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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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Stone PC, Minton O, Richardson A, Buckle P, Enayat ZE, Marston L, Freemantle N. Methylphenidate Versus Placebo for Treating Fatigue in Patients With Advanced Cancer: Randomized, Double-Blind, Multicenter, Placebo-Controlled Trial. J Clin Oncol 2024; 42:2382-2392. [PMID: 38757263 PMCID: PMC11227299 DOI: 10.1200/jco.23.02639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 01/24/2024] [Accepted: 02/28/2024] [Indexed: 05/18/2024] Open
Abstract
PURPOSE To compare effects and side effects of 6 weeks of individually dose-titrated methylphenidate or placebo on fatigue in palliative care patients with advanced cancer. METHODS This is a randomized, double-blind, placebo-controlled, multicenter trial. Eligible patients had advanced incurable cancer and fatigue >3/10. Principal exclusions were hypertension; psychiatric, cardiovascular, cerebrovascular, renal, liver, or blood disorders; substance dependency; and epilepsy. Patients were randomly assigned 1:1 methylphenidate or placebo starting at 5 mg twice daily. Dose of methylphenidate/placebo was titrated once per week, over 6 weeks, up to a maximum of 20 mg three times daily. Trial ended at 10 weeks. Primary outcome was the difference in Functional Assessment of Chronic Illness Therapy Fatigue (FACIT-F) scores between groups at 6 ± 2 weeks. Secondary outcomes included adverse effects, quality of life, and mood. RESULTS One hundred sixty-two patients (73 men; mean, 65.8; standard deviation [SD], 10.3 years) were randomly assigned, and three were excluded from analysis. Seventy-seven were allocated placebo (baseline FACIT-F = 22 [SD, 10]); 82 were allocated methylphenidate (FACIT-F = 20 [SD, 9]). After 6 ± 2 weeks, FACIT-F scores were 1.97 points (95% CI, -0.95 to 4.90; P = .186) higher (better) on methylphenidate than placebo. Across 10 weeks of the study, FACIT-F was nominally higher in the methylphenidate group versus placebo (Diff, 2.20 [95% CI, 0.39 to 4.01]), but this did not reach the minimally clinically important difference (5-points). At 6 weeks, there were no differences between groups in quality-of-life or symptom domains except for depression scores (nominally reduced in the methylphenidate group: Diff, -1.35 [95% CI, -2.41 to -0.30]). There were no differences in mortality or serious adverse events. CONCLUSION After 6 ± 2 weeks of treatment, methylphenidate was not superior to placebo for treating fatigue in advanced cancer. Methylphenidate was safe and well-tolerated.
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Affiliation(s)
- Patrick Charles Stone
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London (UCL), London, United Kingdom
| | - Ollie Minton
- University Hospitals Sussex NHS Foundation Trust, Worthing Hospital, Lyndhurst Road, Worthing, West Sussex, United Kingdom
| | - Alison Richardson
- University of Southampton & University Hospital Southampton NHS Foundation Trust, Southampton General Hospital, Southampton, United Kingdom
| | - Peter Buckle
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London (UCL), London, United Kingdom
| | - Zinat E. Enayat
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London (UCL), London, United Kingdom
| | - Louise Marston
- Department of Primary Care & Population Health, Institute of Epidemiology & Health Care, Faculty of Population Health Sciences, University College London (UCL), London, United Kingdom
| | - Nick Freemantle
- Comprehensive Clinical Trials Unit, University College London (UCL), London, United Kingdom
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Huang Q, Wang D, Chen S, Tang L, Ma C. Association of METS-IR index with depressive symptoms in US adults: A cross-sectional study. J Affect Disord 2024; 355:355-362. [PMID: 38554881 DOI: 10.1016/j.jad.2024.03.129] [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: 09/08/2023] [Revised: 03/04/2024] [Accepted: 03/23/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND An association between insulin resistance (IR) and depression has been identified in recent years. The purpose of this study was to examine the relationship between IR and depression in the general population. METHODS The population for this cross-sectional study consisted of adults participating in the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018. Insulin sensitivity was assessed using the Metabolic Score for IR (METS-IR) index, while depression was evaluated using the Patient Health Questionnaire (PHQ)-9. Logistic regression analyses, subgroup analyses, and dose-response curves were conducted to assess the association between the METS-IR index and depression. RESULTS A total of 13,157 adults aged over 20 years were included in this study. After adjusting for potential confounders, it was observed that each unit increase in the METS-IR index was associated with a 1.1 percentage point increase in the prevalence of depression (OR = 1.011; 95 % CI: 1.008, 1.014). Patients in the 4th quartile of the METS-IR index had a higher likelihood of depression compared to those in the 1st quartile (OR = 1.386, 95 % CI: 1.239, 1.549). Stratified analyses demonstrated consistent results in all subgroups, except for men, patients under 40 years of age, and those with a history of cancer. Dose-response curves indicated a nonlinear relationship between the METS-IR index and the risk of depression, with an inflection point value of 32.443 according to threshold effect analysis. CONCLUSIONS Our findings suggest that higher METS-IR scores are associated with an increased likelihood of experiencing depressive symptoms among U.S. adults.
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Affiliation(s)
- Qi Huang
- Department of Rehabilitation, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China
| | - Denghong Wang
- Department of Traditional Chinese Medicine and Rehabilitation, The Sixth Hospital of Wuhan, Affiliated Hospital of Jianghan University, Wuhan 430311, China
| | - Shanshan Chen
- Key Laboratory for Molecular Diagnosis of Hubei Province, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China
| | - Lei Tang
- Department of Rehabilitation, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China.
| | - Chaoyang Ma
- Department of Rehabilitation, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430014, China.
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Deng MG, Liu F, Wang K, Zhang MJ, Feng Q, Liu J. Association between dietary flavonoid intake and depressive symptoms: A cross-sectional research. Gen Hosp Psychiatry 2024; 86:75-84. [PMID: 38134552 DOI: 10.1016/j.genhosppsych.2023.12.005] [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: 08/27/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVE To investigate the relationship between dietary flavonoid intake and depression symptoms in American adults. METHODS Data sets were obtained from the National Health and Nutrition Examination Survey (NHANES) 2007-2008, 2009-2010, and 2017-2018 survey cycles. Both males and females aged 18 years and older with complete information about dietary flavonoid intake (isoflavones, anthocyanidins, flavan-3-ols, flavanones, flavones, and flavonols), depression symptoms, and covariates were included. Logistic regression models were conducted to calculate the odds ratio (OR) of single dietary flavonoid subclass intake on depression, and the restricted cubic spline (RCS) models were utilized to explore the corresponding dose-response relationships. Additionally, we implemented the weighted quantile sum (WQS) regression and quantile g-computation (qgcomp) models to estimate the mixed effects of six flavonoid subclasses and identify the predominant types. RESULTS After multivariable adjustments, people with higher consumption of flavanones (OR: 0.68, 95% CI: 0.52-0.90, p = 0.008), flavones (OR: 0.63, 95% CI: 0.46-0.87, p = 0.007), flavonols (OR: 0.66, 95% CI: 0.49-0.89, p = 0.008), and total flavonoids (OR: 0.69, 95% CI: 0.50-0.95, p = 0.024) had lower odds of depression symptoms. Meanwhile, significant dose-response relationships were supported by the RCS models. However, no obvious associations between isoflavones, anthocyanidins, flavan-3-ols, and the odds of suffering from depression symptoms were found by the logistic regression models and RCS models. As for the mixed effect, the WQS and qgcomp models both demonstrated that the mixture of six flavonoid subclasses was inversely related to the odds ratios of depression symptoms, and flavones, flavanones, and anthocyanidins were the top 3 contributors. CONCLUSION Our study implied dietary flavonoid intake was associated with the decreased probability of depression symptoms in U.S. adults, among which flavones, flavanones, and anthocyanidins may occupy the predominant roles.
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Affiliation(s)
- Ming-Gang Deng
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan 430012, Hubei, China; Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan 430012, Hubei, China.
| | - Fang Liu
- School of Public Health, Wuhan University, Wuhan 430071, Hubei, China
| | - Kai Wang
- Department of Public Health, Wuhan Fourth Hospital, Wuhan 430033, Hubei, China
| | - Min-Jie Zhang
- School of Public Health, Wuhan University, Wuhan 430071, Hubei, China
| | - Qianqian Feng
- School of Public Health, Wuhan University, Wuhan 430071, Hubei, China
| | - Jiewei Liu
- Department of Psychiatry, Wuhan Mental Health Center, Wuhan 430012, Hubei, China; Department of Psychiatry, Wuhan Hospital for Psychotherapy, Wuhan 430012, Hubei, China.
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Zhan D, Wang X, Zheng Y, Wang S, Yang B, Pan B, Wang N, Wang Z. Integrative dissection of 5-hydroxytryptamine receptors-related signature in the prognosis and immune microenvironment of breast cancer. Front Oncol 2023; 13:1147189. [PMID: 37795441 PMCID: PMC10546427 DOI: 10.3389/fonc.2023.1147189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 08/14/2023] [Indexed: 10/06/2023] Open
Abstract
Background Depression increases the risk of breast cancer recurrence and metastasis. However, there lacks potential biomarkers for predicting prognosis in breast cancer. 5-hydroxytryptamine (5-HT) plays a key role in the pathogenesis and treatment of depression. In this study, we developed a prognostic signature based on 5-HT receptors (5-HTRs) and elucidated its potential immune regulatory mechanisms for breast cancer prognosis. Methods Oncomine, GEPIA, UALCAN, cBioPortal, Kaplan-Meier plotter, and TIMER were used to analyze differential expression, prognostic value, genetic alteration, and immune cell infiltration of HTRs in breast cancer patients. The model training and validation assays were based on the analyses of GSE1456 and GSE86166. A risk signature was established by univariate and multivariate Cox regression analyses. The transwell assay was utilized to verify the effect of the 5-HTRs expression on breast cancer invasion. Effects of HTR2A/2B inhibitor on CD8+ T cell proliferation and infiltration as well as apoptosis of 4T1 cells in the tumor microenvironment were detected by flow cytometry and TUNEL assay. Zebrafish and mouse breast cancer xenografts were used to determine the effect of HTR2A/2B inhibitor on breast cancer metastasis. Results The expression levels of HTR1A, HTR1B, HTR2A, HTR2B, HTR2C, HTR4, and HTR7 were significantly downregulated in highly malignant breast cancer types. 5-HTRs were significantly associated with recurrence-free survival (RFS) in breast cancer patients. The genetic alteration of HTR1D, HTR3A, HTR3B, and HTR6 in breast cancer patients was significantly associated with shorter overall survival (OS). Finally, HTR2A and HTR2B were determined to construct the risk signature. The expression of HTR2A/2B was positively correlated with the infiltration of immune cells such as CD8+ T cells and macrophages. Furthermore, inhibition of HTR2A expression could suppress CD8+ T cell proliferation and enhance invasion and metastasis of breast cancer cells in both zebrafish and mice model. Conclusions The HTR2A/2B risk signature not only highlights the significance of HTRs in breast cancer prognosis by modulating cancer immune microenvironment, but also provides a novel gene-testing tool for early prevention of depression in breast cancer patients and lead to an improved prognosis and quality of life.
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Affiliation(s)
- Dandan Zhan
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xuan Wang
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yifeng Zheng
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Shengqi Wang
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Bowen Yang
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Bo Pan
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Neng Wang
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Integrative Medicine Research Center, School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Zhiyu Wang
- State Key Laboratory of Dampness Syndrome of Chinese Medicine, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Clinical Research on Traditional Chinese Medicine Syndrome, Guangdong Provincial Academy of Chinese Medical Sciences, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
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He LL, Xiao S, Jiang CH, Wu XW, Liu W, Fan CG, Ye X, Zhao Q, Wu WQ, Li YX, Wang H, Liu F. A randomized, controlled trial to investigate cognitive behavioral therapy in prevention and treatment of acute oral mucositis in patients with locoregional advanced nasopharyngeal carcinoma undergoing chemoradiotherapy. Front Oncol 2023; 13:1143401. [PMID: 37350940 PMCID: PMC10282775 DOI: 10.3389/fonc.2023.1143401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/15/2023] [Indexed: 06/24/2023] Open
Abstract
Purpose Oral mucositis is a common side effect of concurrent chemoradiotherapy (CCRT). This study aimed to determine whether cognitive behavioral therapy (CBT) could help prevent oral mucositis during chemoradiation therapy for locoregional advanced nasopharyngeal carcinoma (LA-NPC). Methods and materials Between July 15, 2020, and January 31, 2022, a randomized controlled phase II trial was conducted. Eligible patients (N=282, 18-70 years old) with pathologically diagnosed LA-NPC were randomly assigned to receive CBT or treatment as usual (TAU) during CCRT (computer-block randomization, 1:1). The primary endpoints were the incidence and latency of oral mucositis. Results The incidence of oral mucositis was significantly lower in the CBT group (84.8%; 95% confidence interval [CI], 78.7%-90.9%) than in the TAU group (98.6%; 95% CI, 96.6%-100%; P<0.001). The median latency period was 26 days and 15 days in the CBT and TAU groups, respectively (hazard ratio, 0.16; 95% CI, 0.12-0.22; P<0.001). CBT significantly reduced ≥ grade 3 oral mucositis (71.9% vs. 22.5%, P<0.001), dry mouth (10.8% vs. 3.7%, P=0.021), dysphagia (18% vs. 5.1%, P=0.001), and oral pain (10% vs. 3.6%, P=0.034) compared with TAU. Patients receiving CBT and TAU during CCRT had similar short-term response rates. Conclusions CBT reduced the occurrence, latency, and severity of oral mucositis in patients with LA-NPC during CCRT.
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Affiliation(s)
- Li-li He
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Shuai Xiao
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Cui-hong Jiang
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Xiang-wei Wu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Wen Liu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Chang-gen Fan
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Xu Ye
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Qi Zhao
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Wen-qiong Wu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Yan-xian Li
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Hui Wang
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Translational Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Feng Liu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
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McClintock SM, Dail RB, Howe-Martin L, Mann T, Bailey DE. Assessing Depressive Symptoms in Patients With Cancer Treated With Interleukin-2: A Comparison of 2 Measures. Cancer Nurs 2023; 46:E146-E158. [PMID: 35089873 PMCID: PMC9325919 DOI: 10.1097/ncc.0000000000001056] [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: 11/26/2022]
Abstract
BACKGROUND High-dose interleukin-2 is a therapy available for individuals with renal cell carcinoma; however, it can produce adverse effects, specifically depressive symptoms. There is limited information regarding the trajectory of depressive symptoms and measurement-based care assessment of depressive symptoms. OBJECTIVE The purpose was to describe the trajectory of depressive symptoms and compare 2 depression measures. METHODS A descriptive, mixed-method case study approach was used to describe the longitudinal trajectory of depressive symptoms The qualitative assessment included a journal entry and an interview. The quantitative depression symptom severity measures included the 8-item self-report Patient-Reported Outcomes Measurement Information System Depression and the 30-item Inventory of Depressive Symptomatology-Clinician Rated (IDS-C). RESULTS Ten cases were enrolled. The maximum number of interleukin-2 doses that any patient received within a single hospitalization ranged from 4 to 12. Mean scores on the 8-item Patient-Reported Outcomes Measurement Information System Depression showed no changes in depressive symptoms from pretreatment to posttreatment, nor across hospitalizations. Mean total scores on the IDS-C increased from "normal" to "mild severity" depressive symptom range across all treatment cycles, suggesting transient depressive symptoms within hospitalizations. Qualitative data from the case supported the IDS-C increase, suggesting that the patient developed depressive symptoms pretreatment to posttreatment. CONCLUSIONS Understanding the trajectory of depressive symptoms allows for the identification of critical time points when depressive symptoms present and change across treatment. It is critical to use measurement-based care using validated measures to assess for the presence and changes in depressive symptoms. IMPLICATIONS FOR PRACTICE Validated self-report or clinician-rated depression symptom measures should be used to document the presence or absence of depressive symptoms in this population.
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Affiliation(s)
- Shawn M. McClintock
- Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine
| | | | - Laura Howe-Martin
- Division of Psychology, Department of Psychiatry, UT Southwestern Medical Center
- Moncrief Cancer Institute, UT Southwestern Medical Center
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Criterion and construct validity of the Beck Depression Inventory (BDI-II) to measure depression in patients with cancer: The contribution of somatic items. Int J Clin Health Psychol 2023; 23:100350. [DOI: 10.1016/j.ijchp.2022.100350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/25/2022] [Indexed: 11/27/2022] Open
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Vaz-Luis I, Masiero M, Cavaletti G, Cervantes A, Chlebowski RT, Curigliano G, Felip E, Ferreira AR, Ganz PA, Hegarty J, Jeon J, Johansen C, Joly F, Jordan K, Koczwara B, Lagergren P, Lambertini M, Lenihan D, Linardou H, Loprinzi C, Partridge AH, Rauh S, Steindorf K, van der Graaf W, van de Poll-Franse L, Pentheroudakis G, Peters S, Pravettoni G. ESMO Expert Consensus Statements on Cancer Survivorship: promoting high-quality survivorship care and research in Europe. Ann Oncol 2022; 33:1119-1133. [PMID: 35963481 DOI: 10.1016/j.annonc.2022.07.1941] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/26/2022] [Accepted: 07/29/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The increased number of cancer survivors and the recognition of physical and psychosocial challenges, present from cancer diagnosis through active treatment and beyond, led to the discipline of cancer survivorship. DESIGN AND METHODS Herein, we reflected on the different components of survivorship care, existing models and priorities, in order to facilitate the promotion of high-quality European survivorship care and research. RESULTS We identified five main components of survivorship care: (i) physical effects of cancer and chronic medical conditions; (ii) psychological effects of cancer; (iii) social, work and financial effects of cancer; (iv) surveillance for recurrences and second cancers; and (v) cancer prevention and overall health and well-being promotion. Survivorship care can be delivered by structured care models including but not limited to shared models integrating primary care and oncology services. The choice of the care model to be implemented has to be adapted to local realities. High-quality care should be expedited by the generation of: (i) focused and shared European recommendations, (ii) creation of tools to facilitate implementation of coordinated care and (iii) survivorship educational programs for health care teams and patients. The research agenda should be defined with the participation of health care providers, researchers, policy makers, patients and caregivers. The following patient-centered survivorship research areas were highlighted: (i) generation of a big data platform to collect long-term real-world data in survivors and healthy controls to (a) understand the resources, needs and preferences of patients with cancer, and (b) understand biological determinants of survivorship issues, and (ii) develop innovative effective interventions focused on the main components of survivorship care. CONCLUSIONS The European Society for Medical Oncology (ESMO) can actively contribute in the efforts of the oncology community toward (a) promoting the development of high-quality survivorship care programs, (b) providing educational material and (c) aiding groundbreaking research by reflecting on priorities and by supporting research networking.
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Affiliation(s)
- I Vaz-Luis
- Breast Cancer Unit, Medical Oncology Department, Gustave Roussy-Cancer Campus, Villejuif; UMR 981, Prédicteurs moléculaires et nouvelles cibles en oncologie, Gustave Roussy-Cancer Campus, Villejuif, France.
| | - M Masiero
- Department of Oncology and Hemato-Oncology, University of Milano, Milan; Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan
| | - G Cavaletti
- Experimental Neurology Unit, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - A Cervantes
- Department of Medical Oncology, INCLIVA, Biomedical Research Institute, University of Valencia, Valencia; CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | | | - G Curigliano
- Department of Oncology and Hemato-Oncology, University of Milano, Milan; Division of Early Drug Development, Istituto Europeo di Oncologia, IRCCS, Milan, Italy
| | - E Felip
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - A R Ferreira
- Breast Unit, Champalimaud Clinical Center, Champalimaud Foundation, Lisbon; Catolica Medical School, Universidade Católica Portuguesa, Lisbon, Portugal
| | - P A Ganz
- UCLA Jonsson Comprehensive Cancer Center and UCLA Fielding School of Public Health, Los Angeles, USA
| | - J Hegarty
- School of Nursing and Midwifery, University College Cork, Cork, Ireland
| | - J Jeon
- Exercise Medicine Center for Cancer and Diabetes Patients (ICONS), Department of Sport Industry, Cancer Prevention Center, Yonsei Cancer Center, Shinchon Severance Hospital, Yonsei University College of Medicine, Yonsei University, Seoul, Korea
| | - C Johansen
- Centre for Cancer Late Effect Research (CASTLE), Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - F Joly
- Department of Medical Oncology, Centre François Baclesse, U1086 Anticipe, Unicaen Normandy Universtity, Caen, France
| | - K Jordan
- Department for Hematology, Oncology and Palliative Medicine, Ernst von Bergmann Hospital, Potsdam; Department of Medicine V, Hematology, Oncology and Rheumatology, University of Heidelberg, Heidelberg, Germany
| | - B Koczwara
- Flinders Medical Centre and Flinders University, Adelaide, Australia
| | - P Lagergren
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden; Department of Surgery and Cancer, Imperial College London, London, UK
| | - M Lambertini
- Department of Medical Oncology, U.O. Clinica di Oncologia Medica, IRCCS Ospedale Policlinico San Martino, Genova; Department of Internal Medicine and Medical Specialties (DiMI), School of Medicine, University of Genova, Genova, Italy
| | - D Lenihan
- International Cardio-Oncology Society, Tampa, USA
| | - H Linardou
- Fourth Oncology Department & Comprehensive Clinical Trials Center, Metropolitan Hospital, Athens, Greece
| | | | - A H Partridge
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, USA
| | - S Rauh
- Department of Medical Oncology, Centre Hospitalier Emile Mayrisch, Esch, Luxembourg
| | - K Steindorf
- Division of Physical Activity, Prevention and Cancer, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
| | - W van der Graaf
- Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam; Department of Medical Oncology, Erasmus MC Cancer institute, Erasmus University Medical Center, Rotterdam
| | - L van de Poll-Franse
- Division of Psychosocial Research & Epidemiology, Department of Psycological Research, The Netherlands Cancer Institute, Amsterdam; Department of Research & Development, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht; CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - G Pentheroudakis
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - S Peters
- European Society for Medical Oncology (ESMO), Lugano, Switzerland
| | - G Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milano, Milan; Applied Research Division for Cognitive and Psychological Science, Istituto Europeo di Oncologia, Milan
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10
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Matsumoto Y, Umemura S, Okizaki A, Fujisawa D, Kobayashi N, Tanaka Y, Sasaki C, Shimizu K, Ogawa A, Kinoshita H, Uchitomi Y, Yoshiuchi K, Matsuyama Y, Morita T, Goto K, Ohe Y. Early specialized palliative care for patients with metastatic lung cancer receiving chemotherapy: a feasibility study of a nurse-led screening-triggered programme. Jpn J Clin Oncol 2022; 52:375-382. [PMID: 35079813 DOI: 10.1093/jjco/hyab204] [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: 08/27/2021] [Accepted: 12/04/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Strategies to implement early specialized palliative care have not yet been established. The present study investigated the feasibility of a nurse-led, screening-triggered early specialized palliative care intervention programme and obtained data to design a randomized controlled trial. METHODS Patients with metastatic lung cancer undergoing first-line platinum-based chemotherapy were eligible. The intervention consisted of (1) a questionnaire-based screening programme and (2) advanced-level nurse counselling and care coordination with interdisciplinary team approach. The primary endpoint was the completion rate of the assessment questionnaire after the second course of first-line chemotherapy (T2). Secondary endpoints included changes in Functional Assessment of Cancer Therapy-Lung scores, depression and anxiety rates based on the Patient Health Questionnaire 9 and the Hospital Anxiety and Depression Scale, and the contents of specialized palliative care. RESULTS A total of 50 patients were enrolled between August 2012 and March 2014. Median age was 66 years (range, 40-78 year) and 84% were male. A total of 38 patients had stage IV non-small cell lung carcinoma and 12 had extensive disease small-cell lung carcinoma. The completion rate was 70% (95% confidence interval 56.0-81.0). The median duration between baseline and T2 was 53 days. Improvement from baseline were observed at T2 in Functional Assessment of Cancer Therapy-Lung scores (86.0 ± 18.1 vs 94.9 ± 18.2, P = 0.057), depression (16.0 vs 5.7%; P = 0.26) and anxiety (32.0 vs 22.9%; P = 0.65); however, these results were not statistically significant. CONCLUSIONS This early specialized palliative care intervention is feasible and could be useful in improving patients' quality of life. The present results justify the initiation of a randomized control trial.
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Affiliation(s)
- Yoshihisa Matsumoto
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Japan
| | - Shigeki Umemura
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Ayumi Okizaki
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Naoko Kobayashi
- Nursing Division, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yuko Tanaka
- Nursing Division, National Cancer Center Hospital East, Kashiwa, Japan
| | - Chiyuki Sasaki
- Nursing Division, National Cancer Center Hospital East, Kashiwa, Japan
| | - Ken Shimizu
- Division of Psycho-Oncology, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Asao Ogawa
- Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Hiroya Kinoshita
- Department of Palliative Medicine, Tokatsu Hospital, Chiba, Japan
| | - Yosuke Uchitomi
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yutaka Matsuyama
- Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Koichi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Tokyo, Japan
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11
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Calman L, Turner J, Fenlon D, Permyakova NV, Wheelwright S, Patel M, Din A, Winter J, Richardson A, Smith PWF, Foster C. Prevalence and determinants of depression up to 5 years after colorectal cancer surgery: results from the ColoREctal Wellbeing (CREW) study. Colorectal Dis 2021; 23:3234-3250. [PMID: 34679253 PMCID: PMC9298990 DOI: 10.1111/codi.15949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/03/2021] [Accepted: 06/17/2021] [Indexed: 01/15/2023]
Abstract
AIM Depression experienced by people with colorectal cancer (CRC) is an important clinical problem affecting quality of life. Recognition of depression at key points in the pathway enables timely referral to support. This study aimed to examine depression before and 5 years after surgery to examine its prevalence and identify determinants. METHOD The ColoREctal Wellbeing (CREW) study is a prospective UK cohort study involving 872 adults with nonmetastatic CRC recruited before surgery with curative intent. Questionnaires completed before surgery and 3, 9, 15, 24, 36, 48 and 60 months after surgery captured socio-demographics and assessed depression (Centre for Epidemiologic Studies Depression Scale, CES-D) and other psychosocial factors. Clinical details were also gathered. We present the prevalence of clinically significant depression (CES-D ≥ 20) over time and its predictors assessed before and 2 years after surgery. RESULTS Before surgery, 21.0% of the cohort reported CES-D ≥ 20 reducing to 14.7% 5 years after surgery. Presurgery risk factors predicting subsequent depression were clinically significant depression and anxiety, previous mental health service use, low self-efficacy, poor health, having neoadjuvant treatment and low social support. Postsurgery risk factors at 2 years predicting subsequent depression were clinically significant depression, negative affect, cognitive dysfunction, accommodation type and poor health. CONCLUSION Depression is highly pervasive in people with CRC, exceeding prevalence in the general population across follow-up. Our findings emphasize the need to screen and treat depression across the pathway. Our novel data highlight key risk factors of later depression at important and opportune time points: before surgery and at the end of routine surveillance. Early recognition and timely referral to appropriate support is vital to improve long-term psychological outcomes.
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Affiliation(s)
- Lynn Calman
- School of Health SciencesUniversity of SouthamptonSouthamptonUK
| | - Joshua Turner
- School of Health SciencesUniversity of SouthamptonSouthamptonUK
| | - Deborah Fenlon
- College of Human and Health SciencesSwansea UniversitySwanseaUK
| | | | | | - Mubarak Patel
- Division of Health SciencesUniversity of WarwickWarwickUK
| | - Amy Din
- School of Health SciencesUniversity of SouthamptonSouthamptonUK
| | - Jane Winter
- School of Health SciencesUniversity of SouthamptonSouthamptonUK,University Hospitals Southampton NHS TrustSouthamptonUK
| | - Alison Richardson
- School of Health SciencesUniversity of SouthamptonSouthamptonUK,University Hospitals Southampton NHS TrustSouthamptonUK
| | - Peter W. F. Smith
- Social Statistics and DemographySocial SciencesUniversity of SouthamptonSouthamptonUK
| | - Claire Foster
- School of Health SciencesUniversity of SouthamptonSouthamptonUK
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12
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Morreale M. Psychosocial Aspects of Cancer Pain. Cancer Treat Res 2021; 182:273-280. [PMID: 34542888 DOI: 10.1007/978-3-030-81526-4_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Given the biopsychosocial model of pain, it is not surprising that a strong degree of association exists between cancer pain and psychological distress.
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Affiliation(s)
- Mary Morreale
- Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Service Drive, Detroit, MI, 48201, USA.
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13
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Shi YY, Zheng R, Cai JJ, Qian SZ. The association between triglyceride glucose index and depression: data from NHANES 2005-2018. BMC Psychiatry 2021; 21:267. [PMID: 34030657 PMCID: PMC8146990 DOI: 10.1186/s12888-021-03275-2] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The association between triglyceride glucose (TyG) index and depression is unclear. We conducted this analysis to explore whether higher TyG index is associated with a higher odd of depression. METHODS This was an observational study using data from the National Health and Nutrition Examination Survey (2005-2018), a cross-sectional and nationally representative database. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). TyG index was calculated based on the equation as follows: ln [triglyceride (mg/dL) × fasting blood glucose (mg/dL)/2], and participants were divided into quartiles based on TyG index. Weighted multivariable logistic regression models were used to explore the relationship between the TyG index and depression. RESULTS A total of 13,350 patients were included, involving 1001 (7.50%) individuals with depression. Higher TyG index is significantly associated with elevated depressive symptoms in U.S. adults. Multivariate-adjusted HRs for patients in the TyG index 4th quartile were higher for depression (OR = 1.46; 95% confidence interval (CI) 1.30, 1.64) compared with the 1st quartile of TyG index. Similar results were seen in men and women, across age groups, and baseline comorbidities. CONCLUSION In this large cross-sectional study, our result suggests that population with higher TyG index are significantly more likely to have depressive symptoms in U.S. adults.
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Affiliation(s)
- Yi-Yi Shi
- grid.414906.e0000 0004 1808 0918Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 China
| | - Rui Zheng
- grid.414906.e0000 0004 1808 0918Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 China
| | - Jie-Jie Cai
- grid.414906.e0000 0004 1808 0918Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000 China ,Wenzhou Key Laboratory of Critical Care and Artificial Intelligence, Wenzhou, China
| | - Song-Zan Qian
- Department of Intensive Care Unit, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China. .,Wenzhou Key Laboratory of Critical Care and Artificial Intelligence, Wenzhou, China.
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14
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Liu F, Fu SN, Chen YZ, Yan OY, Tong F, Peng WL, Zou R, Wen MN, Jiang L, Ma HZ, He Q, Liu L, Yang H, Huang XF, Han YQ, Wang H, Liu XH. Effects of Cognitive Behavioral Therapy for Depression and Anxiety, Response Rates and Adverse Events in Patients with Locoregional Advanced Nasopharyngeal Carcinoma. Integr Cancer Ther 2021; 20:15347354211006179. [PMID: 33784875 PMCID: PMC8020041 DOI: 10.1177/15347354211006179] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/08/2022] Open
Abstract
Purpose: This retrospective study investigated the effects of cognitive behavioral
therapy (CBT) on depression, anxiety, response rates, and adverse events in
patients with locoregional advanced nasopharyngeal carcinoma (NPC). Methods: A total of 269 patients with diagnosis of stage III-IVA NPC received either
CBT plus chemoradiotherapy (CBT group, n = 136) or treatment as usual (TAU)
plus chemoradiotherapy (TAU group, n = 133). Patients in the CBT group
received a series of 6 CBT sessions for 6 weeks during concurrent
chemoradiotherapy. Depression and anxiety were assessed using the Hospital
Anxiety and Depression Scale (HADS) score at baseline, the completion of
radiotherapy, and 6, 12, and 24 months after radiotherapy. Response rates
and adverse events were also evaluated. Results: Patients in the CBT group showed significantly less depression and anxiety
than patients in the TAU group after the completion of radiotherapy
(P < .05). Complete response rates were 99.3%
(135/136) and 92.5% (123/133) in the CBT group and TAU group with a small
effect size (Phi coefficient = .171), respectively
(P = .005). Compared with the TAU group, the CBT group
showed a significantly lower incidence of acute adverse events and late
toxic effects. Conclusions: The addition of CBT to chemoradiotherapy significantly reduced depressive and
anxiety symptoms. CBT combined with chemoradiotherapy is associated with
improved response rates, with reduced incidence of toxic effects in patients
with locoregional advanced NPC. Based on this study, we registered a
randomized controlled clinical trials to better define the role of CBT in
patients with locoregional advanced NPC (Registration number:
ChiCTR2000034701).
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Affiliation(s)
- Feng Liu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Sheng-Nan Fu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Yan-Zhu Chen
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Ou-Ying Yan
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Fei Tong
- Psychological Clinic, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Wang-Lian Peng
- Department of Hospice Unit, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Ran Zou
- Department of Hospice Unit, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Min-Ni Wen
- Department of Clinical Spiritual Care, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Ling Jiang
- Department of Clinical Spiritual Care, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Hong-Zhi Ma
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Qian He
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Lin Liu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Hui Yang
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Xu-Fen Huang
- Department of Hospice Unit, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Ya-Qian Han
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Hui Wang
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Xiao-Hong Liu
- Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
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15
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Wang K, Zhao Y, Nie J, Xu H, Yu C, Wang S. Higher HEI-2015 Score Is Associated with Reduced Risk of Depression: Result from NHANES 2005-2016. Nutrients 2021; 13:nu13020348. [PMID: 33503826 PMCID: PMC7911826 DOI: 10.3390/nu13020348] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/11/2021] [Accepted: 01/19/2021] [Indexed: 12/21/2022] Open
Abstract
Globally, the total estimated number of people living with depression increased by 18.4% between 2005 and 2015, with the prevalence being 4.8% in 2015. Many nutrient and diet patterns are proven to be correlated to depression, so we conducted this analysis to explore whether the Healthy Eating Index 2015 (HEI-2015) score is associated with depression, and possibly to provide dietary measures to reduce the risk of depression. Data came from the National Health and Nutrition Examination Survey (2005–2016), a cross-sectional and nationally representative database. The analytic sample was limited to adults: (1) age ≥20 with complete information of HEI-2015 and depression; (2) no missing data of demographics, BMI, drinking, smoking, and fasting plasma glucose. HEI-2015 was calculated using the Dietary Interview: Total Nutrient Intakes, First Day data file. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Weighted logistic regression models were used to explore the relationship between the HEI-2015 score and depression. The final study sample included 10,349 adults, with 51.4% of them being men, representing a population of about 167.8 million non-institutionalized U.S. adults. After multivariable adjustment, average HEI status (OR: 0.848, 95% CI: 0.846–0.849) and optimal HEI status (OR: 0.455, 95% CI: 0.453–0.456) were associated with reduced odds of depression. Poor diet quality is significantly associated with elevated depressive symptoms in U.S. adults. Aligning with the Dietary Guidelines for Americans reduces the risk of depression.
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Affiliation(s)
- Kai Wang
- Department of Nutrition and Food Hygiene, School of Health Science, Wuhan University, 185, Donghu Rd, Wuhan 430071, China; (K.W.); (J.N.); (H.X.)
| | - Yudi Zhao
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Rd, Wuhan 430071, China; (Y.Z.); (C.Y.)
| | - Jiaqi Nie
- Department of Nutrition and Food Hygiene, School of Health Science, Wuhan University, 185, Donghu Rd, Wuhan 430071, China; (K.W.); (J.N.); (H.X.)
| | - Haoling Xu
- Department of Nutrition and Food Hygiene, School of Health Science, Wuhan University, 185, Donghu Rd, Wuhan 430071, China; (K.W.); (J.N.); (H.X.)
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Health Sciences, Wuhan University, 185 Donghu Rd, Wuhan 430071, China; (Y.Z.); (C.Y.)
| | - Suqing Wang
- Department of Nutrition and Food Hygiene, School of Health Science, Wuhan University, 185, Donghu Rd, Wuhan 430071, China; (K.W.); (J.N.); (H.X.)
- Correspondence:
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16
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Fujisawa D, Umemura S, Okizaki A, Satomi E, Yamaguchi T, Miyaji T, Mashiko T, Kobayashi N, Kinoshita H, Mori M, Morita T, Uchitomi Y, Goto K, Ohe Y, Matsumoto Y. Nurse-led, screening-triggered, early specialised palliative care intervention programme for patients with advanced lung cancer: study protocol for a multicentre randomised controlled trial. BMJ Open 2020; 10:e037759. [PMID: 33243791 PMCID: PMC7692832 DOI: 10.1136/bmjopen-2020-037759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 10/14/2020] [Accepted: 10/15/2020] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION It has been suggested that palliative care integrated into standard cancer treatment from the early phase of the disease can improve the quality of life of patients with cancer. In this paper, we present the protocol for a multicentre randomised controlled trial to examine the effectiveness of a nurse-led, screening-triggered, early specialised palliative care intervention programme for patients with advanced lung cancer. METHODS AND ANALYSIS A total of 206 patients will be randomised (1:1) to the intervention group or the control group (usual care). The intervention, triggered with a brief self-administered screening tool, comprises comprehensive need assessments, counselling and service coordination by advanced-level nurses. The primary outcome is the Trial Outcome Index of the Functional Assessment of Cancer Therapy (FACT) at 12 weeks. The secondary outcomes include participants' quality of life (FACT-Lung), depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), illness perception (Prognosis and Treatment Perceptions Questionnaire), medical service use and survival. A mixed-method approach is expected to provide an insight about how this intervention works. ETHICS AND DISSEMINATION This study has been approved by the Institutional Review Board of the National Cancer Center Japan (approval number: 2016-235). The findings will be disseminated through peer-reviewed publications and conference presentations and will be reflected on to the national healthcare policy. TRIAL REGISTRATION NUMBER UMIN000025491.
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Affiliation(s)
- Daisuke Fujisawa
- Department of Neuropsychiatry, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan
- Psycho-Oncology Division, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Shigeki Umemura
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Ayumi Okizaki
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
- Behavioral and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Eriko Satomi
- Department of Palliative Medicine, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University School of Medicine, Sendai, Miyagi, Japan
| | - Tempei Miyaji
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
- Department of Clinical Trial Data Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tomoe Mashiko
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Naoko Kobayashi
- Department of Nursing, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Hiroya Kinoshita
- Department of Palliative Care, Tokatsu Hospital, Nagareyama, Chiba, Japan
| | - Masanori Mori
- Palliative and Supportive Care, Seirei Mikatahara Hospital, Hamamatsu, Shizuoka, Japan
| | - Tatsuya Morita
- Palliative and Supportive Care, Seirei Mikatahara Hospital, Hamamatsu, Shizuoka, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
- Behavioral and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Koichi Goto
- Department of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Yuichiro Ohe
- Department of Thoracic Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Yoshihisa Matsumoto
- Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Chiba, Japan
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17
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Abdel-Rahman O, Salas AS, Watanabe SM, Li X. Burden of depression among Canadian adults with cancer; results from a national survey. Expert Rev Pharmacoecon Outcomes Res 2020; 21:667-672. [PMID: 32885693 DOI: 10.1080/14737167.2020.1819794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE To assess the prevalence and association of depression among Canadian adults with cancer in a population-based context. METHODS The Canadian Community Health Survey (CCHS) (2015-2016) was accessed and adult participants with cancer who completed the Personal Health Questionnaire (PHQ9) were included in the current analysis. Multivariable logistic regression was conducted to elucidate the factors associated with the development of depression. An additional multivariable logistic regression analysis was conducted to evaluate the association of depression with ever contemplating suicide (suicidal ideation). RESULTS A total of 867 participants with cancer have completed PHQ9 were included in the current analysis (including 603 participants (69.6%) without depression (PHQ9 ≤ 4) and 264 participants (30.4%) with depression (PHQ9 > 4)). Moreover, 92 participants (10.6%) fulfill the criteria for moderate/severe depression (PHQ9 > 9). The following factors were associated with the presence of depression (PHQ9 > 4), female sex (OR for males versus females: 0.56; 95% CI: 0.34-0.93; P = 0.02); poor self-perceived health (OR for excellent health versus poor health: 0.12; 95% CI: 0.02-0.62; P = 0.01) and poor self-perceived mental health (OR for excellent mental health versus poor mental health: 0.02; 95% CI: <0.01-0.24; P < 0.01). Additional multivariable logistic regression analysis showed that depression (PHQ9 > 4) was associated with a higher probability of suicidal ideation (OR for no depression versus depression: 0.43; 95% CI: 0.21-0.91; P = 0.02). CONCLUSIONS Depression seems to be an underdiagnosed and possibly undertreated comorbid condition among Canadian adults with cancer.
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Affiliation(s)
- Omar Abdel-Rahman
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Anna Santos Salas
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Sharon M Watanabe
- Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Alberta, Canada
| | - Xinmin Li
- Department of Psychiatry, University of Alberta, Cross Cancer Institute, Edmonton, Alberta, Canada
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18
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Comparing the hospital anxiety and depression scale to the Brief Edinburgh Depression Scale for identifying cases of major depressive disorder in advanced cancer palliative patients. Palliat Support Care 2020; 19:170-174. [PMID: 32830630 DOI: 10.1017/s1478951520000760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study sought to compare the Hospital Anxiety and Depression Subscale (HADS-D) and Brief Edinburgh Depression Scale (BEDS) as case-finding tools of major depressive disorder in patients with advanced cancer in a palliative care service. METHODS An observational study was performed which included patients with advanced cancer who attended the palliative care service at the National Institute of Cancer in Mexico. Patients were asked to fill out the Hospital Anxiety and Depression Scale (HADS) and BEDS and were then assessed by a psychiatrist to evaluate major depressive disorder (MDD) as per the DSM-5 criteria. The case-finding capability of each scale was determined using receiver operating characteristic curves, assessing the area under the curve (AUC) in comparison to the clinical diagnosis. RESULTS Eighty-nine patients were included; median age was 57 years, and 71% were female. Among these, 19 patients were diagnosed with MDD during the interview. When comparing the self-reported scales, BEDS had a better performance compared with HADS-D (AUC 0.8541 vs. 0.7665). Limitations include a heterogeneous population and a limited sample size. SIGNIFICANCE OF RESULTS The BEDS outperformed the HADS-D tool in discriminating patients with and without depression. A BEDS cutoff value of ≥5 is suggested as a case-finding score for depression in this population.
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19
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Mendonça AB, Pereira ER, Magnago C, Silva RMCRA, Martins ADO. Nursing process for a patient with needle phobia: a case study. Rev Bras Enferm 2020; 73:e20190095. [PMID: 32578738 DOI: 10.1590/0034-7167-2019-0095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 10/12/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES to report a clinical case of needle phobia which culminated in cardiac arrest and describe the outcome of a care plan based on fear and anxiety diagnoses, using the Roy adaptation model as the framework. METHODS case study conducted in a chemotherapy outpatient unit in Rio de Janeiro. Care was guided by the nursing process and the use of instruments to assess the venous network, anxiety and fear. RESULTS the Roy adaptation model enabled proposing nursing interventions that allowed the study subject to adapt to the external and internal stimuli triggered by vasovagal syndrome. The instruments indicated the choice of an adequate semi-implanted venous access device and led to improved levels of anxiety and fear. FINAL CONSIDERATIONS after carrying out the nursing activities, anxiety was reduced, and the patient achieved greater control over fear.
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Affiliation(s)
| | | | - Carinne Magnago
- Universidade do Estado do Rio de Janeiro. Rio de Janeiro, Rio de Janeiro, Brazil
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20
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Ribi K, Luo W, Walley BA, Burstein HJ, Chirgwin J, Ansari RH, Salim M, van der Westhuizen A, Abdi E, Francis PA, Chia S, Harvey VJ, Giobbie-Hurder A, Fleming GF, Pagani O, Di Leo A, Colleoni M, Gelber RD, Goldhirsch A, Coates AS, Regan MM, Bernhard J. Treatment-induced symptoms, depression and age as predictors of sexual problems in premenopausal women with early breast cancer receiving adjuvant endocrine therapy. Breast Cancer Res Treat 2020; 181:347-359. [PMID: 32274665 DOI: 10.1007/s10549-020-05622-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/29/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE Sexual dysfunction is an important concern of premenopausal women with early breast cancer. We investigated predictors of sexual problems in two randomized controlled trials. METHODS A subset of patients enrolled in TEXT and SOFT completed global and symptom-specific quality-of-life indicators, CES-Depression and MOS-Sexual Problems measures at baseline, six, 12 and 24 months. Mixed models tested the association of changes in treatment-induced symptoms (baseline to 6 months), depression at 6 months, and age at randomization with changes in sexual problems over 2 years. RESULTS Sexual problems increased by 6 months and persisted at this level. Overall, patients with more severe worsening of vaginal dryness, sleep disturbances and bone or joint pain at 6 months reported a greater increase in sexual problems at all time-points. Depression scores were significantly associated with sexual problems in the short-term. All other symptoms had a smaller impact on sexual problems. Age was not associated with sexual problems at any time-point. CONCLUSION Among several key symptoms, vaginal dryness, sleep disturbance, and bone and joint pain significantly predicted sexual problems during the first 2 years. Early identification of these symptoms may contribute to timely and tailored interventions.
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Affiliation(s)
- Karin Ribi
- International Breast Cancer Study Group (IBCSG) Coordinating Center, Effingerstrasse 40, 3008, Bern, Switzerland.
| | - Weixiu Luo
- IBCSG Statistical Center, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Barbara A Walley
- University of Calgary and Canadian Cancer Trials Group, Calgary, AB, Canada
| | - Harold J Burstein
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Jacquie Chirgwin
- Box Hill and Maroondah Hospitals, Monash University, Clayton, VIC, Australia.,Breast Cancer Trials Australia & New Zealand, University of Newcastle, Callaghan, Australia
| | - Rafat H Ansari
- Norther Indiana Cancer Research Consortium, South Bend, USA
| | | | - Andre van der Westhuizen
- Breast Cancer Trials Australia & New Zealand, University of Newcastle, Callaghan, Australia.,Calvary Mater Newcastle Hospital, Waratah, NSW, Australia
| | - Ehtesham Abdi
- The Tweed Hospital, Griffith University Gold Coast, Tweed Heads, NSW, Australia
| | - Prudence A Francis
- Breast Cancer Trials Australia & New Zealand, University of Newcastle, Callaghan, Australia.,Peter MacCallum Cancer Center, St Vincent's Hospital, University of Melbourne, Melbourne, Australia
| | - Stephen Chia
- BCCA-Vancouver Cancer Center, Vancouver, BC, Canada
| | | | | | - Gini F Fleming
- The University of Chicago Medical Center, Chicago, IL, USA
| | - Olivia Pagani
- Institute of Oncology of Southern Switzerland, Geneva University Hospitals, Swiss Group for Clinical Cancer Research (SAKK), Lugano Viganello, Switzerland
| | - Angelo Di Leo
- Hospital of Prato-AUSL Toscana Centro and International Breast Cancer Study Group, Prato, Italy
| | | | - Richard D Gelber
- IBCSG Statistical Center, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Harvard University, Boston, MA, USA.,Harvard TH Chan School of Public Health, Frontier Science and Technology Research Foundation, Boston, MA, USA
| | - Aron Goldhirsch
- International Breast Cancer Study Group (IBCSG) Coordinating Center, Effingerstrasse 40, 3008, Bern, Switzerland.,MultiMedica, Milan, Italy
| | - Alan S Coates
- International Breast Cancer Study Group (IBCSG) Coordinating Center, Effingerstrasse 40, 3008, Bern, Switzerland.,University of Sydney, Sydney, Australia
| | - Meredith M Regan
- IBCSG Statistical Center, Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Harvard University, Boston, MA, USA
| | - Jürg Bernhard
- International Breast Cancer Study Group (IBCSG) Coordinating Center, Effingerstrasse 40, 3008, Bern, Switzerland.,Bern University Hospital, Inselspital, Bern, Switzerland
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21
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Ota A, Kawada K, Tsutsumi A, Yatsuya H. Cross-sectional association between working and depression prevalence in cancer survivors: a literature review. ENVIRONMENTAL AND OCCUPATIONAL HEALTH PRACTICE 2020. [DOI: 10.1539/eohp.2020-0006-ra] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Atsuhiko Ota
- Department of Public Health, Fujita Health University School of Medicine
| | - Kenji Kawada
- Department of Medical Oncology, Fujita Health University School of Medicine
| | - Akizumi Tsutsumi
- Department of Public Health, Kitasato University School of Medicine
| | - Hiroshi Yatsuya
- Department of Public Health, Fujita Health University School of Medicine
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22
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Cheung S, Spaeth-Rublee B, Shalev D, Li M, Docherty M, Levenson J, Pincus HA. A Model to Improve Behavioral Health Integration into Serious Illness Care. J Pain Symptom Manage 2019; 58:503-514.e1. [PMID: 31175941 DOI: 10.1016/j.jpainsymman.2019.05.017] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 05/29/2019] [Accepted: 05/29/2019] [Indexed: 11/16/2022]
Abstract
Behavioral health problems are highly prevalent among people with serious medical illness. Individuals living with these comorbidities have complex clinical and social needs yet face siloed care, high health care costs, and poor outcomes. Interacting factors contribute to these inequalities including historical separation of behavioral and physical health provision. Several care models for integrating behavioral health and general medical care have been developed and tested, but the evidence base focuses primarily on primary care populations and settings. This article advances that work by proposing a Behavioral Health-Serious Illness Care model. Developed through a mixed methods approach combining literature review, surveys, interviews, and input from an expert advisory panel, it provides a conceptual framework of building blocks for behavioral health integration tailored to serious illness care populations and the range of settings in which they receive care. The model is intended to serve as foundation to support the development and implementation of integrated behavioral health and serious illness care. The key components of the model are described, barriers to implementation discussed, and recommendations for policy approaches to address these barriers presented.
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Affiliation(s)
| | | | - Daniel Shalev
- Columbia University Medical Center, New York, New York, USA; New York State Psychiatric Institute, New York, New York, USA
| | - Mingjie Li
- New York State Psychiatric Institute, New York, New York, USA
| | - Mary Docherty
- New York State Psychiatric Institute, New York, New York, USA
| | - Jon Levenson
- Columbia University Medical Center, New York, New York, USA
| | - Harold Alan Pincus
- Columbia University Medical Center, New York, New York, USA; New York State Psychiatric Institute, New York, New York, USA.
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23
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Li J, Zhao F, Bai H, Lin P, Shao D, Sun J, Zhang H, Cao F. Psychometric properties of the Chinese version of the Center for Epidemiologic Studies Depression Scale-Revised in patients with cancer: A cross-sectional study. Int J Nurs Stud 2019; 97:14-20. [PMID: 31129444 DOI: 10.1016/j.ijnurstu.2019.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/24/2019] [Accepted: 04/13/2019] [Indexed: 12/23/2022]
Abstract
BACKGROUND Depressive symptoms are common in patients with cancer and more prevalent in Chinese patients. The Center for Epidemiologic Studies Depression Scale is one of the most widely used self-report scales to assess depressive symptoms in both community and hospitalized samples. A revised Center for Epidemiologic Studies Depression Scale has been created, but the evidence on psychometric properties is limited. OBJECTIVES To develop the Chinese version of the scale, and to examine the cross-cultural validity, structural validity, construct validity, internal consistency, test-retest reliability, measurement error, responsiveness, and floor/ceiling effect of the scale among patients with cancer according to the recommendation in the consensus-based standards for the selection of health status measurement instruments checklist. DESIGN A cross-sectional survey design with 33 participants (approximately 10%) completing the follow-up survey for evaluating the test-retest reliability. SETTINGS Randomly selected eight wards of an oncology hospital in China. PARTICIPANTS Of the 595 patients we approached in the randomly selected eight wards, 310 gave their informed consent and completed the survey. METHODS The Chinese version of the Center for Epidemiologic Studies Depression Scale-Revised was developed by four researchers (two translators and two reviewers) who were proficient in both English and Chinese. Participants completed the scale and the depression module of the Patient Health Questionnaire. Principal components analyses, Spearman's correlation, the Mann-Whitney U test, Cronbach's alpha, and the intraclass correlation coefficient were used. RESULTS The cross-culture validity was excellent based on the consensus-based standards for the selection of the health status measurement instruments checklist. A two-factor structure was determined: somatic symptoms and affective-cognitive symptoms. The sufficient construct validity was supported by that the score of the Center for Epidemiologic Studies Depression Scale-Revised was strongly correlated with the depression module of the Patient Health Questionnaire score (rho = 0.73, p < 0.001) and patients who had received chemotherapy (p = 0.002)/radiotherapy (p = 0.035) reported higher scores of depression than those who have not. The Cronbach's alphas of the total scale and subscales ranged from 0.82-0.88. The test-retest reliability was sufficient (intraclass correlation coefficient = 0.73-0.81, all p < 0.001) for total scale and subscales. The smallest detectable change was 2.98 and the responsiveness was adequate, with no floor/ceiling effect. CONCLUSIONS This study supports the Chinese version of the Center for Epidemiologic Studies Depression Scale-Revised as a valid and reliable measurement of depressive symptoms in patients with cancer.
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Affiliation(s)
- Jie Li
- School of Nursing, Shandong University, Jinan, Shandong Province, 250012, China
| | - Fengling Zhao
- Department of Mental Health Care, Shandong Cancer Hospital, Jinan, Shandong Province, 250117, China
| | - Huayu Bai
- School of Nursing, Shandong University, Jinan, Shandong Province, 250012, China
| | - Pingzhen Lin
- School of Nursing, Shandong University, Jinan, Shandong Province, 250012, China
| | - Di Shao
- School of Nursing, Shandong University, Jinan, Shandong Province, 250012, China
| | - Jiwei Sun
- School of Nursing, Shandong University, Jinan, Shandong Province, 250012, China
| | - Huihui Zhang
- School of Nursing, Shandong University, Jinan, Shandong Province, 250012, China
| | - Fenglin Cao
- School of Nursing, Shandong University, Jinan, Shandong Province, 250012, China.
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24
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Fervaha G, Izard JP, Tripp DA, Rajan S, Leong DP, Siemens DR. Depression and prostate cancer: A focused review for the clinician. Urol Oncol 2019; 37:282-288. [DOI: 10.1016/j.urolonc.2018.12.020] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 12/03/2018] [Accepted: 12/22/2018] [Indexed: 12/14/2022]
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25
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Mercadante S, Adile C, Ferrera P, Cortegiani A, Casuccio A. Symptom hyper-expression in advanced cancer patients with anxiety and depression admitted to an acute supportive/palliative care unit. Support Care Cancer 2019; 27:3081-3088. [PMID: 30607679 DOI: 10.1007/s00520-018-4624-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Accepted: 12/19/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of this study was to compare symptom expression in advanced cancer patients with depression and anxiety and in patients with no such symptoms. METHODS Secondary analysis of a previous study assessing the role of an acute palliative supportive care unit (APSCU) in a comprehensive cancer center. Patients completed the Edmonton Symptom Assessment System (ESAS) at admission (T0) and 7 days after or at discharge (T7). RESULTS Three hundred-fourteen consecutive cancer patients admitted to the APSCU were surveyed. Eighty-six and 66 patients improved their level of depression and anxiety, respectively (passing from ≥ 4 to 0-3, from T0 to T7), after that palliative care intervention resulted in a significant improvement of the other symptoms. Changes were statistically significant for both symptoms (P < 0.0005). Patients admitted for uncontrolled pain were more likely to be anxious, while patients admitted for other symptoms or end-of-life care were more likely to be depressed. The presence of anxiety and depression (≥ 4/10 on ESAS) was significantly associated with a higher level of symptom expression at admission and at T7 (P < 0.0005). In patients presenting both psychological symptoms, symptom expression was significantly more relevant in comparison with patients not reporting moderate-severe psychological symptoms. Pain and depression were independently associated with anxiety at T0. Variables independently associated with depression at T0 were drowsiness, appetite, and anxiety. CONCLUSIONS Psychological symptoms of ESAS concur to hyper-express some symptoms and make symptom control more difficult. A clear association between anxiety and depression exists.
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Affiliation(s)
- Sebastiano Mercadante
- Main Regional Center for Pain Relief and Palliative/Supportive Care, Via san Lorenzo 312, 90145, Palermo, Italy. .,Department of Supportive Care & Rehabilitation, MD Anderson, Houston, TX, USA.
| | - Claudio Adile
- Main Regional Center for Pain Relief and Palliative/Supportive Care, Via san Lorenzo 312, 90145, Palermo, Italy
| | - Patrizia Ferrera
- Main Regional Center for Pain Relief and Palliative/Supportive Care, Via san Lorenzo 312, 90145, Palermo, Italy
| | - Andrea Cortegiani
- Department of Biopathology, Medical and Forensic Biotechnologies (DIBIMEF), Section of Anesthesia, Analgesia, Intensive Care and Emergency, Policlinico "P, Giaccone", University of Palermo, Palermo, Italy
| | - Alessandra Casuccio
- Department of Sciences for Health Promotion and Mother Child Care, University of Palermo, Palermo, Italy
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26
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Lemos MF, Lemos‐Neto SV, Barrucand L, Verçosa N, Tibirica E. A informação no pré‐operatório reduz a ansiedade pré‐operatória em pacientes com câncer submetidos à cirurgia: utilidade do Inventário Beck de Ansiedade. Braz J Anesthesiol 2019; 69:1-6. [DOI: 10.1016/j.bjan.2018.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 07/10/2018] [Accepted: 07/17/2018] [Indexed: 10/27/2022] Open
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27
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Lemos MF, Lemos-Neto SV, Barrucand L, Verçosa N, Tibirica E. Preoperative education reduces preoperative anxiety in cancer patients undergoing surgery: Usefulness of the self-reported Beck anxiety inventory. Braz J Anesthesiol 2019. [PMID: 30401475 PMCID: PMC9391836 DOI: 10.1016/j.bjane.2018.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background and objectives Methods Results Conclusions
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Affiliation(s)
- Marilia F Lemos
- Instituto Nacional de Câncer (Inca), Rio de Janeiro, RJ, Brasil
| | | | - Louis Barrucand
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Medicina, Rio de Janeiro, RJ, Brasil
| | - Nubia Verçosa
- Universidade Federal do Rio de Janeiro (UFRJ), Faculdade de Medicina, Departamento de Cirurgia, Rio de Janeiro, RJ, Brasil
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28
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Decker V, Sikorskii A, Given CW, Given BA, Vachon E, Krauss JC. Effects of depressive symptomatology on cancer-related symptoms during oral oncolytic treatment. Psychooncology 2018; 28:99-106. [PMID: 30311987 DOI: 10.1002/pon.4916] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 08/29/2018] [Accepted: 09/02/2018] [Indexed: 12/29/2022]
Abstract
OBJECTIVE This manuscript assesses association between depressive symptoms and symptoms from cancer and its treatment during the first 12 weeks of a new oral oncolytic treatment. METHODS This secondary analysis used data from a recently completed trial of an intervention to improve adherence to oral oncolytic treatment and manage symptoms. Following the initiation of the new oral oncolytic medication, 272 patients were interviewed at intake and weeks 4, 8, and 12 to assess depressive symptoms, and symptoms from cancer and its treatment. Depressive symptoms were measured using the Center for Epidemiologic Studies-Depression (CES-D20). The summed index of 18 cancer-related and treatment-related symptoms as well as the number of symptoms above threshold at intake, weeks 4, 8, and 12 were related to intake and time-varying CES-D20 using linear mixed effects models. RESULTS Depressive symptomatology was a significant predictor of cancer-related and treatment-related symptoms at all-time points, but the strength of this relationship was greatest at the time of oral oncolytic agent initiation and at week 4. The strength of this relationship was the same for both summed symptom severity index and the number of symptoms above threshold, and using either intake or time-varying CES-D20. CONCLUSION Introducing strategies to treat and manage symptoms of depression along with other symptoms might have added benefits among patients who start a new oral oncolytic treatment and report modest to higher levels of depressive symptoms. Assessments for the impact of strategies to lower depressive symptoms can be taken within the first 4 weeks.
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Affiliation(s)
- Veronica Decker
- College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Alla Sikorskii
- Department of Psychiatry and Department of Statistics and Probability, Michigan State University, East Lansing, MI, United States
| | - Charles W Given
- College of Nursing, Michigan State University, East Lansing, MI, United States
| | - Barbara A Given
- College of Nursing, Michigan State University, East Lansing, MI, United States
| | - Eric Vachon
- College of Nursing, Michigan State University, East Lansing, MI, United States
| | - John C Krauss
- Hematology Oncology, University of Michigan, Ann Arbor, MI, United States
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29
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Saracino RM, Cham H, Rosenfeld B, J Nelson C. Latent Profile Analyses of Depressive Symptoms in Younger and Older Oncology Patients. Assessment 2018; 27:1383-1398. [PMID: 29947548 DOI: 10.1177/1073191118784653] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The aging of America will include a significant increase in the number of older patients with cancer, many of whom will experience significant depressive symptoms. Although geriatric depression is a well-studied construct, its symptom presentation in the context of cancer is less clear. Latent profile analysis was conducted on depressive symptoms in younger (40-64 years) and older (≥65 years) patients with cancer (N = 636). The sample was clinically heterogeneous (i.e., included all stages, dominated by advanced stage disease). Participants completed questionnaires including the Center for Epidemiological Studies Depression Scale, which was used for the latent profile analysis. A four-class pattern was supported for each age group. However, the four-class pattern was significantly different between the younger and older groups in terms of the item means within each corresponding latent class; differences were primarily driven by severity such that across classes, older adults endorsed milder symptoms. An unexpected measurement issue was uncovered regarding reverse-coded items, suggesting that they may generate unreliable scores on the Center for Epidemiological Studies Depression Scale for a significant subset of patients. The results indicate that cancer clinicians can expect to see depressive symptoms along a continuum of severity for patients of any age, with less severe symptoms among older patients.
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Affiliation(s)
- Rebecca M Saracino
- Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Fordham University, Bronx, NY, USA
| | | | - Barry Rosenfeld
- Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Fordham University, Bronx, NY, USA
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30
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Anxiety and depression associated with tyrosine kinase inhibitor discontinuation in patients with chronic myeloid leukemia. Int J Clin Oncol 2018; 23:974-979. [DOI: 10.1007/s10147-018-1275-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/05/2018] [Indexed: 10/17/2022]
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31
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Martinez Tyson D, Medina-Ramirez P, Vázquez-Otero C, Gwede CK, Babilonia MB, McMillan SC. Initial evaluation of the validity and reliability of the culturally adapted Spanish CaSUN (S-CaSUN). J Cancer Surviv 2018; 12:509-518. [PMID: 29623531 DOI: 10.1007/s11764-018-0689-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 03/13/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE There is a dearth of knowledge and limited research on the needs of Hispanic male cancer survivors (HMCSs). There is a clear need for the development of culturally and linguistically adapted needs assessment tools that are valid and reliable for use among the growing HMCS population. Thus, the purpose of this paper is to describe the field testing and psychometric evaluation of the translated and culturally adapted Spanish Cancer Survivor Unmet Needs Measure (S-CaSUN). METHODS Hispanic male cancer survivors (n = 84) completed the Spanish CaSUN (S-CaSUN), the Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Cancer Therapy-General Population (FACT-GP). Construct validity of the S-CaSUN was assessed by correlation analysis among aforesaid measures. A test-retest procedure with 2-week delay was used to examine reproducibility with a participant subsample (n = 50). Cronbach's alpha was computed to assess internal consistency of the S-CaSUN. RESULTS Construct validity of the S-CaSUN was estimated by moderate correlation with the HADS anxiety (r = 0.55, P < 0.001) and depression scales (r = 0.60, P < 0.001) and the FACT-GP (r = - 0.62, P < 0.001). The test-retest correlation coefficient for the S-CaSUN was 0.78. Cronbach's alpha was 0.96. Field testing yielded a mean S-CaSUN score of 38.3 (SD = 26.2); all needs and positive change items were endorsed. CONCLUSION Findings from field testing and preliminary psychometric evaluation of the S-CaSUN provide initial evidence of validity and reliability of the measure and highlight the importance of going beyond translation when adapting measures to take culture, literacy, and language into consideration. IMPLICATIONS FOR CANCER SURVIVORS Reliable, culturally, and linguistically valid instruments facilitate identification of unique unmet needs of Hispanic cancer survivors that, in turn, can be addressed with evidence-based interventions. As cancer centers continue to develop survivorship programs, the S-CaSUN may be useful for a growing group of cancer survivors.
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Affiliation(s)
- Dinorah Martinez Tyson
- Department of Community and Family Health, University of South Florida, 13201 Bruce B. Downs Blvd, MDC56, Tampa, FL, 33612-3805, USA.
| | | | - Coralia Vázquez-Otero
- Department of Community and Family Health, University of South Florida, 13201 Bruce B. Downs Blvd, MDC56, Tampa, FL, 33612-3805, USA
| | - Clement K Gwede
- Health Outcomes and Behavior, Moffitt Cancer Center and Research Institute, Tampa, FL, USA.,Department of Oncologic Sciences, Morsani College of Medicine, Tampa, FL, USA
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Saracino RM, Rosenfeld B, Nelson CJ. Performance of four diagnostic approaches to depression in adults with cancer. Gen Hosp Psychiatry 2018; 51:90-95. [PMID: 29427869 PMCID: PMC5869111 DOI: 10.1016/j.genhosppsych.2018.01.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 01/17/2018] [Accepted: 01/18/2018] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The potentially confounding influence of somatic symptoms in identifying depression in medically ill patients has long been of concern, resulting in several proposed alternative diagnostic approaches. These approaches have been compared in the cancer setting, but the strengths and weaknesses of the alternative approaches have rarely been examined. The purpose of the current study was to examine the performance of four approaches to depression assessment among ambulatory cancer patients. METHOD Outpatients were recruited from a large cancer center (N = 611). Participants had to be 40 years or older, English-speaking, and have a cancer diagnosis. All participants completed a sociodemographic questionnaire and a modified Patient Health Questionnaire-9 with additional items targeting the Endicott and Cavanaugh substitutive criteria. RESULTS Depression prevalence varied significantly by diagnostic approach, with the inclusive approach identifying the largest proportion as depressed (9.3%, n = 57), followed by the Endicott-substitutive (6.2%, n = 38), exclusive (4.6%, n = 28), and Cavanaugh-substitutive approach (1.8%, n = 11). Somatic items were significantly elevated across all four approaches. CONCLUSIONS The inclusive approach that retains use of somatic symptoms is appropriate when screening cancer patients for depression. The fact that somatic symptoms were more prevalent across approaches suggests that they may not inflate the prevalence of depression as much as some have feared. Rather, somatic items may explain variance in depressive symptoms beyond that explained by the presence of cancer and its treatment. Additionally, the Endicott items appeared useful for capturing depressive symptoms that are not included in the existing DSM criteria, and may have a place in clinical and research settings.
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Affiliation(s)
- Rebecca M Saracino
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, NY, New York 10022, United States; Psychology Department, Fordham University, Dealy Hall 226, 441 East Fordham Road, Bronx, NY 10458, United States.
| | - Barry Rosenfeld
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, NY, New York 10022, United States; Psychology Department, Fordham University, Dealy Hall 226, 441 East Fordham Road, Bronx, NY 10458, United States
| | - Christian J Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, NY, New York 10022, United States
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Marziliano A, Pessin H, Rosenfeld B, Breitbart W. Measuring Cohesion and Self-Disclosure in Psychotherapy Groups for Patients with Advanced Cancer: An Analysis of the Psychometric Properties of the Group Therapy Experience Scale. Int J Group Psychother 2018; 68:407-427. [PMID: 31263314 DOI: 10.1080/00207284.2018.1435284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Objectives Understanding the group process informs group interventions. However, there is little systematic research on group process variables in psychotherapy groups for patients with cancer. Methods We analyzed the psychometric properties of the Group Therapy Experience Scale and evaluated its potential importance in advanced cancer therapy groups. Results The GTES demonstrated good internal consistency (coefficient alpha=.84). An exploratory factor analysis with varimax rotation yielded four factors. Although all four models were explored, the 1- and 2-factor models appeared to provide the best fit for the data. The GTES total score was negatively correlated with group size and positively correlated with number of groups attended by participants. Furthermore, the GTES total score was correlated with post-intervention spiritual well-being, benefit finding, post-traumatic growth and quality of life.
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Affiliation(s)
| | | | | | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center
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Pastore AL, Mir A, Maruccia S, Palleschi G, Carbone A, Lopez C, Camps N, Palou J. Psychological distress in patients undergoing surgery for urological cancer: A single centre cross-sectional study. Urol Oncol 2017; 35:673.e1-673.e7. [DOI: 10.1016/j.urolonc.2017.08.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 08/06/2017] [Accepted: 08/08/2017] [Indexed: 11/16/2022]
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Park S, Sado M, Fujisawa D, Sato Y, Takeuchi M, Ninomiya A, Takahashi M, Yoshimura K, Jinno H, Takeda Y. Mindfulness-based cognitive therapy for Japanese breast cancer patients—a feasibility study. Jpn J Clin Oncol 2017; 48:68-74. [DOI: 10.1093/jjco/hyx156] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 10/06/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sunre Park
- Faculty of Nursing and Medicine Care, Keio University
- Palliative Care Center, Keio University Hospital
| | - Mitsuhiro Sado
- Department of Neuropsychiatry, Keio University School of Medicine
| | - Daisuke Fujisawa
- Palliative Care Center, Keio University Hospital
- Department of Neuropsychiatry, Keio University School of Medicine
| | - Yasuko Sato
- Department of Nursing, National Hospital Organization Tokyo Medical Center
| | | | - Akira Ninomiya
- Department of Neuropsychiatry, Keio University School of Medicine
| | | | - Kimio Yoshimura
- Department of Health Policy and Management, Keio University School of Medicine
| | - Hiromitsu Jinno
- Department of Surgery, Teikyo University School of Medicine, Japan
| | - Yuko Takeda
- Faculty of Nursing and Medicine Care, Keio University
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Caruso R, Nanni MG, Riba MB, Sabato S, Grassi L. The burden of psychosocial morbidity related to cancer: patient and family issues. Int Rev Psychiatry 2017; 29:389-402. [PMID: 28753076 DOI: 10.1080/09540261.2017.1288090] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
With cancer incidence increasing over time, attention to the burden of related psychiatric and psychosocial consequences of the disease and treatment is a major topic for both cancer patients and their caregivers. Among cancer patients, psychiatric (e.g. adjustment, anxiety, depressive disorders) and neuropsychiatric disorders (e.g. cognitive disorders secondary to treatment, delirium) have been shown to affect an average of 30-35% patients, with differences according to stage and type of cancer. Also other psychosocial syndromes (e.g. demoralization, health anxiety, irritable mood) not taken into account in usual nosological systems should be considered for their impact on the patient's quality-of-life. Also, it has been repeatedly reported that psychological distress reverberates substantially throughout the nuclear family, and that a family approach is necessary in cancer care, with the caregiver-patient dyad as a unit to be the focus and direction of assessment and intervention. In this review the most significant psychosocial disorders causing burden for cancer patients and their caregivers are examined, and the main methods of assessment for more proper referral and treatment are summarized.
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Affiliation(s)
- Rosangela Caruso
- a Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences , University of Ferrara , Ferrara , Italy.,b University Hospital Psychiatric Unit , Program of Psycho-Oncology and Psychiatry in Palliative Care, Integrated Department of Mental Health and Addictive Behavior , S. Anna University Hospital and Health Authority , Ferrara , Italy
| | - Mara Giulia Nanni
- a Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences , University of Ferrara , Ferrara , Italy.,b University Hospital Psychiatric Unit , Program of Psycho-Oncology and Psychiatry in Palliative Care, Integrated Department of Mental Health and Addictive Behavior , S. Anna University Hospital and Health Authority , Ferrara , Italy
| | - Michelle B Riba
- c Department of Psychiatry , University of Michigan , Ann Arbor , MI , USA.,d University of Michigan Comprehensive Cancer Center , Ann Arbor , MI , USA.,e Psycho-oncology Program , University of Michigan Comprehensive Cancer Center , Ann Arbor , MI , USA
| | - Silvana Sabato
- a Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences , University of Ferrara , Ferrara , Italy
| | - Luigi Grassi
- a Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences , University of Ferrara , Ferrara , Italy.,b University Hospital Psychiatric Unit , Program of Psycho-Oncology and Psychiatry in Palliative Care, Integrated Department of Mental Health and Addictive Behavior , S. Anna University Hospital and Health Authority , Ferrara , Italy
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Lum A, Wakefield CE, Donnan B, Burns MA, Fardell JE, Marshall GM. Understanding the school experiences of children and adolescents with serious chronic illness: a systematic meta-review. Child Care Health Dev 2017; 43:645-662. [PMID: 28543609 DOI: 10.1111/cch.12475] [Citation(s) in RCA: 83] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 03/17/2017] [Accepted: 04/15/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND Serious chronic illness can have a detrimental effect on school attendance, participation and engagement, leaving affected students at risk of failing to meet their developmental potential. An improved understanding of factors that help to explain or mitigate this risk can help educators and health professionals deliver the most effective support. This meta-review critiqued the available evidence examining the link between six chronic illnesses (asthma, cancer, chronic kidney diseases, heart diseases, cystic fibrosis and gastrointestinal diseases) and children's and adolescents' school experiences and outcomes, as well as investigating the medical, school, psychosocial and sociodemographic factors that are linked to poorer or better school outcomes. METHODS We searched CINAHL, Cochrane Database, EMBASE, ERIC, MEDLINE, ProQuest Theses and Dissertations, and PsycINFO (2000-2015). Systematic and narrative reviews, and meta-analyses, of original studies examining students' subjective school experiences and objective school outcomes were eligible. We used the Preferred Reporting Items for Systematic Reviews and Meta-analyses criteria to critically appraise all systematic reviews. The Grading of Recommendations Assessment, Development, and Evaluation system guided our recommendations for practice and research. RESULTS Eighteen reviews of 172 studies including more than 40 000 students were eligible. Therefore, we chose to conduct a meta-review to provide an overview of the literature on the relationship between chronic illness and school experiences and outcomes. We also explored the associated medical, school, psychosocial and sociodemographic factors affecting the relationship between illness and school experiences and outcomes. CONCLUSION Students with chronic illness demonstrate mixed school experiences and outcomes that are often worse than students without chronic illness. Modifiable factors, such as students' engagement with school, may be novel yet appropriate targets of educational support to ensure that these students reach their full schooling potential.
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Affiliation(s)
- A Lum
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
| | - C E Wakefield
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
| | - B Donnan
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia.,Ronald McDonald House Charities, Sydney, NSW, Australia
| | - M A Burns
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
| | - J E Fardell
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
| | - G M Marshall
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia
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38
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Participation in psychosocial oncology and quality-of-life research: a systematic review. Lancet Oncol 2017; 18:e153-e165. [DOI: 10.1016/s1470-2045(17)30100-6] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 10/27/2016] [Accepted: 10/27/2016] [Indexed: 11/20/2022]
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Caruso R, Nanni MG, Riba M, Sabato S, Mitchell AJ, Croce E, Grassi L. Depressive spectrum disorders in cancer: prevalence, risk factors and screening for depression: a critical review. Acta Oncol 2017; 56:146-155. [PMID: 28140731 DOI: 10.1080/0284186x.2016.1266090] [Citation(s) in RCA: 116] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Although depression and mood-related disorders are common in persons with cancer, these conditions remain frequently overlooked in clinical practice. Negative consequences of depressive disorder spectrum have been reported (e.g. suicidal ideation, increase physical complications and somatic symptoms, negative influence on prognosis), indicating the need for routine screening, assessment and management. METHODS A search of the major databases (Medline, Embase, PsycLIT, PsycINFO, and the Cochrane Library) was conducted on the reviews and meta-analyses available in order to summarize relevant data concerning depressive disorders spectrum in terms of prevalence, risk factors, and screening and assessment among patients with cancer across the trajectory of the disease. RESULTS The data show a prevalence of depression and depressive disorders between 5% and 60% according to the different diagnostic criteria, the tools used in the studies (e.g. semi-structured psychiatric interview and psychometric questionnaires), as well as the stage and type of cancer. Furthermore, despite the significant health care resources devoted to cancer care and the importance of addressing depressive symptoms, assessment and management of depressive spectrum disorders in cancer patients remains suboptimal. CONCLUSIONS Routine screening and adequate assessment of depressive spectrum disorders is necessary in patients with cancer in order to effectively manage the multifaceted and complex consequences on cancer care.
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Affiliation(s)
- R. Caruso
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Disorders, S. Anna University Hospital and Health Authorities, Ferrara, Italy
| | - M. G. Nanni
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Disorders, S. Anna University Hospital and Health Authorities, Ferrara, Italy
| | - M. Riba
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA and University of Michigan Comprehensive Cancer Center, Ann, Arbor, MI, USA
- Psycho-oncology Program, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA
| | - S. Sabato
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - A. J. Mitchell
- Department of Psycho-oncology, University of Leicester and Leicestershire Partnership Trust, Leicester, UK
| | - E. Croce
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
| | - L. Grassi
- Institute of Psychiatry, Department of Biomedical and Specialty Surgical Sciences, University of Ferrara, Ferrara, Italy
- University Hospital Psychiatry Unit, Integrated Department of Mental Health and Addictive Disorders, S. Anna University Hospital and Health Authorities, Ferrara, Italy
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40
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Schellekens MPJ, van den Hurk DGM, Prins JB, Molema J, van der Drift MA, Speckens AEM. The suitability of the Hospital Anxiety and Depression Scale, Distress Thermometer and other instruments to screen for psychiatric disorders in both lung cancer patients and their partners. J Affect Disord 2016; 203:176-183. [PMID: 27295374 DOI: 10.1016/j.jad.2016.05.044] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 04/13/2016] [Accepted: 05/22/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Lung cancer patients and their partners report high rates of distress. Although distress is of importance, psychiatric disorders might be more important in terms of prognostic value and additional psychological treatment. This study examined the suitability of the Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), Beck Depression Inventory (BDI-II) and State subscale of State Trait Anxiety Inventory (STAI-S) to screen for psychiatric disorders in lung cancer patients and partners. METHODS A consecutive sample of lung cancer patients and partners completed the screening instruments. The Structured Clinical Interview DSM-IV (SCID-I) was used to diagnose psychiatric axis I disorders. RESULTS In 144 patients, overall ability of HADS total score (HADS-T) screening for patients with psychiatric disorders was good, whereas DT appeared less suitable. In 98 partners, the performance of HADS-T was good. Although no instrument was successful in identifying psychiatric disorders, HADS-T came closest with a fair performance in patients and partners. LIMITATIONS Several patients and partners declined participation because they perceived participation as too distressing. As decliners possibly have the highest rates of disorders, our findings might underestimate the prevalence of psychiatric disorders. A low prevalence negatively affects the positive predictive value and complicates efficient screening for psychiatric disorders. CONCLUSION The HADS-T appears to be a suitable screening instrument for ruling out those lung cancer patients and partners without a psychiatric disorder. Regarding identifying those with a psychiatric disorder, HADS-T should be used to refer both patients and partners for further diagnostics and treatment to a psychiatrist/psychologist.
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Affiliation(s)
- Melanie P J Schellekens
- Department of Psychiatry, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
| | - Desiree G M van den Hurk
- Department of Pulmonary Diseases, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Judith B Prins
- Department of Medical Psychology, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Johan Molema
- Department of Pulmonary Diseases, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Miep A van der Drift
- Department of Pulmonary Diseases, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Anne E M Speckens
- Department of Psychiatry, Radboud University Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands
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Kim HJ, Abraham I. Psychometric comparison of single-item, short, and comprehensive depression screening measures in Korean young adults. Int J Nurs Stud 2016; 56:71-80. [DOI: 10.1016/j.ijnurstu.2015.12.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 12/11/2015] [Accepted: 12/12/2015] [Indexed: 11/27/2022]
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Hinz A, Mehnert A, Kocalevent RD, Brähler E, Forkmann T, Singer S, Schulte T. Assessment of depression severity with the PHQ-9 in cancer patients and in the general population. BMC Psychiatry 2016; 16:22. [PMID: 26831145 PMCID: PMC4736493 DOI: 10.1186/s12888-016-0728-6] [Citation(s) in RCA: 129] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 01/28/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The Patient Health Questionnaire PHQ-9 is a widely used instrument to screen for depression in clinical research. The first aim of this study was to psychometrically test the PHQ-9 in a large sample of cancer patients. The second aim was to calculate unbiased estimates of the depression burden for several cancer groups taking into account age and gender distributions. METHODS A sample of 2,059 cancer patients with varying diagnoses were examined in this study six months after discharge from a rehabilitation clinic. A representative sample of 2,693 people from the general population served as controls. Expected PHQ-9 mean scores of the general population sample, regressed on age and gender, were calculated to enable a fair comparison of different groups of cancer patients. RESULTS While the reliability (Cronbach's alpha) for the PHQ-9 scale was good (alpha ≥ 0.84), the CFA fit indices of the one-dimensional solution were unsatisfactory in the patients' sample. The factorial analysis confirmed two factors. PHQ-9 mean scores for 15 types of cancer are given, ranging from 4.0 (prostate) to 8.2 (thyroid gland). Differences between expected mean scores (derived from the general population) and raw mean scores of the cancer subsamples are reported that provide a better estimate of the depression burden. CONCLUSIONS The results confirmed that the PHQ-9 performs well in testing depression in cancer patients. Regression coefficients can be used for performing unbiased comparisons among cancer groups, not only for this study. The burden of patients with testis cancer and Hodgkin lymphoma is underestimated when age and gender are not taken into account.
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Affiliation(s)
- Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
| | - Anja Mehnert
- Section of Psychooncology, Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
| | - Rüya-Daniela Kocalevent
- Institute and Policlinic for Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany. .,Department of Psychosomatic Medicine and Psychotherapy, University of Mainz, Mainz, Germany.
| | - Thomas Forkmann
- Institute of Medical Psychology and Medical Sociology, University Hospital of RWTH Aachen, Aachen, Germany.
| | - Susanne Singer
- Department of Medical Biostatistics, Epidemiology, and Informatics, University of Mainz, Mainz, Germany.
| | - Thomas Schulte
- Rehabilitation Clinic Bad Oexen, Bad Oeynhausen, Germany.
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Butow P, Price MA, Shaw JM, Turner J, Clayton JM, Grimison P, Rankin N, Kirsten L. Clinical pathway for the screening, assessment and management of anxiety and depression in adult cancer patients: Australian guidelines. Psychooncology 2015; 24:987-1001. [PMID: 26268799 DOI: 10.1002/pon.3920] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Revised: 05/10/2015] [Accepted: 07/01/2015] [Indexed: 01/21/2023]
Abstract
PURPOSE A clinical pathway for anxiety and depression in adult cancer patients was developed to guide best practice in Australia. METHODS The pathway was based on a rapid review of existing guidelines, systematic reviews and meta-analyses, stakeholder interviews, a Delphi process with 87 multidisciplinary stakeholders and input from a multidisciplinary advisory panel. RESULTS The pathway recommends formalized routine screening for anxiety and depression in patients with cancer at key points in the patient's journey. The Edmonton Symptom Assessment System or distress thermometer with problem checklist is recommended as brief screening tools, combined with a more detailed tool, such as the Hospital Anxiety and Depression Scale, to identify possible cases. A structured clinical interview will be required to confirm diagnosis. When anxiety or depression is identified, it is recommended that one person in a treating team takes responsibility for coordinating appropriate assessment, referral and follow-up (not necessarily carrying these out themselves). A stepped care model of intervention is proposed, beginning with the least intensive available that is still likely to provide significant health gain. The exact intervention, treatment length and follow-up timelines, as well as professionals involved, are provided as a guide only. Each service should identify their own referral network based on local resources and current service structure, as well as patient preference. DISCUSSION This clinical pathway will assist cancer services to design their own systems to detect and manage anxiety and depression in their patients, to improve the quality of care.
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Affiliation(s)
- Phyllis Butow
- Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Melanie A Price
- Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Joanne M Shaw
- Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia
| | - Jane Turner
- Faculty of Medicine and Biomedical Sciences, The University of Queensland, Brisbane, Australia
| | - Josephine M Clayton
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia.,HammondCare Palliative & Supportive Care Service, Pallister House, Greenwich Hospital, Sydney, NSW, Australia.,Sydney Medical School, University of Sydney, Sydney, NSW, Australia
| | - Peter Grimison
- Sydney Medical School, University of Sydney, Sydney, NSW, Australia.,Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Nicole Rankin
- Sydney Catalyst Translational Cancer Research Centre, Camperdown, NSW, Australia
| | - Laura Kirsten
- Psycho-Oncology Co-operative Research Group (PoCoG), The University of Sydney, Sydney, NSW, Australia.,Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology, The University of Sydney, Sydney, NSW, Australia.,Nepean Cancer Care Centre, Sydney West Cancer Network, Kingswood, UK
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