefit of adding TIPC for caregivers of non-responders with elevated baseline symptoms. CONCLUSION SMSH + TIPC did not result in better symptom outcomes at week 17 than SMSH alone. Lower intensity SMSH may improve depression and anxiety symptoms for most survivors and their caregivers. TRIAL REGISTRATION Clinicaltrails.gov ID number, NCT03743415; approved and posted on 11/16/2018.
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Affiliation(s)
- Terry Badger
- College of Nursing, University of Arizona, 1305 N. Martin Avenue, Tucson, AZ, 85721, USA.
| | - Chris Segrin
- Department of Communication, University of Arizona, Tucson, AZ, 85721, USA
| | - Tracy E Crane
- Division of Medical Oncology, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Pavani Chalasani
- Division of Hematology-Oncology, George Washington University, Washington, DC, USA
| | - Waqas Arslan
- College of Medicine, University of Arizona, Phoenix, AZ, USA
| | - Mary Hadeed
- College of Nursing, University of Arizona, 1305 N. Martin Avenue, Tucson, AZ, 85721, USA
| | - Charles W Given
- College of Nursing, Michigan State University, East Lansing, MI, USA
| | - Alla Sikorskii
- Department of Psychiatry, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
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Adejumo OA, Edeki IR, Sunday Oyedepo D, Falade J, Yisau OE, Ige OO, Adesida AO, Daniel Palencia H, Sabri Moussa A, Abdulmalik J, Noubiap JJ, Ekrikpo UE. Global prevalence of depression in chronic kidney disease: a systematic review and meta-analysis. J Nephrol 2024:10.1007/s40620-024-01998-5. [PMID: 38954184 DOI: 10.1007/s40620-024-01998-5] [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: 01/29/2024] [Accepted: 05/20/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Chronic kidney disease (CKD) is commonly associated with psychosocial problems, especially depression, contributing to poor overall outcomes. Depression has not been given adequate priority in the management of CKD patients despite its significant adverse impact on all major outcomes. This systematic review and meta-analysis determined the pooled prevalence of clinical depression in the global CKD population and sub-populations. METHODS PubMed, African Journals Online (AJOL), and EMBASE were systematically searched to identify published articles with relevant data. The pooled prevalence of clinical depression in the global CKD population was determined using random effects meta-analytic techniques. The study protocol was registered with PROSPERO (CRD42022382708). RESULTS Sixty-five articles were included in this review, comprising 80,932 individuals with CKD from 27 countries. The participants' mean age ranged from 11.0 to 76.3 years. Most (70.4%) of the studies had medium methodological quality. The overall pooled prevalence of depression was 26.5% (95% CI 23.1-30.1%). Studies using the Diagnostic Statistical Manual for Mental Diseases (DSM) and International Classification of Disease (ICD) returned a pooled prevalence of 25.5% and 39.6%, respectively, p = 0.03. There was a significant difference in the pooled prevalence across regions; p = 0.002.The prevalence of depression was higher among individuals on chronic hemodialysis compared to pre-dialysis patients (29.9% versus 18.5%; p = 0.01) and among those on hemodialysis compared to peritoneal dialysis (30.6% versus 20.4%; p = 0.04). There was no significant difference between adults and children (26.8% versus 15.9%, p = 0.21). There was an increasing temporal trend in depression prevalence, though this did not achieve statistical significance (p = 0.16). CONCLUSION Depression is common in patients with CKD. The findings of this study highlight the need for clinicians to make efforts to evaluate individuals with CKD for depression, especially those with advanced stages of the disease.
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Affiliation(s)
| | - Imuetinyan Rashida Edeki
- Department of Internal Medicine, University of Benin Teaching Hospital, Benin, Edo State, Nigeria
| | - Dapo Sunday Oyedepo
- Department of Internal Medicine, University of Ilorin Teaching Hospital, Ilorin, Kwara State, Nigeria
| | - Joshua Falade
- Department of Mental Health, University of Medical Sciences, Ondo, Ondo State, Nigeria
| | - Olawale Elijah Yisau
- Department of Internal Medicine, University of Medical Sciences, Ondo, Ondo State, Nigeria
| | - Olanrewaju Olumide Ige
- Department of Internal Medicine, University of Medical Sciences, Ondo, Ondo State, Nigeria
| | | | | | | | - Jibril Abdulmalik
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
- Directorate Office, Asido Foundation, Ibadan, Nigeria
| | - Jean Jacques Noubiap
- Division of Cardiology, Department of Medicine, University of California-San Francisco, San Francisco, CA, USA
| | - Udeme Ekpenyong Ekrikpo
- Research Team, DaVita HealthCare, Riyadh, Saudi Arabia.
- Department of Internal Medicine, University of Uyo, Uyo, Akwa Ibom State, Nigeria.
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Lyleroehr MJ, Webster KA, Perry LM, Patten EA, Cantoral J, Smith JD, Cella D, Penedo FJ, Garcia SF. A mixed methods evaluation of patient perspectives on the implementation of an electronic health record-integrated patient-reported symptom and needs monitoring program in cancer care. J Patient Rep Outcomes 2024; 8:66. [PMID: 38954112 PMCID: PMC11219691 DOI: 10.1186/s41687-024-00742-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 06/03/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND As cancer centers have increased focus on patient-centered, evidenced-based care, implementing efficient programs that facilitate effective patient-clinician communication remains critical. We implemented an electronic health record-integrated patient-reported symptom and needs monitoring program ('cPRO' for cancer patient-reported outcomes). To aid evaluation of cPRO implementation, we asked patients receiving care in one of three geographical regions of an academic healthcare system about their experiences. METHODS Using a sequential mixed-methods approach, we collected feedback in two waves. Wave 1 included virtual focus groups and interviews with patients who had completed cPRO. In Wave 2, we administered a structured survey to systematically examine Wave 1 themes. All participants had a diagnosed malignancy and received at least 2 invitations to complete cPRO. We used rapid and traditional qualitative methods to analyze Wave 1 data and focused on identifying facilitators and barriers to cPRO implementation. Wave 2 data were analyzed descriptively. RESULTS Participants (n = 180) were on average 62.9 years old; were majority female, White, non-Hispanic, and married; and represented various cancer types and phases of treatment. Wave 1 participants (n = 37) identified facilitators, including cPRO's perceived value and favorable usability, and barriers, including confusion about cPRO's purpose and various considerations for responding. High levels of clinician engagement with, and patient education on, cPRO were described as facilitators while low levels were described as barriers. Wave 2 (n = 143) data demonstrated high endorsement rates of cPRO's usability on domains such as navigability (91.6%), comprehensibility (98.7%), and relevance (82.4%). Wave 2 data also indicated low rates of understanding cPRO's purpose (56.7%), education from care teams about cPRO (22.5%), and discussing results of cPRO with care teams (16.3%). CONCLUSIONS While patients reported high value and ease of use when completing cPRO, they also reported areas of confusion, emphasizing the importance of patient education on the purpose and use of cPRO and clinician engagement to sustain participation. These results guided successful implementation changes and will inform future improvements.
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Affiliation(s)
- Madison J Lyleroehr
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2100, Chicago, IL, 60611, USA
| | - Kimberly A Webster
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2100, Chicago, IL, 60611, USA
| | - Laura M Perry
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2100, Chicago, IL, 60611, USA
| | - Elijah A Patten
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2100, Chicago, IL, 60611, USA
| | - Jackelyn Cantoral
- Biological Sciences Division, University of Chicago, Chicago, IL, 60637, USA
| | - Justin D Smith
- Department of Population Health Sciences, Division of Health System Innovation and Research, Spencer Fox Eccles School of Medicine at the University of Utah, Salt Lake City, UT, 84108, USA
| | - David Cella
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2100, Chicago, IL, 60611, USA
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 675 N. St. Clair St. Fl 21 Ste 100, Chicago, IL, 60611, USA
| | - Frank J Penedo
- Departments of Psychology and Medicine, University of Miami, Coral Gables, FL, 33124, USA
- Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, 33136, USA
| | - Sofia F Garcia
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave., Suite 2100, Chicago, IL, 60611, USA.
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, 675 N. St. Clair St. Fl 21 Ste 100, Chicago, IL, 60611, USA.
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Petrova D, Ubago-Guisado E, Garcia-Retamero R, Redondo-Sánchez D, Pérez-Gómez B, Catena A, Caparros-Gonzalez RA, Sánchez MJ. Allostatic Load and Depression Symptoms in Cancer Survivors: A National Health and Nutrition Examination Survey Study. Cancer Nurs 2024; 47:290-298. [PMID: 36920171 DOI: 10.1097/ncc.0000000000001216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
BACKGROUND Individuals with cancer often experience stress throughout the cancer trajectory and have a high risk of experiencing depression. OBJECTIVE The aim of this study was to examine the relationship between allostatic load (AL), a measure of cumulative stress-related physiologic dysregulation of different body systems, and symptoms of depression in cancer survivors. METHODS Participants were 294 adult cancer survivors from the US National Health and Nutrition Examination Survey (NHANES 2007-2018). Allostatic load was measured using 14 indicators representing cardiometabolic risk, glucose metabolism, cardiopulmonary functioning, parasympathetic functioning, and inflammation. Depressive symptoms were measured with the Patient Health Questionnaire-9. The relationship between AL and depressive symptoms was investigated using multiple regression adjusted for diverse sociodemographic and diagnosis variables. RESULTS Higher AL was associated with higher depressive symptom scores. The higher risk of depression was concentrated among those survivors in the highest AL quartile, with 21% (95% confidence interval, 11%-32%) of survivors presenting a high risk of depression compared with 8% to 11% of survivors in the lower quartiles. In exploratory analyses, the relationship between AL and depressive symptoms was only significant among survivors with a lower income. In contrast, in survivors in the highest income group, depressive symptoms were lower and unrelated to AL. CONCLUSION High AL is associated with more depressive symptoms among cancer survivors. IMPLICATIONS FOR PRACTICE Nurses have an important role in identifying psychological distress in cancer patients and survivors. Further research is needed to investigate the usefulness of AL as a marker in the context of cancer follow-up care and screening for psychological distress.
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Affiliation(s)
- Dafina Petrova
- Author Affiliations: Instituto de Investigación Biosanitaria, ibs.GRANADA (Drs Petrova, Ubago-Guisado, Caparros-Gonzalez, and Sánchez, and Mr Rendondo-Sánchez), Granada; Escuela Andaluza de Salud Pública (Drs Petrova, Ubago-Guisado, and Sánchez, and Mr Rendondo-Sánchez), Granada; CIBER of Epidemiology and Public Health (Drs Petrova, Ubago-Guisado, Pérez-Gómez, and Sánchez, and Mr Rendondo-Sánchez), Madrid; University of Granada (Drs Garcia-Retamero, Catena, and Caparros-Gonzalez); National Center for Epidemiology, Health Institute Carlos III (Dr Pérez-Gómez), Madrid; and Departamento de Medicina Preventiva y Salud Pública, Universidad de Granada (Dr Sánchez), Spain
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Carriero MC, Leo A, Lezzi A, Lupo R, Conte L, Fanizzi A, Massafra R, Vitale E, Carriero A. Attitudes, Knowledge and Clinical Practice of Health Professionals towards Psychological Disorders in Cancer Patients: An Observational Study. Diseases 2024; 12:141. [PMID: 39057112 PMCID: PMC11276451 DOI: 10.3390/diseases12070141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/27/2024] [Accepted: 06/29/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND The suffering associated with a cancer diagnosis can find different channels to express itself: sleep disorders, psychiatric disorders, sexuality. These are not always analyzed by health professionals, but they have an impact on the patient's quality of life and on the outcome of the disease. METHODS An observational study was conducted in order to investigate attitudes, knowledge and clinical practice towards psychological symptoms in cancer patients. RESULTS A total of 132 clinicians from all Italian regions responded. In total, 99.2% (n = 131) considered the figure of the psychologist useful in the oncology field and recommended him/her in clinical practice (n = 115; 87.7%), especially in the terminal phase of the illness (58.6%; n = 99). Despite the importance given to the figure of the psychologist, psychiatric disorders are not diagnosed. Only 20.0% (n = 26) identified depressive disorder as accurate and only 33.9% (n = 43) identified demoralization syndrome as accurate. CONCLUSIONS Results prove the need for training on psychological disorders in oncology and the emotional repercussions of cancer illness.
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Affiliation(s)
| | - Antonio Leo
- “Santa Chiara” Institute, Via Campania, 1, 73100 Lecce, Italy
| | - Alessia Lezzi
- ANT Italia ONLUS Foundation (National Cancer Association), 73100 Lecce, Italy
| | - Roberto Lupo
- “San Giuseppe da Copertino” Hospital, ASL (Local Health Authority), 73100 Lecce, Italy
| | - Luana Conte
- Laboratory of Biomedical Physics and Environment, Department of Mathematics and Physics “E. De Giorgi”, University of Salento, Via Antonio Miglietta, 5, 73100 Lecce, Italy
- Laboratory of Interdisciplinary Research Applied to Medicine (DReAM), University of Salento and ASL (Local Health Authority), Via Antonio Miglietta, 5, 73100 Lecce, Italy
| | - Annarita Fanizzi
- Laboratorio di Biostatistica e Bioinformatica, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Raffaella Massafra
- Laboratorio di Biostatistica e Bioinformatica, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Elsa Vitale
- Scientific Directorate, IRCCS Istituto Tumori “Giovanni Paolo II”, Viale Orazio Flacco 65, 70124 Bari, Italy
| | - Antonio Carriero
- Department of Oncology, “V. Fazzi” Hospital, Piazza Filippo Muratore, 1, 73100 Lecce, Italy
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Guo J, Wang H, Zou X, Huang R, Liang Z, Liang S. The challenge of survivors of gynecological carcinomas: a retrospective study on occurrence of second tumors. Arch Gynecol Obstet 2024; 310:525-533. [PMID: 38709268 DOI: 10.1007/s00404-024-07497-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 03/25/2024] [Indexed: 05/07/2024]
Abstract
OBJECTIVE To clarify the epidemiologic characteristics and risk of other tumors in survivors of gynecological tumors. MATERIALS AND METHODS This is a retrospective study based on the Surveillance, Epidemiology, and End Results database (SEER). RESULTS The morbidity of other malignant tumors in patients with gynecological cancer was 8.07%. The most common subsequent tumors are breast, lung, colorectal, thyroid, and bladder cancers. Taking the incidence rate of the general population as reference, the second tumor with the highest relative risk in patients with cervical cancer is vulvar cancer. Bladder cancer is the second tumor with the highest relative risk value both in patients with corpus and ovarian cancer. The median period from the diagnosis of the initial tumor to the diagnosis of the second tumor was 5 years. Most patients with other tumors following gynecological cancer showed worse prognosis than patients with gynecological tumors only. However, thyroid cancer following ovarian cancer is a protective factor in survival. CONCLUSION Patients with gynecological tumors have a significantly higher risk of malignant tumors in other systems compared to ordinary population. It is necessary to be vigilant against subsequent high-risk tumors and tumors with poor prognosis within 5 years of initial diagnosis.
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Affiliation(s)
- Jianbin Guo
- Department of Obstetrics and Gynecology, Shandong First Medical University Affiliated Provincial Hospital, Jinan, 250021, Shandong, China
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, 100730, Beijing, China
| | - Hao Wang
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, 100730, Beijing, China
| | - Xueke Zou
- Department of Dermatology, Shandong First Medical University Affiliated Provincial Hospital, Jinan, 250021, Shandong, China
| | - Roujie Huang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, 100730, Beijing, China
| | - Zhiyong Liang
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, 100730, Beijing, China.
| | - Shuo Liang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetric & Gynecologic Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1, Shuaifuyuan, Dongcheng District, 100730, Beijing, China.
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Moreno PI, Worch SM, Thomas JL, Nguyen RL, Medina HN, Penedo FJ, Moskowitz JT, Yanez B, Kircher SM, Kundu SD, Flury SC, Cheung EO. Quality of Life in Patients and Their Spouses and Cohabitating Partners in the Year Following a Cancer Biopsy (the Couples Cope Study): Protocol for a Prospective Observational Study. JMIR Res Protoc 2024; 13:e52361. [PMID: 38889402 PMCID: PMC11220434 DOI: 10.2196/52361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 03/11/2024] [Accepted: 03/12/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Receiving a diagnosis of cancer is a profound and often very stressful experience. Few studies have prospectively recruited patients prior to receiving a new diagnosis of cancer and included spouses or partners. OBJECTIVE The aim of the Couples Cope Study is to understand the impact of undergoing a diagnostic biopsy and receiving a new cancer diagnosis on quality of life (QoL) in both patients and their spouses or partners, as well as on the quality of their relationship. This protocol paper describes the study design and assesses the feasibility of recruitment and retention. METHODS Study staff reviewed the schedules of collaborating physicians using specific encounter codes to identify patients scheduled for breast or prostate biopsies. Potential participants were prescreened via the electronic health record and sent a recruitment letter at least 2 to 3 weeks prior to their biopsy procedure. Patients subsequently underwent a phone screening to determine eligibility. Patients who enrolled provided study staff with contact information for their spouses or partners. All consent forms were completed online. Surveys were completed online prior to receiving the biopsy results (baseline), and at 1, 3, 6, and 9 months after the biopsy. Study staff engaged in ongoing, personalized contact with participants and sent assessment completion reminders via phone and email. RESULTS A total of 2294 patients undergoing a breast or prostate biopsy were identified and 69% (n=1582) were eligible for phone screening following electronic health record prescreening. Of the 431 patients who underwent phone screening, 75% (n=321) were eligible to participate. Of the eligible patients, 72% (n=231) enrolled and 82% (n=190) of enrolled patients had an accompanying partner or spouse who also enrolled. A total of 77% (34/44) of patients who received a cancer diagnosis and 72% (26/36) of their spouses or partners were retained through 9 months, while 80% (53/66) of patients who received a benign diagnosis and 68% (42/62) of their partners were retained. CONCLUSIONS Prospective recruitment of patients undergoing diagnostic biopsy and their partners is feasible and requires both strategic collaboration with providers and concerted prescreening and recruitment efforts by study staff. Importantly, this study was able to conduct all study activities online without disrupting clinical workflow and without requiring patients and their spouses or partners to come into the laboratory. Consideration should be given to the ratio of biopsies to cancer diagnoses, which can vary significantly by cancer type. Prospective studies are needed and can inform our ability to provide effective support earlier to couples facing a possible cancer diagnosis. Future studies should examine other tumor types that have received less attention in QoL studies, include behavioral and neurobiological assessments beyond self-report measures, and follow couples beyond 9 months in order to examine long-term effects on QoL. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52361.
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Affiliation(s)
- Patricia I Moreno
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Sarah M Worch
- Department of Psychology, Lynn University, Boca Raton, FL, United States
| | - Jessica L Thomas
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Rebecca L Nguyen
- Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD, United States
| | - Heidy N Medina
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Frank J Penedo
- Departments of Medicine & Psychology, University of Miami, Miami, FL, United States
| | - Judith T Moskowitz
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Betina Yanez
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sheetal M Kircher
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Shilajit D Kundu
- Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL, United States
| | - Sarah C Flury
- Department of Urology, Vanderbilt University School of Medicine, Nashville, TN, United States
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Schulze JB, Dörner M, Huber M, Jordan KD, Känel RV, Euler S. Psychiatric Diagnoses and Their Treatment in Women With Breast Cancer: A Latent Class Analysis of 1062 Inpatients. Clin Breast Cancer 2024:S1526-8209(24)00176-9. [PMID: 39153934 DOI: 10.1016/j.clbc.2024.06.011] [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: 09/22/2023] [Revised: 05/11/2024] [Accepted: 06/14/2024] [Indexed: 08/19/2024]
Abstract
INTRODUCTION Psycho-oncological support (POS) and psychopharmacological interventions are effective in treating psychiatric symptoms in patients with breast cancer. However, despite high prevalences of psychiatric disorders in patients with breast cancer, a significant proportion remains untreated. METHODS Data from 1062 breast cancer patients who had been diagnosed and treated at a Comprehensive Cancer Center between 2012 and 2019 were analyzed retrospectively. We descriptively evaluated the number of patients with a psychiatric diagnosis, POS and psychiatric medication. Latent class analysis was used to examine the relationship between ICD-10 coded psychiatric diagnoses, POS, psychiatric medication, and, as important prognostic factors, tumor stage and somatic comorbidity. RESULTS 31.5% of all patients had a psychiatric diagnosis, 20% received POS and up to 60% received psychiatric medication. Latent class analysis revealed three subgroups: 1) patients with a low cancer stage, low somatic comorbidity, no psychiatric diagnosis, no POS and no psychiatric medication; 2) patients with a low cancer stage, low somatic comorbidity, a psychiatric diagnosis, and a higher probability of POS and psychiatric medication than class 1 and class 3; 3) patients with advanced cancer stage, high somatic comorbidity, a higher probability of a psychiatric diagnosis and POS than class 1, and no psychiatric medication. CONCLUSION This study indicated a high prevalence of psychiatric disorders among patients with breast cancer and a discrepancy between the number of patients having a psychiatric disorder and those receiving psychiatric medication. The identification of subgroups might contribute to better tailored treatment for those patients whose needs are insufficiently met.
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Affiliation(s)
- Jan Ben Schulze
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Zurich, Switzerland.
| | - Marc Dörner
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Zurich, Switzerland; German Center for Neurodegenerative Diseases (DZNE) within the Helmholtz Association, Magdeburg, Saxony-Anhalt, Germany
| | - Mona Huber
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Zurich, Switzerland
| | - Katja-Daniela Jordan
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Zurich, Switzerland
| | - Sebastian Euler
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Zurich, Switzerland
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Wang B, Li M, Haihambo N, Qiu Z, Sun M, Guo M, Zhao X, Han C. Characterizing Major Depressive Disorder (MDD) using alpha-band activity in resting-state electroencephalogram (EEG) combined with MATRICS Consensus Cognitive Battery (MCCB). J Affect Disord 2024; 355:254-264. [PMID: 38561155 DOI: 10.1016/j.jad.2024.03.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Revised: 03/24/2024] [Accepted: 03/25/2024] [Indexed: 04/04/2024]
Abstract
BACKGROUND The diagnosis of major depressive disorder (MDD) is commonly based on the subjective evaluation by experienced psychiatrists using clinical scales. Hence, it is particularly important to find more objective biomarkers to aid in diagnosis and further treatment. Alpha-band activity (7-13 Hz) is the most prominent component in resting electroencephalogram (EEG), which is also thought to be a potential biomarker. Recent studies have shown the existence of multiple sub-oscillations within the alpha band, with distinct neural underpinnings. However, the specific contribution of these alpha sub-oscillations to the diagnosis and treatment of MDD remains unclear. METHODS In this study, we recorded the resting-state EEG from MDD and HC populations in both open and closed-eye state conditions. We also assessed cognitive processing using the MATRICS Consensus Cognitive Battery (MCCB). RESULTS We found that the MDD group showed significantly higher power in the high alpha range (10.5-11.5 Hz) and lower power in the low alpha range (7-8.5 Hz) compared to the HC group. Notably, high alpha power in the MDD group is negatively correlated with working memory performance in MCCB, whereas no such correlation was found in the HC group. Furthermore, using five established classification algorithms, we discovered that combining alpha oscillations with MCCB scores as features yielded the highest classification accuracy compared to using EEG or MCCB scores alone. CONCLUSIONS Our results demonstrate the potential of sub-oscillations within the alpha frequency band as a potential distinct biomarker. When combined with psychological scales, they may provide guidance relevant for the diagnosis and treatment of MDD.
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Affiliation(s)
- Bin Wang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, 100191 Beijing, China
| | - Meijia Li
- Faculty of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Naem Haihambo
- Faculty of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Zihan Qiu
- Avenues the World School Shenzhen Campus, Shenzhen 518000, China
| | - Meirong Sun
- School of Psychology, Beijing Sport University, Beijing 100084, China
| | - Mingrou Guo
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong
| | - Xixi Zhao
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing 100088, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, 100191 Beijing, China.
| | - Chuanliang Han
- School of Biomedical Sciences and Gerald Choa Neuroscience Institute, The Chinese University of Hong Kong, Hong Kong.
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Van Wijk CH. Prevalence Estimate for Adjustment Disorders in the South African Navy. Clin Pract Epidemiol Ment Health 2024; 20:e17450179301661. [PMID: 39135946 PMCID: PMC11318156 DOI: 10.2174/0117450179301661240528064329] [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: 01/24/2024] [Revised: 05/06/2024] [Accepted: 05/15/2024] [Indexed: 08/15/2024]
Abstract
Introduction and Aim Adjustment Disorder is among the most commonly diagnosed mental disorders in the armed forces, with a mean prevalence estimated at 7.4% across military populations. The prevalence in South African military populations is not known. This study aimed to estimate the prevalence of Adjustment Disorders in the South African Navy and to explore potential risk factors. Methods In this cross-sectional study, a representative sample of 714 sailors completed the International Adjustment Disorder Questionnaire, and also provided information from their biennial occupational health assessment mental health screening, which included other clinical screeners of mental health and adjustment history. Results The estimated prevalence of Adjustment Disorders in the South African Navy was 6.9%, and was proportionally distributed across gender and age categories. Depression and PTSD were the main comorbid conditions. Risk factors included a) history of adjustment difficulties during military deployment or family adjustment difficulties, b) domestic discord (difficulties in relationship with spouse/partner or immediate family), and c) the experience of stress overload (i.e., that the demands of life are overwhelming available resources). Conclusion The estimated prevalence was similar to the expectation of military personnel generally, although the self-report data needs to be interpreted cautiously. The contributing risk factors offer possible direction for targeted intervention, e.g., skills training and relationship counselling to enhance coping with military service and family challenges, and cognitive behaviour therapy generally to address sailors' experience of stress overload.
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Affiliation(s)
- Charles H. Van Wijk
- Division of Health Systems and Public Health, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
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Feldstain A. Psychosocial intervention in palliative care: What do psychologists need to know. J Health Psychol 2024; 29:707-720. [PMID: 38282369 PMCID: PMC11141107 DOI: 10.1177/13591053231222848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024] Open
Abstract
Emotional and existential suffering is prevalent in advanced diseases and psychologists have valuable skills to support people in this time of life. Yet, psychologists are rarely integrated in palliative care and relevant training is sparse. Being integrated in other areas of health, it is likely that we will be supporting these patients, whether integrated in a specialized team or not. This article is meant to serve psychologists, already skilled in the art and science of psychosocial intervention, who may find themselves supporting patients with advanced disease. Relevant history of palliative care is provided to elucidate palliative philosophy and approach. Evidence-based existential interventions will be reviewed. Integration of psychological models and both palliative theory and practice is provided to support palliative-appropriate case conceptualizations. Finally, case examples are provided throughout to help readers reconcile their existing practice in this domain of care.
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Foo BMY, Sharpe L, Clayton JM, Wiese M, Menzies RE. The role of psychologists in supporting illness-related dying and death: A systematic mixed studies review. Clin Psychol Rev 2024; 110:102393. [PMID: 38615491 DOI: 10.1016/j.cpr.2024.102393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 01/09/2024] [Accepted: 01/18/2024] [Indexed: 04/16/2024]
Abstract
Psychologists remain underrepresented in end-of-life care, and there is limited understanding of their role among healthcare professionals, patients, and caregivers. This systematic mixed-studies review, prospectively registered on PROSPERO (CRD42020215775), explored the role of psychologists, and the facilitators and barriers they experience, in supporting clients with illness-related dying and death. A search of six research databases was conducted in October 2023. Fifty-one studies, mainly qualitative and from the perspectives of psychologists, met inclusion criteria. Thematic synthesis highlighted how psychologists provided expertise across various contexts. They supported clients with preparing for death, and adjusting to dying, provided professional consultancy and support, and undertook leadership in enhancing psychological end-of-life care. Results illustrated the sustaining factors and ongoing challenges working in end-of-life care, namely, the unique nature of navigating the death space, recognition and awareness of psychologists' contribution, and the support, training and development required. Given the universality of dying and death, this review is relevant to psychologists working within and beyond more traditional end-of-life care contexts, such as employee assistance programs, private practice, schools, and other psychological services. Policy, clinical and research implications are discussed, including the need for greater engagement and training of psychologists in the dying and death space.
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Affiliation(s)
- Baby M Y Foo
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales 2006, Australia.
| | - Louise Sharpe
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales 2006, Australia.
| | - Josephine M Clayton
- The Palliative Centre, HammondCare, Greenwich Hospital, Sydney, Australia; Northern Clinical School, The University of Sydney, Australia.
| | - Michele Wiese
- School of Psychology, Western Sydney University, Penrith, New South Wales 2751, Australia.
| | - Rachel E Menzies
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales 2006, Australia.
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Akechi T, Furukawa TA, Noma H, Iwata H, Toyama T, Higaki K, Matsuoka H, Zenda S, Iwatani T, Akahane K, Inoue A, Sagara Y, Uchida M, Imai F, Momino K, Imaizumi G, Yamaguchi T, Mashiko T, Miyaji T, Horikoshi M, Sakurai N, Onishi T, Kanemitsu Y, Murata T, Wanifuchi-Endo Y, Kuroda H, Nishikawa R, Miyashita M, Abe M, Uchitomi Y. Optimizing smartphone psychotherapy for depressive symptoms in patients with cancer: Multiphase optimization strategy using a decentralized multicenter randomized clinical trial (J-SUPPORT 2001 Study). Psychiatry Clin Neurosci 2024; 78:353-361. [PMID: 38468404 DOI: 10.1111/pcn.13657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 01/28/2024] [Accepted: 02/08/2024] [Indexed: 03/13/2024]
Abstract
AIM Patients with cancer experience various forms of psychological distress, including depressive symptoms, which can impact quality of life, elevate morbidity risk, and increase medical costs. Psychotherapy and pharmacotherapy are effective for reducing depressive symptoms among patients with cancer, but most patients prefer psychotherapy. This study aimed to develop an efficient and effective smartphone psychotherapy component to address depressive symptom. METHODS This was a decentralized, parallel-group, multicenter, open, individually randomized, fully factorial trial. Patients aged ≥20 years with cancer were randomized by the presence/absence of three cognitive-behavioral therapy (CBT) skills (behavioral activation [BA], assertiveness training [AT], and problem-solving [PS]) on a smartphone app. All participants received psychoeducation (PE). The primary outcome was change in the patient health questionnaire-9 (PHQ-9) total score between baseline and week 8. Secondary outcomes included anxiety. RESULTS In total, 359 participants were randomized. Primary outcome data at week 8 were obtained for 355 participants (99%). The week 8 PHQ-9 total score was significantly reduced from baseline for all participants by -1.41 points (95% confidence interval [CI] -1.89, -0.92), but between-group differences in change scores were not significant (BA: -0.04, 95% CI -0.75, 0.67; AT: -0.16, 95% CI -0.87, 0.55; PS: -0.19, 95% CI -0.90, 0.52). CONCLUSION As the presence of any of the three intervention components did not contribute to a significant additive reduction of depressive symptoms, we cannot make evidence-based recommendations regarding the use of specific smartphone psychotherapy.
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Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Center for Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Hisashi Noma
- Department of Data Science, The Institute of Statistical Mathematics, Tokyo, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center, Nagoya, Japan
| | - Tatsuya Toyama
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | | | - Hiromichi Matsuoka
- Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Sadamoto Zenda
- Division of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - Tsuguo Iwatani
- Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan
| | | | - Akira Inoue
- Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan
| | - Yasuaki Sagara
- Department of Breast and Thyroid Surgical Oncology, Hakuaikai Medical Corporation, Sagara Hospital, Kagoshima, Japan
| | - Megumi Uchida
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Center for Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya, Japan
| | - Fuminobu Imai
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kanae Momino
- Department of Nursing Administration and Management, Nagoya City University Graduate School of Nursing, Nagoya, Japan
| | - Gen Imaizumi
- Department of Psychiatric and Mental Health Nursing, Nagoya City University Graduate School of Nursing, Nagoya, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tomoe Mashiko
- Division of Survivorship, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Tempei Miyaji
- Division of Survivorship, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Masaru Horikoshi
- National Center for Cognitive Behavior Therapy and Research, National Center of Neurology and Psychiatry, Tokyo, Japan
| | | | - Tatsuya Onishi
- Department of Breast Surgery, National Cancer Center Hospital East, Chiba, Japan
| | - Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Takeshi Murata
- Department of Breast Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Yumi Wanifuchi-Endo
- Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiroaki Kuroda
- Department of Thoracic Surgery, Aichi Cancer Center, Nagoya, Japan
| | - Ryutaro Nishikawa
- Department of Obstetrics and Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Minoru Miyashita
- Department of Breast and Endocrine Surgical Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Masakazu Abe
- Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Yosuke Uchitomi
- Division of Survivorship, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
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Senger AR, G Ratcliff C, K Semelsberger R, Chaoul A, Cohen L. The Role of Coping and Posttraumatic Stress in Fostering Posttraumatic Growth and Quality of Life Among Women with Breast Cancer. J Clin Psychol Med Settings 2024; 31:368-378. [PMID: 37803095 DOI: 10.1007/s10880-023-09977-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2023] [Indexed: 10/08/2023]
Abstract
Tedeschi & Calhoun's model of posttraumatic growth (PTG) suggests that intrusive thoughts about a traumatic event, in combination with helpful coping strategies, facilitates PTG. This manuscript applies this model to a sample of breast cancer survivors, augments it to conceptualize coping strategies as "active" or "avoidant," and extends it to include health-related quality of life (HRQOL). This is a secondary analysis of a subset of breast cancer patients (N = 123) in a randomized clinical trial of Tibetan yoga, which examines the associations of coping at study entry with PTG, PTSS (i.e., intrusive thoughts and avoidance), and HRQOL (physical (PCS) and mental (MCS) component scales) reported 9 and 15 months later. Mediation analyses revealed that higher baseline active coping predicted higher 9-month PTG, which in turn predicted higher 15-month PCS [effect = .46, 95% CI (.06, 1.07)]. Exploratory moderated mediation analyses revealed that higher baseline intrusive thoughts about cancer predicted lower 9-month PTG, which in turn predicted lower 15-month PCS, but only for those reporting low active coping [effect = - .06, 95% CI (- .16, - .003)]. Active coping may play a critical role of fostering PTG and improving subsequent HRQOL in the presence of rumination about cancer.
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Affiliation(s)
| | - Chelsea G Ratcliff
- Department of Psychology and Philosophy, Sam Houston State University, 1901 Avenue I, Suite 390, Huntsville, TX, 77341, USA.
- Baylor College of Medicine, Houston, TX, USA.
| | - Robin K Semelsberger
- Department of Psychology and Philosophy, Sam Houston State University, 1901 Avenue I, Suite 390, Huntsville, TX, 77341, USA
| | | | - Lorenzo Cohen
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Chen X, Ye C, Liu L, Li X. Factors associated with depressive symptoms among cancer patients: a nationwide cross-sectional study. BMC Public Health 2024; 24:1443. [PMID: 38811910 PMCID: PMC11137935 DOI: 10.1186/s12889-024-18898-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 05/20/2024] [Indexed: 05/31/2024] Open
Abstract
OBJECTIVE Research on factors contributing to depressive symptoms in cancer patients at a national level, encompassing a comprehensive set of variables was limited. This study aimed to address this gap by identifying the factors associated with depressive symptoms among cancer patients through a nationwide cross-sectional analysis. METHODS Various factors, including demographic, socioeconomic, behavioral patterns, general and self-rated health status, chronic conditions, dietary habits, and cancer-related factors, were examined. Data was from the National Health and Nutrition Examination Survey. Univariate and multivariate logistic regression analyses were performed to identify associated factors. The receiver-operating characteristic (ROC) curve was used to evaluate the performance of the logistic model. RESULTS The findings showed that five sociodemographic factors, two behavioral styles, self-rated health status, comorbid arthritis, two dietary factors and two cancer-related factors were strongly associated with depressive symptoms. Compared with those aged 20-39 years, cancer individuals aged 40-59 years (OR = 0.48, P < 0.05) and those 60 years or older (OR = 0.18, P < 0.05) had lower odds of depression. Positive factors included being never married (OR = 1.98, P < 0.05), widowed, divorced or separated (OR = 1.75, P < 0.05), unemployment (OR = 1.87, P < 0.05), current smoking (OR = 1.84, P < 0.05), inadequate sleep (OR = 1.96, P < 0.05), comorbid arthritis (OR = 1.79, P < 0.05), and poor self-rated health status (OR = 3.53, P < 0.05). No significant association was identified between the Healthy Eating Index 2015 and the Dietary Inflammatory Index with depression (P > 0.05). Shorter cancer diagnosis duration was associated with reduced odds of depression (P < 0.05). The logistic model had an area under the curve of 0.870 (95% CI: 0.846-0.894, P < 0.05). CONCLUSIONS Cancer patients should receive enhanced family and social support while cultivating a healthy lifestyle and diet. Incorporating plenty of fruits, greens, and beans is highly recommended, along with establishing a comprehensive health management framework.
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Affiliation(s)
- Xiaoqing Chen
- Library, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China
- Department of Big Data in Health Science, Center for Clinical Big Data and Statistics, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310058, China
| | - Chaoyan Ye
- Department of Big Data in Health Science, Center for Clinical Big Data and Statistics, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310058, China
| | - Li Liu
- Library, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310003, China
| | - Xiuyang Li
- Department of Big Data in Health Science, Center for Clinical Big Data and Statistics, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310058, China.
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Yang Y, Yi Y, Shi X, Yang X. Comparative efficacy of psychological interventions on anxiety and depression in patients with cancer: A systematic review and network meta-analysis. Medicine (Baltimore) 2024; 103:e38155. [PMID: 38787974 PMCID: PMC11124676 DOI: 10.1097/md.0000000000038155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 04/16/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Numerous studies have demonstrated that psychological interventions are effective in alleviating anxiety and depression in patients with cancer. However, the optimal psychological intervention to alleviate anxiety and depression in patients with cancer remains unknown. This study was carried out to compare and rank the comparative effectiveness of various psychological interventions on anxiety and depression in patients with cancer. METHODS Databases, namely PubMed, Embase, Cochrane Library, Web of Science, PsycINFO, CNKI, WanFang, VIP and CBM were systematically searched from their inception dates to December 2023 for randomized controlled trials of psychological interventions for anxiety and depression in patients with cancer. Utilizing the Cochrane Review Manager 5.4, we evaluated the risk of bias in the studies included in the current study based on the Cochrane Handbook 5.1.0 Methodological Quality Evaluation Criteria. The NMA was conducted using STATA 15.0. This study did not involve human participants and therefore did not require ethical approval. RESULTS Thirty-one randomized controlled trials involving 3471 participants were included. MT [SMD = 1.35, 95% CI (0.76, 1.93)] and cognitive behavioral therapy (CBT) [SMD = 0.97, 95% CI (0.53, 1.42)] were superior to usual care in alleviating anxiety. Besides, interpersonal psychotherapy (IPT) [SMD = 1.17, 95% CI (0.06, 2.28)], CBT [SMD = 0.97, 95 % CI (0.63, 1.30)], and MT [SMD = 0.93, 95% CI (0.35, 1.50)] were superior to usual care in alleviating depression. In addition, CBT was superior to family therapy in alleviating depression [SMD = 0.73, 95% CI (0.08, 1.38)]. The MT, CBT, and IPT ranked in the top three in alleviating anxiety, while IPT, CBT, and MT ranked in the top three in alleviating depression. CONCLUSION MT and IPT would be a more appropriate option in alleviating anxiety and depression in patients with cancer, respectively. This study also suggested that CBT had a significant effect in alleviating negative emotions in patients with cancer. However, the results need to be validated by high-quality and large-sample studies.
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Affiliation(s)
- Yinhao Yang
- School of Nursing, Hubei University of Medicine, Shiyan, China
- Institute of Cancer Clinical Prevention and Control, Medical Department of Jingchu University of Technology, Jingmen, China
| | - Yingying Yi
- School of Nursing, Hubei University of Medicine, Shiyan, China
| | - Xixi Shi
- Institute of Cancer Clinical Prevention and Control, Medical Department of Jingchu University of Technology, Jingmen, China
| | - Xueqin Yang
- Institute of Cancer Clinical Prevention and Control, Medical Department of Jingchu University of Technology, Jingmen, China
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Vitale E, Halemani K, Shetty A, Chang YC, Hu WY, Massafra R, Moretti A. Sex Differences in Anxiety and Depression Conditions among Cancer Patients: A Systematic Review and Meta-Analysis. Cancers (Basel) 2024; 16:1969. [PMID: 38893089 PMCID: PMC11171373 DOI: 10.3390/cancers16111969] [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: 04/12/2024] [Revised: 05/15/2024] [Accepted: 05/16/2024] [Indexed: 06/21/2024] Open
Abstract
(1) Background: Evidence suggested inconsistent results in anxiety and depression scores among female and male cancer patients. The present systematic review and meta-analysis aimed to assess how anxiety and depression conditions among cancer patients vary according to sex. (2) Methods: This systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). The protocol was registered in PROSPERO with id no. CRD42024512553. The search strategy involved combining keywords using Boolean operators, including "Anxiety", "Cancer", and "Depression", across several databases: Embase, PubMed, Scopus, and Web of Science. The outcomes were evaluated using the Hospital Anxiety and Depression Scale (HADS). (3) Results: Data were collected from five studies, enrolling a total of 6317 cancer patients, of whom 2961 were females and 3356 males. For each study, HADS-A and HADS-D scores were considered, also differentiating HADS scores according to cancer typology, and then three different meta-analyses were performed. Generally, females reported significantly higher levels of depression scores than males and, conversely, males reported significantly greater levels of anxiety than females. (4) Conclusions: Previous studies suggested higher rates of depression and anxiety conditions in females than in males, but the present data highlighted controversial findings, since males reported significantly higher levels of anxiety than females. In this scenario, the theoretical approach justified females being more open than males to expressing anxiety or depression conditions. It would be necessary for healthcare professionals to improve effective measures purposed at assessing and mitigating depressive symptoms in cases of advanced cancer, thereby improving their mental health, given the high rates of depression in advanced cancer patients, due to the difficulty level of performing their daily living activities, which deteriorate further over time.
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Affiliation(s)
- Elsa Vitale
- Scientific Directorate, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy
| | - Kurvatteppa Halemani
- College of Nursing, All India Institute of Medical Sciences (AIIMS), Raebareli 229405, India;
| | - Asha Shetty
- College of Nursing, All India Institute of Medical Sciences (AIIMS), Bhubaneswar 751019, India;
| | - Yun-Chen Chang
- School of Nursing and Graduate Institute of Nursing, China Medical University, Taichung 406040, Taiwan;
- Nursing Department, China Medical University Hospital, Taichung 404328, Taiwan
| | - Wen-Yu Hu
- School of Nursing, College of Medicine, National Taiwan University, Taipei 106319, Taiwan;
- Department of Nursing, National Taiwan University Hospital, Taipei 100225, Taiwan
| | - Raffaella Massafra
- Laboratorio di Bioinformatica e Biostatistica, IRCCS Istituto Tumori “Giovanni Paolo II”, 70124 Bari, Italy;
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Bhagavan C, Glue P, Evans W, Reynolds L, Turner T, King C, Russell BR, Morunga E, Mills JL, Layton G, Menkes DB. Effect of MDMA-assisted therapy on mood and anxiety symptoms in advanced-stage cancer (EMMAC): study protocol for a double-blind, randomised controlled trial. Trials 2024; 25:336. [PMID: 38773523 PMCID: PMC11110200 DOI: 10.1186/s13063-024-08174-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 05/13/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Symptoms of anxiety and depression are common in patients with terminal illness and multiple challenges exist with timely and effective care in this population. Several centres have reported that one dose of the serotonergic psychedelic psilocybin, combined with therapeutic support, improves these symptoms for up to 6 months in this patient group. Drawing upon related therapeutic mechanisms, 3,4-methylenedioxymethamphetamine (MDMA)-assisted therapy may have the potential to achieve similar, positive mental health outcomes in this group. Preliminary evidence also supports the tolerability of MDMA-assisted therapy for anxiety and depression in advanced-stage cancer. METHODS Up to 32 participants with advanced-stage cancer and associated depression and anxiety will be randomised in a 1:1 ratio into one of two blinded parallel treatment arms. The intervention group will receive 120 mg (+ 60 mg optional supplemental dose) MDMA-assisted therapy. The psychoactive control group will receive 20 mg oral (+ 10 mg optional supplemental dose) methylphenidate-assisted therapy. For each medication-assisted therapy session, participants will undergo two 90-min therapeutic support sessions in the week preceding, and one 90-min support session the day after the experimental session. A battery of measures (mood, anxiety, quality of life, mystical experience, spiritual wellbeing, attitudes towards death, personality traits, holistic health and wellbeing, connectedness, demoralisation, expectations, qualitative data and safety measures) will be assessed at baseline and through to the end of the protocol. Participants will be followed up until either 12 months post-randomisation or death, whichever occurs first. DISCUSSION This study will examine the effect of MDMA-assisted therapy on symptoms of anxiety and depression in advanced-stage cancer. Potential therapeutic implications include establishing the safety and effectiveness of a novel treatment that may relieve mental suffering in patients with life-threatening illness. TRIAL REGISTRATION Trial registered on Australian New Zealand Clinical Trials Registry. REGISTRATION NUMBER ACTRN12619001334190p. Date registered: 30/09/2019. URL: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378153&showOriginal=true&isReview=true.
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Affiliation(s)
- Chiranth Bhagavan
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand.
| | - Paul Glue
- Department of Psychological Medicine, Division of Health Sciences, University of Otago, 464 Cumberland Street, Central Dunedin, Dunedin, 9016, New Zealand
| | - Will Evans
- Mana Health, 7 Ruskin St, Parnell, Auckland, 1052, New Zealand
| | - Lisa Reynolds
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, 22-30 Park Avenue, Grafton, Auckland, 1023, New Zealand
| | - Thivya Turner
- Te Whatu Ora Southern, Dunedin Public Hospital, 201 Great King Street, Dunedin, 9016, New Zealand
| | - Chris King
- Te Whatu Ora Southern, Dunedin Public Hospital, 201 Great King Street, Dunedin, 9016, New Zealand
| | - Bruce R Russell
- School of Pharmacy, University of Otago, 18 Frederick Street, Dunedin North, Dunedin, 9016, New Zealand
| | - Eva Morunga
- Te Whatu Ora Te Toka Tumai, Auckland City Hospital, 2 Park Road, Grafton, Auckland, 1023, New Zealand
| | - Jessica Lee Mills
- University of Auckland, 6 Symonds Street, Auckland, 1010, New Zealand
| | - Geoff Layton
- Ashburn Clinic, 496 Taieri Road, Halfway Bush, Dunedin, 9010, New Zealand
| | - David B Menkes
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Waikato Clinical Campus, Peter Rothwell Academic Centre, Pembroke Street, Hamilton, 3240, New Zealand
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Lin J, Xiao L, Nie X, Wang Z, Luo Y, Zhang L, Liu Y. Investigating the role of TGF-β and BDNF in cancer-related depression: a primary cross-sectional study. Support Care Cancer 2024; 32:365. [PMID: 38758235 DOI: 10.1007/s00520-024-08542-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/02/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Cancer-related depression is a well-documented condition that significantly impacts long-term quality of life. Brain-derived neurotrophic factor (BDNF), a neurotrophin essential for neurogenesis and neuronal plasticity, has been implicated in various neuropsychological disorders including depression associated with cancer. Cytokines, on the other hand, play a crucial role in regulating depression, potentially by influencing BDNF expression. Transforming growth factor-β (TGF-β), a key immune regulator within the tumor microenvironment, has been found to elevate BDNF levels, establishing a link between peripheral immune responses and depression. The study aims to investigate the correlation of TGF-β and BDNF in cancer-related depression. METHODS This study involved a cohort of 153 gynecological patients, including 61 patients with gynecological cancer and 92 patients without cancer. Depression levels were assessed using the subscale of Hospital Anxiety and Depression Scale (HADS-D), and TGF-β and BDNF plasma levels were measured using enzyme-linked immunosorbent assay (ELISA). RESULTS The study revealed elevated plasma TGF-β levels in patients with cancer (32.24 ± 22.93 ng/ml) compared to those without cancer (25.24 ± 19.72 ng/ml) (P = 0.046). Additionally, reduced levels of BDNF were observed in patients presenting depression symptoms (44.96 ± 41.06 pg/ml) compared to those without depression (133.5 ± 176.7 pg/ml) (P = 0.036). Importantly, a significant correlation between TGF-β and BDNF was found in patients without cancer but with depression (correlation coefficient = 0.893, **P < 0.01). Interestingly, cancer appeared to influence the association between TGF-β and BDNF in patients with depression, as evidenced by a significant difference in the correlation of TGF-β and BDNF between cancer and non-cancer groups (P = 0.041). CONCLUSIONS These findings underscore the active involvement of TGF-β and BDNF crosstalk in the context of cancer-related depression.
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Affiliation(s)
- Jingjing Lin
- School of Nursing, Southern Medical University, Guangzhou, China
- Health College, Zhejiang Industry Polytechnic College, Shaoxing, China
| | - Lin Xiao
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Xinchen Nie
- Department of Biology, University of Copenhagen, Copenhagen, Denmark
| | - Zhijian Wang
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yuanyuan Luo
- School of Nursing, Southern Medical University, Guangzhou, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, Guangzhou, China.
| | - Yawei Liu
- School of Nursing, Southern Medical University, Guangzhou, China.
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Bernard M, Gamondi C, Sterie AC, Larkin PJ, Jox RJ, Borasio GD. Interdisciplinary research approach based on a mixed-methods design to explore patient altruism at the end of life: a study protocol. BMJ Open 2024; 14:e085632. [PMID: 38729755 PMCID: PMC11097832 DOI: 10.1136/bmjopen-2024-085632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
INTRODUCTION In the end of life context, patients are often seen as somewhat passive recipients of care provided by health professionals and relatives, with little opportunity to be perceived as autonomous and active agents. Since studies show a very high prevalence of altruistic dispositions in palliative care patients, we strive to investigate the concept of patient altruism in a set of six interdisciplinary studies by considering three settings: (1) in the general palliative context-by studying to what extent patient altruism is associated with essential psychological outcomes of palliative care (subproject 1a), how altruism is understood by patients (subproject 1b) and how altruism expressed by patients is experienced by palliative care nurses (subproject 1c); (2) in two concrete decision-making contexts-advance care planning (subproject 2a) and assisted suicide (subproject 2b); and (3) through verbal and non-verbal patient communication in palliative care settings (subproject 3). METHODS AND ANALYSIS Subproject 1a: a cross-sectional study using validated and standardised questionnaires. Subprojects 1b and 1c: a constructivist grounded theory method aiming at developing a novel theory from semistructured interviews in both patients and nurses. Subproject 2a: a thematic analysis based on (1) audio-recordings of advance care planning encounters and (2) follow-up semidirective interviews with patients and their relatives. Subproject 2b: a qualitative study based on thematic analysis of interviews with patients actively pursuing assisted suicide and one of their relatives.Subproject 3: a conversation analysis based on audio and video-recorded interactions in two settings: (1) palliative inpatient unit and (2) advance care planning discussions. ETHICS AND DISSEMINATION The study project was approved by the Ethics Committees of the Canton of Vaud, Bern and Ticino (no: 2023-00088). In addition to participation in national and international conferences, each project will be the subject of two scientific publications in peer-reviewed journals. Additional publications will be realised according to result triangulation between projects. A symposium opened to professionals, patients and the public will be organised in Switzerland at the end of the project.
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Affiliation(s)
- Mathieu Bernard
- Palliative and Supportive Care Service, Chair of Palliative Psychology, Lausanne University Hospital and University of Lausanne, Lausanne, Vaud, Switzerland
| | - Claudia Gamondi
- Palliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne, Lausanne, Vaud, Switzerland
| | - Anca-Cristina Sterie
- Palliative and Supportive Care Service and Service of Geriatric Medicine and Geriatric Rehabilitation, Chair of Geriatric Palliative Care and Chair of Palliative Psychology, Lausanne University Hospital and University of Lausanne, Lausanne, Vaud, Switzerland
| | - Philip J Larkin
- Palliative and Supportive Care Service, Chair of Palliative Care Nursing, Lausanne University Hospital and University of Lausanne, Lausanne, Vaud, Switzerland
| | - Ralf J Jox
- Palliative and Supportive Care Service and Service of Geriatric Medicine and Geriatric Rehabilitation, Chair of Geriatric Palliative Care, Lausanne University Hospital and University of Lausanne, Lausanne, Vaud, Switzerland
| | - Gian Domenico Borasio
- Palliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne, Lausanne, Vaud, Switzerland
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Singer S, Sykiotis G, Al-Ibraheem A, Pinto M, Iakovou I, Østhus AA, Hammerlid E, Locati LD, Gamper EM, Arraras JI, Jordan S, Buettner M, Engesser D, Taylor K, Canotilho R, Ioannidis G, Husson O, Gama RR, Fanetti G, Moss L, Inhestern J, Andry G, Rimmele H, Kiyota N. The impact of electronic versus paper-based data capture on data collection logistics and on missing scores in thyroid cancer patients. Endocrine 2024; 84:635-645. [PMID: 38103143 PMCID: PMC11076317 DOI: 10.1007/s12020-023-03628-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 11/23/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE The purpose of this study was to investigate the impact of the type of data capture on the time and help needed for collecting patient-reported outcomes as well as on the proportion of missing scores. METHODS In a multinational prospective study, thyroid cancer patients from 17 countries completed a validated questionnaire measuring quality of life. Electronic data capture was compared to the paper-based approach using multivariate logistic regression. RESULTS A total of 437 patients were included, of whom 13% used electronic data capture. The relation between data capture and time needed was modified by the emotional functioning of the patients. Those with clinical impairments in that respect needed more time to complete the questionnaire when they used electronic data capture compared to paper and pencil (ORadj 24.0; p = 0.006). This was not the case when patients had sub-threshold emotional problems (ORadj 1.9; p = 0.48). The odds of having the researcher reading the questions out (instead of the patient doing this themselves) (ORadj 0.1; p = 0.01) and of needing any help (ORadj 0.1; p = 0.01) were lower when electronic data capture was used. The proportion of missing scores was equivalent in both groups (ORadj 0.4, p = 0.42). CONCLUSIONS The advantages of electronic data capture, such as real-time assessment and fewer data entry errors, may come at the price of more time required for data collection when the patients have mental health problems. As this is not uncommon in thyroid cancer, researchers need to choose the type of data capture wisely for their particular research question.
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Affiliation(s)
- Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany.
- University Cancer Centre, Mainz, Germany.
| | - Gerasimos Sykiotis
- Service of Endocrinology, Diabetology and Metabolism, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Akram Al-Ibraheem
- Department of Nuclear Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Monica Pinto
- Rehabilitation Medicine Unit, Strategic Health Services Department, Istituto Nazionale Tumori - IRCCS - Fondazione G. Pascale, Naples, Italy
| | - Ioannis Iakovou
- Department of Nuclear Medicine, Aristotle University, Thessaloniki, Greece
| | - Arild Andre Østhus
- ENT and Head and Neck Department, University Medical Centre Oslo, Oslo, Norway
| | - Eva Hammerlid
- Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology-Head and Neck Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Laura Deborah Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS istituto Nazionale dei Tumori, Milan, Italy
| | - Eva Maria Gamper
- Department of Nuclear Medicine and Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Susan Jordan
- School of Public Health, The University of Queensland, Brisbane, QLD, Australia
| | - Matthias Buettner
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Deborah Engesser
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Katherine Taylor
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre Mainz, Mainz, Germany
| | - Rita Canotilho
- Instituto Português do Oncologia do Porto Francisco Gentil, Porto, Portugal
| | | | - Olga Husson
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Giuseppe Fanetti
- Division of Radiotherapy, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, PN, Italy
| | - Laura Moss
- Velindre Cancer Centre, Velindre University NHS Trust, Cardiff, UK
| | - Johanna Inhestern
- Department of Otorhinolaryngology, Oberhavelkliniken, Hennigsdorf, Germany
| | - Guy Andry
- Surgery Department, Jules Bordet Institute, Brussels, Belgium
| | - Harald Rimmele
- Bundesverband Schilddrüsenkrebs - Ohne Schilddrüse leben e. V., Berlin, Germany
| | - Naomi Kiyota
- Department of Medical Oncology and Hematology, Cancer Center, Kobe University Hospital, Kobe, Japan
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Graser A. [Antidepressants for the treatment of depression in people with cancer]. UROLOGIE (HEIDELBERG, GERMANY) 2024; 63:488-491. [PMID: 38600363 DOI: 10.1007/s00120-024-02331-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 04/12/2024]
Affiliation(s)
- Annabel Graser
- Urologische Klinik, Klinikum der Universität München, Großhadern, Marchioninistr. 15, 81377, München, Deutschland.
- UroEvidence, Deutsche Gesellschaft für Urologie, 14163, Berlin, Deutschland.
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50
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Chau YF, Zhou H, Chen B, Ren H, Ma Z, Zhang X, Duan J. Screening for depression and anxiety in lung cancer patients: A real-world study using GAD-7 and HADS. Thorac Cancer 2024; 15:1041-1049. [PMID: 38523362 PMCID: PMC11062860 DOI: 10.1111/1759-7714.15287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 03/03/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024] Open
Abstract
BACKGROUND The psychological well-being of lung cancer patients is critical in-patient care but frequently overlooked. METHODS This study, employing a cross-sectional, questionnaire-based design, aimed to elucidate the prevalence of depressive and anxiety symptoms among lung cancer patients and identify associated risk factors. Participants' demographic, medical history, disease stage, and pathology were systematically collected. Psychological assessment was conducted using the general anxiety disorder-7 (GAD-7), patient health questionnaire-9 (PHQ-9), and hospital anxiety and depression scale (HADS). Statistical analyses were performed using SPSS software (version 25.0). RESULTS Out of 294 distributed questionnaires, 247 lung cancer patients were included in the final analysis, with an average completion time of 9.08 min. Notably, 32.4% exhibited depressive symptoms, while 30% displayed signs of anxiety. A significant correlation was found between both depressive and anxiety symptoms and a history of tobacco and alcohol consumption. Specifically, increased nicotine dependence and greater cumulative tobacco use were linked to higher rates of depressive symptoms, whereas cumulative alcohol consumption was associated with increased risks of anxiety symptoms. CONCLUSION The study affirms the feasibility of GAD-7, PHQ-9, and HADS as screening tools for depressive and anxiety symptoms in lung cancer patients. It further highlights tobacco and alcohol consumption as significant risk factors for poor psychological health in this population.
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Affiliation(s)
- Yi Fung Chau
- CAMS Key Laboratory of Translational Research on Lung Cancer, State Key Laboratory of Molecular Oncology, Department of Medical OncologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical CollegeBeijingChina
| | - Huixia Zhou
- CAS Key Laboratory of Mental HealthInstitute of Psychology, Chinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | | | - Hengqin Ren
- CAS Key Laboratory of Mental HealthInstitute of Psychology, Chinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | - Zixiao Ma
- CAMS Key Laboratory of Translational Research on Lung Cancer, State Key Laboratory of Molecular Oncology, Department of Medical OncologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical CollegeBeijingChina
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental HealthInstitute of Psychology, Chinese Academy of SciencesBeijingChina
- Department of PsychologyUniversity of Chinese Academy of SciencesBeijingChina
| | - Jianchun Duan
- CAMS Key Laboratory of Translational Research on Lung Cancer, State Key Laboratory of Molecular Oncology, Department of Medical OncologyNational Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, Peking Union Medical CollegeBeijingChina
- Department of Medical OncologyShanxi Province Cancer Hospital/Shanxi Hospital Affiliated to Cancer Hospital, Chinese Academy of Medical Sciences/Cancer Hospital Affiliated to Shanxi Medical UniversityTaiyuanChina
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