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Pao M, Horowitz L. Palliative care and suicidality: Complicated conversations at two ends of the spectrum. Pediatr Blood Cancer 2024; 71:e30956. [PMID: 38511908 PMCID: PMC11039356 DOI: 10.1002/pbc.30956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 02/15/2024] [Accepted: 02/21/2024] [Indexed: 03/22/2024]
Affiliation(s)
- Maryland Pao
- Office of the NIMH Clinical Director, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
| | - Lisa Horowitz
- Office of the NIMH Clinical Director, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland, USA
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Ernst M, Schwinn T, Hirschmiller J, Cleare S, Robb KA, Brähler E, Zwerenz R, Wiltink J, O'Connor RC, Beutel ME. To what extent are psychological variables considered in the study of risk and protective factors for suicidal thoughts and behaviours in individuals with cancer? A systematic review of 70 years of research. Clin Psychol Rev 2024; 109:102413. [PMID: 38518584 DOI: 10.1016/j.cpr.2024.102413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 11/29/2023] [Accepted: 03/08/2024] [Indexed: 03/24/2024]
Abstract
Psychological variables substantially shape the risk of suicidal thoughts and behaviours (STBs). However, it is unclear to what extent they are considered in individuals with cancer. We synthesized the quantitative research landscape concerning psychological risk/protective factors of STBs in the (psycho-) oncological context. This pre-registered review (PROSPERO-ID CRD42022331484) systematically searched the databases PubMed/Medline, CINAHL, PsycInfo, Cochrane Library, and Web of Science (as well as the grey literature and preprints). Risk of bias (RoB) was estimated using the ROBINS-I tool. Of 11,159 retrieved records, 319 studies were eligible for inclusion. Of those, 163 (51.1%) had investigated psychological factors (affective: n = 155; social: n = 65; cognitive: n = 63; personality/individual differences: n = 37; life events: n = 6), in a combined 3,561,741 participants. The most common STBs were suicidal ideation (n = 107) or death wishes (n = 20) rather than behaviour (suicide deaths: n = 26; attempts: n = 14). Most studies had a serious RoB. Thus, a large body of research investigated STBs in cancer patients/survivors, but it rarely aligned with the theoretical or clinical developments in suicide research. We propose a conceptual model of STBs in cancer delineating moderation and mediation effects to advance the integration of the fields, and to inform future research and practice.
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Affiliation(s)
- Mareike Ernst
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria; Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom; Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - Tamara Schwinn
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Judith Hirschmiller
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Seonaid Cleare
- Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Kathryn A Robb
- Cancer Behaviour Research Group, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany; Department of Medical Psychology and Medical Sociology, University Hospital Leipzig, Leipzig, Germany
| | - Rüdiger Zwerenz
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Rory C O'Connor
- Suicidal Behaviour Research Laboratory, School of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
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Nigussie K, Tesfaye D, Abdisa L, Tolosa L, Bete T, Gemechu K, Negash A, Sertsu A, Dereje J, Debele GR, Dechasa DB. Suicidal ideation, attempt and associated factors among people with cancer attending cancer center, eastern Ethiopia. Front Psychiatry 2023; 14:1184921. [PMID: 37779615 PMCID: PMC10540465 DOI: 10.3389/fpsyt.2023.1184921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 09/04/2023] [Indexed: 10/03/2023] Open
Abstract
Background Suicide is one of the most common public health problems and the second leading cause of death among individuals 15-29 years of age. Suicidal ideation and attempt are one of the common psychiatric emergence in patients with cancer that needs early detection and management before patients end their lives. Therefore, the aim of the study was to assess the magnitude of suicidal ideation, attempts, and associated factors among people with cancer in Eastern Ethiopia. Methods An institutional-based cross-sectional study design was conducted among 362 participants. A composite international diagnostic interview was used to evaluate suicidal ideation and attempt. Epi-Data version 4.6.2 was used for data entry, and SPSS version 20 was used for analysis. Logistic regression analysis was done to identify associated factors for both suicidal ideation and attempt. p-values less than 0.05 are considered statistically significant, and the strength of the association will be represented by an adjusted odds ratio with a 95% confidence interval. Results The magnitude of suicidal ideation and attempt among people with in this study was 22.9% [95% CI, 18.7-27.4] and 9.8% [95%CI, 6.7-12.8] respectively. Being living alone [AOR = 4.90, 95% CI, 2.08-11.90], and having depressive symptoms [AOR = 3.28, 95% CI, 1.37-7.73], female ([AOR = 1.53, 95% CI, 1.30-3.23], anxiety symptoms [AOR = 3.06, 95% CI, 1.35-6.73)] and having poor social support [AOR = 3.08, 95% CI, 1.72-5.05], were significantly associated suicidal ideation whereas, Being living alone [AOR = 2.89, 95% CI, 1.09-7.65], having a depressive symptoms [AOR = 4.88, 95% CI, 1.45-13.28], being divorced/widowed [AOR = 3.46, 95% CI, 1.09-10.09] and stage four cancer [AOR = 5.53, 95% CI 2.97-7.47] were significantly associated with suicidal attempt. Conclusion Nearly one-quarter and one-tenth of people with cancer have suicide ideation and attempt, respectively. Suicidal behavior among cancer patients was found in this study to be a common problem. Living alone, having depressive and anxiety symptoms, being a female, having poor social support, and being in forth stage of cancer were risk factors for suicide. Therefore, early screening, diagnosing, and treating suicide and its factors will be mandatory and expected from health care providers and non-governmental organizations.
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Affiliation(s)
- Kabtamu Nigussie
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Dejene Tesfaye
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lemesa Abdisa
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Lidiya Tolosa
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Tilahun Bete
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Kabtamu Gemechu
- School of Medical Laboratory Science, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abraham Negash
- Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addisu Sertsu
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Jerman Dereje
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Gebiso Roba Debele
- Department of Public Health, College of Health Science, Mettu University, Metu, Ethiopia
| | - Deribe Bekele Dechasa
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Mofatteh M, Mashayekhi MS, Arfaie S, Chen Y, Malhotra AK, Alvi MA, Sader N, Antonick V, Fatehi Hassanabad M, Mansouri A, Das S, Liao X, McIntyre RS, Del Maestro R, Turecki G, Cohen-Gadol AA, Zadeh G, Ashkan K. Suicidal ideation and attempts in brain tumor patients and survivors: A systematic review. Neurooncol Adv 2023; 5:vdad058. [PMID: 37313501 PMCID: PMC10259251 DOI: 10.1093/noajnl/vdad058] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023] Open
Abstract
Background Subsequent to a diagnosis of a brain tumor, psychological distress has been associated with negative effects on mental health as well as suicidality. The magnitude of such impact has been understudied in the literature. We conducted a systematic review to examine the impact of a brain tumor on suicidality (both ideation and attempts). Methods In accordance with the PRISMA guidelines, we searched for relevant peer-reviewed journal articles on PubMed, Scopus, and Web of Science databases from inception to October 20, 2022. Studies investigating suicide ideation and/or attempt among patients with brain tumors were included. Results Our search yielded 1,998 articles which were screened for eligibility. Seven studies consisting of 204,260 patients were included in the final review. Four studies comprising 203,906 patients (99.8%) reported elevated suicidal ideation and suicide attempt incidence compared with the general population. Prevalence of ideation and attempts ranged from 6.0% to 21.5% and 0.03% to 3.33%, respectively. Anxiety, depression, pain severity, physical impairment, glioblastoma diagnosis, male sex, and older age emerged as the primary risk factors associated with increased risk of suicidal ideation and attempts. Conclusion Suicidal ideation and attempts are increased in patients and survivors of brain tumors compared to the general population. Early identification of patients exhibiting these behaviors is crucial for providing timely psychiatric support in neuro-oncological settings to mitigate potential harm. Future research is required to understand pharmacological, neurobiological, and psychiatric mechanisms that predispose brain tumor patients to suicidality.
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Affiliation(s)
- Mohammad Mofatteh
- Corresponding Author: Mohammad Mofatteh, PhD, MPH, MSc, PGCert TLHE, BSc (Hons), School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, 97 Lisburn Road, Belfast BT9 7BL, United Kingdom ()
| | - Mohammad Sadegh Mashayekhi
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
- Neuro International Collaboration (NIC), Vancouver, British Columbia, Canada
| | - Saman Arfaie
- Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada
- Department of Molecular and Cell Biology, University of California Berkeley, California, USA
- Neuro International Collaboration (NIC), Montreal, Quebec, Canada
| | - Yimin Chen
- Department of Neurology, Foshan Sanshui District People’s Hospital, Foshan, China
- Neuro International Collaboration (NIC), Foshan, China
| | - Armaan K Malhotra
- Division of Neurosurgery, Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mohammed Ali Alvi
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, USA
- Neuro International Collaboration (NIC), Toronto, Ontario, Canada
| | - Nicholas Sader
- Division of Neurosurgery, University of Calgary, Alberta, Canada
- Neuro International Collaboration (NIC), Calgary, Alberta, Canada
| | - Violet Antonick
- University of Vermont, Burlington, Vermont, USA
- Neuro International Collaboration (NIC), Vermont, USA
| | | | - Alireza Mansouri
- Department of Neurosurgery, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - Sunit Das
- Division of Neurosurgery, St. Michael’s Hospital, Toronto, Ontario, Canada
| | - Xuxing Liao
- Department of Neurosurgery, Foshan Sanshui District People’s Hospital, Foshan, China
- Department of Surgery of Cerebrovascular Diseases, Foshan First People’s Hospital, Foshan, China
| | - Roger S McIntyre
- Neuro International Collaboration (NIC), Toronto, Ontario, Canada
- Mood Disorder Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Brain and Cognition Discovery Foundation, Toronto, Ontario, Canada
| | - Rolando Del Maestro
- Neuro International Collaboration (NIC), Montreal, Quebec, Canada
- Neurosurgical Simulation and Artificial Intelligence Learning Centre, Department of Neurology & Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Hospital Research Center, Montreal, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Aaron A Cohen-Gadol
- The Neurosurgical Atlas, Carmel, Indiana, USA
- Department of Neurological Surgery, Indiana University, Indianapolis, Indiana, USA
- Neuro International Collaboration (NIC), Indiana, USA
| | - Gelareh Zadeh
- Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Keyoumars Ashkan
- Neuro International Collaboration (NIC), London, UK
- Department of Neurosurgery, King’s College Hospital NHS Foundation Trust, London, UK
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK
- King’s Health Partners Academic Health Sciences Centre, London, UK
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King’s College London, UK
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Molla A, Aderaw M, Mulat H, Fanta B, Nenko G, Adane A. Suicidal ideation, attempt and associated factors among people living with cancer in Ethiopia: a cross-sectional study. Ann Gen Psychiatry 2022; 21:28. [PMID: 35883094 PMCID: PMC9316727 DOI: 10.1186/s12991-022-00407-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 07/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Suicide and cancer are serious public health problems worldwide, and people living with cancer are at high risk of having suicidal behaviors, such as ideation, plan and attempt. Patients with cancer had high possibilities of having suicidal ideation and attempt which lead to poor adherence of medication, worsening of their medical illness, and end the life. Even though people are affected by cancer in Ethiopia, there are limited studies regarding suicidal problem among patients with cancer. Therefore, this study was aimed to assess the magnitude and associated factors of suicidal ideation and attempt among people living with cancer in Ethiopia. METHODS Institutional-based cross-sectional study was conducted among total of 416 participants. Outcome variables were assessed using suicidality module of World health organization (WHO) composite international diagnostic interview (CIDI). Data were analyzed using SPSS-20 and bivariate and multivariate logistic regressions were conducted and variables with P value less than 0.05 were considered as statistically significant with corresponding 95% CI. RESULTS The overall magnitude of suicidal ideation and attempt were 16.6% and 5.5%, respectively. Being divorced [(AOR = 2.97, (95% CI 1.22, 7.22)], having depression [(AOR = 2.67, (95%CI 1.34, 5.32)], the first 18 months, since diagnosed cancer [(AOR = 2.57, (95%CI 1.15, 5.75)], severe pain [(AOR = 3.27, (95%CI 1.18, 9.04)] and stage IV cancer [(AOR = 3.35, (95%CI 1.26, 9.04)] were significantly associated with suicidal Ideation. Whereas, female sex [(AOR = 5.32, (95%CI 1.39, 20.25)], having depression [(AOR = 4.8, (95%CI 1.23, 18)] and advanced stage of cancer [(AOR = 6.76, (95%CL 1.2, 37)] were significantly associated with suicidal attempt. CONCLUSIONS The magnitude of Suicidal ideation and attempt in this study were high. Health care providers working in cancer treatment unit should give more attention to patients with high suicidal risk factors. Consultation services should be strengthened with psychiatric professionals in oncology treatment clinic.
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Affiliation(s)
- Alemayehu Molla
- Department of Psychiatry, College of Health and Medical Science, Dilla University, Dilla, Ethiopia.
| | - Mekidem Aderaw
- College of Medicine and Health Science, Comprehensive Specialized Hospital, University of Gondar, Gondar, Ethiopia
| | - Haregewoin Mulat
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Biruk Fanta
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Goshu Nenko
- Department of Psychiatry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
| | - Aynishet Adane
- Department of Internal Medicine, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Osei EA, Ani-Amponsah M. Ghanaian women's perception on cervical cancer threat, severity, and the screening benefits: A qualitative study at Shai Osudoku District, Ghana. PUBLIC HEALTH IN PRACTICE 2022; 3:100274. [PMID: 36101759 PMCID: PMC9461327 DOI: 10.1016/j.puhip.2022.100274] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/28/2022] [Accepted: 05/10/2022] [Indexed: 11/30/2022] Open
Abstract
Objective Cervical is one of the topmost causes of fatalities worldwide with mortality and incidence rates highest in sub-Saharan Africa including Ghana. The knowledge about cervical cancer threat and severity has not been extensively studied in most developing and developed countries of which Ghana is not exempted. The study, therefore, aimed to explore the views of women about cervical cancer threat, severity, and the benefits of cervical cancer screening in rural communities in the Greater Accra Region of Ghana. Study design Qualitative exploratory descriptive design was used to purposively sample 17 participants. Methods The data collection tool was pretested among 4 women from women to ensure its trustworthiness. Participants were interviewed face to face using a semi-structured interview guide. The interviews were recorded with audio recorders, transcribed verbatim and content analyzed. Ethics approval was obtained from Noguchi Memorial Institute for Medical Research Institutional Review Board (NMIMR-IRB). Results Findings of this study discovered that participants perceived Cervical cancer (CC) as serious on the basis that it is causing death of most women and lead to depression, isolation and thoughts of suicide, and poor sexual performance. Almost all the women in this study were aware that cervical cancer screening (CCS) is beneficial in the early detection of cervical cancer and protecting women against cervical cancer in order to reduce the mortalities associated with cervical cancer. In conclusion, there is high perceived severity to CC and benefits of CCS and hence other studies could be done to assess the uptake of the screening and willingness to participate in the screening among these participants. It is expected that this high perceived severity and benefits will translate into their practices of CCS and hence other researchers could explore this phenomenon.
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Affiliation(s)
- Evans Appiah Osei
- School of Nursing and Midwifery, Department of Midwifery, Valley View University, Ghana. P.O. Box DT 595, Oyibi, Ghana
- Corresponding author.
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Choi E, Becker H, Kim S. Unmet needs in adolescents and young adults with cancer: A mixed-method study using social media. J Pediatr Nurs 2022; 64:31-41. [PMID: 35149257 DOI: 10.1016/j.pedn.2022.01.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/21/2022] [Accepted: 01/28/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study is to identify and compare the unmet needs of adolescents and young adults (AYAs) with cancer by age and gender. DESIGN AND METHODS This is a mixed-methods study to analyze textual data from blog posts on AYAs' unmet needs. Themes were identified using a qualitative descriptive method with content analysis, and a quantitative method was used to compare themes by age and gender. RESULTS The findings from blog posts of 100 AYAs showed that AYAs with cancer expressed somewhat different needs by age and gender. Young adults (26-39 years) with cancer tended to describe significantly more feelings of fear (p = .043) and parenting needs (p < .001) and significantly fewer educational needs (p < .001) than did emerging adults (18-25 years) with cancer. Female AYAs with cancer described significantly more feelings of guilt (p = .020), sexual needs (p = .003), fertility issues (p = .023), and social needs (p = .013) than did male AYAs with cancer. There were no statistically significant differences in the remaining themes between age and gender groups, although how they described unmet needs differed qualitatively. CONCLUSIONS AYAs with cancer have various unmet needs and their unmet needs were different by age and gender. PRACTICE IMPLICATIONS Nurses should proactively provide integrated systematic screening by offering a safe, non-judgmental environment to encourage AYAs to express their needs across their cancer journey. Nurses also should respond with developmentally appropriate support, resources, and referrals based on these expressed needs.
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Affiliation(s)
- Eunju Choi
- Department of Nursing, University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.
| | - Heather Becker
- School of Nursing, University of Texas at Austin, 1710 Red River St, Austin, TX 78712, USA
| | - Soojeong Kim
- School of Nursing, University of Texas at Austin, 1710 Red River St, Austin, TX 78712, USA
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Increased Risk of Suicide among Cancer Survivors Who Developed a Second Malignant Neoplasm. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:2066133. [PMID: 35047029 PMCID: PMC8763535 DOI: 10.1155/2022/2066133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/07/2021] [Indexed: 02/05/2023]
Abstract
Background. Cancer diagnosis entails substantial psychological distress and is associated with dramatically increased risks of suicidal behaviors. However, little is known about the suicide risk among cancer survivors who developed a second malignant neoplasm (SMN). Methods. Using the Surveillance, Epidemiology, and End Results database, we conducted a population-based cohort study involving 7,824,709 patients with first malignant neoplasm (FMN). We measured the hazard ratios (HRs) of suicide death after receiving a SMN diagnosis using Cox proportional hazard models, as compared with patients with FMN. The comparison with the US population was achieved by calculating standardized mortality ratios (SMRs). Results. Totally 685,727 FMN patients received a diagnosis of SMN during follow-up, and we in total identified 10,930 and 937 suicide deaths among FMN and SMN patients, respectively. The HR of suicide deaths was 1.23 (95% confidence interval (CI), 1.14–1.31) after a SMN diagnosis, compared with FMN patients, after adjusting for sociodemographic factors, tumor characteristics, and cancer treatment. As compared with the general population, while both SMN and FMN patients suffered an increased risk of suicide deaths, the excess risk was higher among SMN patients than FMN patients (age-, sex-, and calendar-year-adjusted SMR 1.65 (95% CI 1.54–1.75) vs. 1.29 (95% CI 1.26–1.31);
). Notably, across different time periods, we observed the greatest risk elevation during the first 3 months after a cancer diagnosis. Conclusions. Compared with either patients with FMN or the general population, cancer survivors who received a SMN diagnosis were at increased risk of suicide death. The risk elevation was most prominent soon after the cancer diagnosis, highlighting the necessity of providing timely psychological support to cancer survivors with a SMN.
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Sharkey CM, Hardy KK, Gioia A, Weisman H, Walsh K. Suicidal ideation and executive functioning in pediatric cancer. Psychooncology 2021; 31:745-752. [PMID: 34797956 DOI: 10.1002/pon.5858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 10/10/2021] [Accepted: 11/11/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Neurocognitive impairments and psychological distress are among the most common difficulties experienced by children treated for cancer. Elevated rates of suicidal ideation (SI) are documented among cancer survivors, and a link between neurocognitive deficits and SI is evident, yet the relationship between SI and pediatric cancer-related neurocognitive effects has not yet been studied. PARTICIPANTS AND METHODS Participants were 166 pediatric cancer patients (57.8% Brain Tumor, 31.3% leukemia, 10.8% other cancers) aged 6-23 (M = 11.57, SD = 3.82; 45.8% female) referred for neuropsychological surveillance. SI prevalence was measured by parent, teacher, or patient endorsement of self-harm related items on informant-report measures (e.g., the Child Behavior Checklist). Executive functioning (Behavior Rating Inventory of Executive Function), ADHD symptoms (ADHD Rating Scale), and performance-based measures were compared between those with SI and those without. RESULTS 17.5% of pediatric cancer patients experienced SI, of which 44.7% had self-endorsement only, 58.5% parent-endorsement only, 20.6% teacher-endorsement only, and 24.1% had two endorsements. Those with SI had significantly greater impairments in global executive composite scores by both parent- and teacher-report (ps < 0.05). Parents of children with SI endorsed significantly more inattention symptoms (M = 6.10, SD = 15.48) than those without SI (M = 50.56, SD = 8.70; p < 0.01), but hyperactivity symptoms did not differ. Intellectual and executive function performance did not differ between those with and without SI (ps > 0.1). CONCLUSIONS An elevated number of children treated for cancer experience SI and related neurocognitive problems. Screening for SI and further assessment of the connection between executive functioning and SI in pediatric cancer populations is needed.
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Affiliation(s)
- Christina M Sharkey
- Division of Pediatric Neuropsychology, Children's National Hospital, Washington, District of Columbia, USA
| | - Kristina K Hardy
- Division of Pediatric Neuropsychology, Children's National Hospital, Washington, District of Columbia, USA
| | - Anthony Gioia
- Department of Psychology, University of Houston, Houston, Texas, USA
| | - Hannah Weisman
- Division of Pediatric Neuropsychology, Children's National Hospital, Washington, District of Columbia, USA
| | - Karin Walsh
- Division of Pediatric Neuropsychology, Children's National Hospital, Washington, District of Columbia, USA
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Wang C, Hu K, Luo C, Deng L, Fall K, Tamimi RM, Valdimarsdóttir UA, Fang F, Lu D. Cardiovascular mortality among cancer survivors who developed breast cancer as a second primary malignancy. Br J Cancer 2021; 125:1450-1458. [PMID: 34580431 PMCID: PMC8575780 DOI: 10.1038/s41416-021-01549-w] [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] [Received: 03/06/2021] [Revised: 08/17/2021] [Accepted: 09/14/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND To assess the risk of cardiovascular mortality among cancer survivors who developed breast cancer as a second malignancy (BCa-2) compared with patients with first primary breast cancer (BCa-1) and the general population. METHODS Using the Surveillance, Epidemiology, and End Results database, we conducted a population-based cohort study including 1,024,047 BCa-1 and 41,744 BCa-2 patients diagnosed from the age 30 between 1975 and 2016, and the corresponding US female population (994,415,911 person-years; 5,403,551 cardiovascular deaths). Compared with the general population and BCa-1 patients, we calculated incidence rate ratios (IRRs) of cardiovascular deaths among BCa-2 patients using Poisson regression. To adjust for unmeasured confounders, we performed a nested, case-crossover analysis among BCa-2 patients who died from cardiovascular disease. RESULTS Although BCa-2 patients had a mildly increased risk of cardiovascular mortality compared with the population (IRR 1.08) and BCa-1 patients (IRR 1.15), the association was pronounced among individuals aged 30-49 years (BCa-2 vs. population: IRR 6.61; BCa-2 vs. BCa-1: IRR 3.03). The risk elevation was greatest within the first month after diagnosis, compared with the population, but comparable with BCa-1 patients. The case-crossover analysis confirmed these results. CONCLUSION Our findings suggest that patients with BCa-2 are at increased risk of cardiovascular mortality.
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Affiliation(s)
- Chengshi Wang
- grid.13291.380000 0001 0807 1581Laboratory of Molecular Diagnosis of Cancer, and Department of Medical Oncology, Clinical Research Center for Breast Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan P. R. China ,grid.54549.390000 0004 0369 4060Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Kejia Hu
- grid.4714.60000 0004 1937 0626Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Chuanxu Luo
- grid.13291.380000 0001 0807 1581Laboratory of Molecular Diagnosis of Cancer, and Department of Medical Oncology, Clinical Research Center for Breast Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan P. R. China
| | - Lei Deng
- grid.240614.50000 0001 2181 8635Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY USA
| | - Katja Fall
- grid.15895.300000 0001 0738 8966Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, 701 85 Örebro, Sweden
| | - Rulla M. Tamimi
- grid.38142.3c000000041936754XDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA USA ,grid.5386.8000000041936877XDepartment of Population Health Sciences, Weill Cornell Medicine, New York, NY USA
| | - Unnur A. Valdimarsdóttir
- grid.38142.3c000000041936754XDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA USA ,grid.14013.370000 0004 0640 0021Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Sturlugata 8, 101 Reykjavik, Iceland ,grid.465198.7Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12a, 171 77 Solna, Sweden
| | - Fang Fang
- grid.4714.60000 0004 1937 0626Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Donghao Lu
- grid.4714.60000 0004 1937 0626Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden ,grid.38142.3c000000041936754XDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA USA ,grid.13291.380000 0001 0807 1581West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China
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11
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Heynemann S, Thompson K, Moncur D, Silva S, Jayawardana M, Lewin J. Risk factors associated with suicide in adolescents and young adults (AYA) with cancer. Cancer Med 2021; 10:7339-7346. [PMID: 34586755 PMCID: PMC8525084 DOI: 10.1002/cam4.4246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/30/2021] [Accepted: 08/10/2021] [Indexed: 01/17/2023] Open
Abstract
Background Higher rates of death by suicide are recognized both in individuals of any age with cancer and, separately, among adolescents and young adults (AYA) without cancer. Given this intersection, identifying risk factors associated with suicidal risk among AYA with cancer is critical. Objective To identify characteristics associated with suicide among AYA with cancer. Methods A retrospective analysis of AYA (aged 15–39) during 1975–2016 from the Surveillance, Epidemiology, and End Results database was conducted. Clinical and demographic factors associated with death by suicide among the AYA cancer population were compared to (i) US population normative data (standardized mortality ratios [SMRs]) and (ii) other AYA individuals with cancer (odds ratios). Results In total, 922 suicides were found in 500,366 AYA with cancer (0.18%), observed for 3,198,261 person‐years. The SMR for AYA with cancer was 34.1 (95% confidence interval [CI]: 31.4–36.9). Suicide risk was particularly high in females (SMR = 43.4, 95% CI: 37.2–50.4), unmarried persons (SMR = 50.6, 95% CI: 44.7–57.1), those with metastatic disease (SMR = 45.2, 95% CI: 33.1–60.3), or certain histological subtypes (leukemia, central nervous system, and soft tissue sarcoma). Risk generally reduced over time, however remained elevated ≥5 years following a cancer diagnosis (SMR > 5 years = 28.1, 95% CI: 25.4–31.0). When comparing those who died from suicide and those who did not, the following factors demonstrated significant associations: sex (males > females), race (White ethnicity > Black/other ethnicity), relationship status (never married > other), and disease stage (distant > localized). Conclusions Death due to suicide/non‐accidental injury is high compared to normative data, requiring increased awareness among health‐care providers, suicide risk monitoring in AYA, and appropriately tailored psychosocial interventions.
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Affiliation(s)
- Sarah Heynemann
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Kate Thompson
- ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Donovan Moncur
- ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Psychiatry, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Sandun Silva
- Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Hawthorn, Victoria, Australia.,NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Madawa Jayawardana
- Office of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Jeremy Lewin
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
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12
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Chen C, Lin H, Xu F, Liu J, Cai Q, Yang F, Lv L, Jiang Y. Risk factors associated with suicide among esophageal carcinoma patients from 1975 to 2016. Sci Rep 2021; 11:18766. [PMID: 34548616 PMCID: PMC8455550 DOI: 10.1038/s41598-021-98260-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 08/25/2021] [Indexed: 12/24/2022] Open
Abstract
Throughout the world, esophageal cancer patients had a greater suicidal risk compared with ordinary people. Thus, we aimed to affirm suicide rates, standardized mortality rates, and underlying suicide-related risk factors of esophageal cancer patients. Patients suffering esophageal cancer were chosen from the Surveillance, Epidemiology, and End Results repository in 1975–2016. Suicide rates as well as standardized mortality rates in the patients were measured. Univariable and multivariable Cox regression had been adopted for establishing the latent suicide risk factors among patients suffering esophageal cancer. On multivariable Cox regression, gender (male vs. female, HR: 6.37), age of diagnosis (70–105 vs. 0–55, HR: 2.69), marital status, race (white race vs. black race, HR: 6.64; American Indian/Alaska Native, Asian/Pacific Islander vs. black race, HR: 8.60), histologic Grade (Grade III vs. Grade I, HR: 2.36), no surgery performed (no/unknown vs. yes, HR: 2.01), no chemotherapy performed were independent risk factors related to suicide in patients suffering esophageal cancer. Male sex, the older age, unmarried state, non-black race, histologic Grade III, no surgery performed, no chemotherapy performed were strongly related to suicide in patients suffering esophageal cancer.
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Affiliation(s)
- Chongfa Chen
- Department of Hepatobiliary Surgery, Dongfang Hospital, Xiamen University, No.156, West Second Ring North Road, Gulou District, Fuzhou, People's Republic of China
| | - Huapeng Lin
- Department of Intensive Care Unit, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Fengfeng Xu
- Department of Cardiothoracic Surgery, 900 Hospital of the Joint Logistics Team, Fuzhou, People's Republic of China
| | - Jianyong Liu
- Department of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Team, Fuzhou, People's Republic of China
| | - Qiucheng Cai
- Department of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Team, Fuzhou, People's Republic of China
| | - Fang Yang
- Department of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Team, Fuzhou, People's Republic of China
| | - Lizhi Lv
- Department of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Team, Fuzhou, People's Republic of China
| | - Yi Jiang
- Department of Hepatobiliary Surgery, Dongfang Hospital, Xiamen University, No.156, West Second Ring North Road, Gulou District, Fuzhou, People's Republic of China.
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13
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Abstract
OBJECTIVE The present study aimed to determine whether the suicide risk increased after a cancer diagnosis. DESIGN Population-based cohort study. SETTING AND PARTICIPANTS This study incorporated the National Health Insurance Service-National Sample Cohort in South Korea. Of the 975 348 subjects, 39 027 with cancer and 936 321 who were cancer free participated between 2005 and 2013. PRIMARY OUTCOME MEASURE Suicide. RESULTS A total of 110 suicides (82 men, 28 women) were identified among these 39 027 subjects with cancer during a total of 127 184 person-years; among the 936 321 cancer-free subjects, 2163 suicides were reported during a total of 8 222 479 person-years. Cox proportional hazards models were used to compare all-cause and suicide mortalities after cancer diagnosis following adjustment for possible confounding covariates. After adjusting for factors related to suicide, we identified an elevated relative risk of suicide among patients with cancer (HR: 1.480, 95% CI: 1.209 to 1.812). Among men, the relative risk was substantially increased among patients with lip, oral cavity/pharyngeal, colon and rectal, pancreatic and lung cancers when compared with cancer-free subjects; whereas among women, the relative risk was substantially increased among patients with colon and rectal cancers. CONCLUSION Our study observed an increased risk of suicide among patients with cancer that varied according to the anatomical cancer site, even after accounting for clinical comorbidities and psychiatric illness. Our findings indicate a need for social support and suicide prevention strategies for patients with cancer.
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Affiliation(s)
- Young Choi
- Department of Healthcare Management, Catholic University of Pusan, Busan, Republic of Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine and Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea
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14
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Zhang A, Ji Q, Zhang K, Cao Q, Chen Y, Chen J, DuVall A. Solution-focused brief therapy for adolescent and young adult cancer patients in China: a pilot randomized controlled trial. J Psychosoc Oncol 2021; 40:816-833. [PMID: 34232115 DOI: 10.1080/07347332.2021.1931627] [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: 01/04/2023]
Abstract
OBJECTIVE This pilot clinical trial investigated solution-focused brief therapy (SFBT) for psychological distress among adolescent and young adult (AYA) patients with cancer in China. METHODS Fifty Chinese AYA patients diagnosed with cancer were randomized into the treatment group (SFBT) and control group (active control). Psychological distress was measured by the brief symptom inventory and hope was measured by the Herth-Hope-Index. Treatment effects were analyzed using analysis-of-covariance and between-group small-sample-size corrected Hedges' g. RESULTS The results indicated that SFBT resulted in a significant reduction in the psychological distress and improvement in hope of AYA patients with cancer. Analyses of the 4-week posttreatment score suggest the short-term sustainability of SFBT for psychological distress among AYAs diagnosed with cancer. CONCLUSIONS AND IMPLICATIONS This study has demonstrated that SFBT's impact is statistically significant and clinically meaningful. The inclusion of positive emotions, i.e., hope, as part of the investigation also highlighted the significance of promoting positive emotions among AYA patients with cancer.
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Affiliation(s)
- Anao Zhang
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Qingying Ji
- Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Kan Zhang
- Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qing Cao
- Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuting Chen
- Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jingzhi Chen
- Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Adam DuVall
- Department of Medicine, University of Chicago, Chicago, IL, USA
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15
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Mendes MVDC, Santos SLD, Ceballos AGDCD, Furtado BMASM, Bonfim CVD. Risk factors for suicide in individuals with cancer: an integrative literature review. Rev Bras Enferm 2021; 74:e20190889. [PMID: 34037173 DOI: 10.1590/0034-7167-2019-0889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 10/31/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to develop an integrative literature review on risk factors for suicide in individuals with cancer. METHOD searching for articles was conducted in the Scientific Electronic Library Online, Medicinal Literature Analysis and Retrieval System Online, Latin American & Caribbean Literature in Health Sciences, Cumulative Index to Nursing and Allied Health Literature and SciVerse Scopus databases, using the descriptors "suicide" and "cancer". RESULTS eighteen articles were selected. Lung, bladder and colorectal cancers are the types of highest risk for suicide. Male, white and over 60 years of age are demographic factors with higher risk for suicide in individuals with cancer. CONCLUSION this review made it possible to verify that cancer may be a risk factor for suicide. This evidence can be useful for planning preventive actions in order to reduce the risk of suicide.
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16
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Chen C, Jiang Y, Yang F, Cai Q, Liu J, Wu Y, Lin H. Risk factors associated with suicide among hepatocellular carcinoma patients: A surveillance, epidemiology, and end results analysis. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2021; 47:640-648. [PMID: 33051117 PMCID: PMC7538389 DOI: 10.1016/j.ejso.2020.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 10/02/2020] [Indexed: 12/09/2022]
Abstract
BACKGROUND Throughout the world, hepatocellular carcinoma (HCC) remains the primary type of liver cancer. The suicide risk was higher among patients with HCC than the general population. Hence, the purpose of this study was to confirm the suicide rates, standardized mortality ratios (SMRs), and the potential risk factors associated with suicide among HCC patients. METHODS HCC patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database during 1975-2016. Suicide rates and SMRs among these patients were calculated, and the general population of the United States (U.S.) during 1975-2016 was used as a reference. Univariable and multivariable Cox regression were taken to find out the underlying risk factors of suicide in HCC patients. RESULTS There were 70 suicides identified among 102,567 individuals with HCC observed for 160,500.88 person years. The suicide rate was 43.61 per 100,000 person-years, and SMR was 2.26 (95% CI: 1.78-2.84). On Cox regression, year of diagnosis (1975-1988 vs. 2003-2016, HR: 3.00, 95% CI: 1.01-8.89, P = 0.047; 1989-2002 vs. 2003-2016, HR: 1.92, 95% CI: 1.10-3.34, P = 0.021), gender (male vs. female, HR: 8.72, 95% CI: 2.73-27.81, P < 0.001), age at diagnosis (63-105 years old vs. 0-55 years old, HR: 2.28, 95% CI: 1.21-4.31, P = 0.011), race (white race vs. American Indian/Alaska Native, Asian/Pacific Islander, HR: 3.02, 95% CI: 1.35-6.76, P = 0.007) were independent risk factors of suicide among HCC patients. CONCLUSIONS Diagnosed in the early years (1975-2002), male sex, the older age (63-105 years old), white race, survival months (<2 months) were significantly associated with suicide among HCC patients. For the sake of preventing suicide behaviors, the government, clinicians, and family members should take adequate measures to decrease the rate of suicide, especially in patients with high-risk factors of suicide.
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Affiliation(s)
- Chongfa Chen
- Department of Hepatobiliary Surgery, Dongfang Hospital, Xiamen University, China
| | - Yi Jiang
- Department of Hepatobiliary Surgery, Dongfang Hospital, Xiamen University, China
| | - Fang Yang
- Department of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Team, China
| | - Qiucheng Cai
- Department of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Team, China
| | - Jianyong Liu
- Department of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Team, China
| | - Yushen Wu
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, China.
| | - Huapeng Lin
- Department of Intensive Care Unit, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, China.
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17
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Lubas MM, Mirzaei Salehabadi S, Lavecchia J, Alberts NM, Krull KR, Ehrhardt MJ, Srivastava D, Robison LL, Hudson MM, Brinkman TM. Suicidality among adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort Study. Cancer 2020; 126:5347-5355. [PMID: 32964427 DOI: 10.1002/cncr.33187] [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] [Received: 05/01/2020] [Revised: 07/14/2020] [Accepted: 08/10/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Suicide is a serious public health concern. An increased risk of suicide ideation previously has been reported among survivors of childhood cancer. METHODS Suicide mortality was assessed for all potentially eligible survivors (those aged ≥18 years who were ≥5 years after their cancer diagnosis; 7312 survivors). Risk factors for acute suicidal ideation were assessed among clinically evaluated survivors (3096 survivors) and the prevalence of acute ideation was compared with that of community controls (429 individuals). The prevalence of 12-month suicidality was assessed among survivors who could be compared with population data (1255 survivors). Standardized mortality ratios compared rates of suicide mortality among survivors with those of the general population. Risk ratios (RRs) and 95% confidence intervals (95% CIs) derived from generalized linear models identified risk factors associated with acute suicidal ideation. Standardized incidence ratios (SIRs) compared the prevalence of 12-month suicidality among survivors with that of a matched sample from the general population. RESULTS Survivors reported a similar 12-month prevalence of ideation compared with the general population (SIR, 0.68; 95% CI, 0.35-1.01) and a lower prevalence of suicidal behaviors (planning: SIR, 0.17 [95% CI, 0.07-0.27]; attempts: SIR, 0.07 [95% CI, 0.00-0.15]) and mortality (standardized mortality ratio, 0.60; 95% CI, 0.34-0.86). Among survivors, depression (RR, 12.30; 95% CI, 7.89-19.11), anxiety (RR, 2.19; 95% CI, 1.40-3.40), and financial stress (RR, 1.47; 95% CI, 1.00-2.15) were found to be associated with a higher prevalence of acute suicidal ideation. CONCLUSIONS Survivors of childhood cancer were found to be at a lower risk of suicidal behaviors and mortality, yet endorsed a prevalence of ideation similar to that of the general population. These results are in contrast to previous findings of suicidal ideation among survivors and support the need for further research to inform screening strategies and interventions. LAY SUMMARY The purpose of the current study was to compare the risk of suicidal ideation, behaviors, and mortality in adult survivors of childhood cancer with those of the general population. Risk factors associated with suicidal ideation among survivors of childhood cancer also were examined. Survivors of childhood cancer reported a similar risk of ideation compared with the general population, but a lower risk of suicidal behaviors and mortality. Psychological health and financial stressors were found to be risk factors associated with suicidal ideation. Although adult survivors of childhood cancer did not report a greater risk of suicidality compared with the general population, psychosocial care in survivorship remains essential.
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Affiliation(s)
- Margaret M Lubas
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | | | - Jeanette Lavecchia
- Department of Social Work, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Nicole M Alberts
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Matthew J Ehrhardt
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Deokumar Srivastava
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Tara M Brinkman
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
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18
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Harashima S, Fujimori M. Risk of suicide among adolescents and young adults with cancer and a need for targeted interventions. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:428. [PMID: 32395472 PMCID: PMC7210179 DOI: 10.21037/atm.2020.02.180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Saki Harashima
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Chuo-ku, Tokyo, Japan.,Department of Stress Sciences and Psychosomatic Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Maiko Fujimori
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Chuo-ku, Tokyo, Japan
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19
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Abstract
Cancer is one of the most common diseases and suicide is one of the causes of cancer patients' mortality. However, the suicide mortality rate in cancer patients has not been thoroughly investigated. The aim of this study was to perform a systematic review and a meta-analysis of suicide mortality risk in cancer patients. The authors systematically searched PubMed, Scopus, psycInfo, and Google Scholar databases using MESH keywords until July 2018; searching was limited to English. Random effects model was used for meta-analyzing the studies. Forest plot was calculated for the whole of the 22 studies and the subgroups. Publication bias was examined, and qualitative evaluation of the articles entered into the meta-analysis was also carried out. 22 studies were included in the meta-analysis. Pooled Standardized Mortality Ratio (SMR) for suicide mortality (SMR = 1.55; 95% and confidence interval (CI) CI = 1.37-1.74) in cancer patients were achieved. It has been shown (SMR = 1.67; 95% CI = 1.48-1.89 and p < 0.001) that cancer has increased suicidal rates in men and also in women (SMR = 1.34; 95% CI = 1.20-1.50 and p < 0.001). The following results were reported based on the subtypes of cancer; pooled SMR = 2.06; 95% CI = 1.32-3.23, and p < 0.001 in esophagus, stomach, pancreas and liver cancers; SMR = 1.57; 95% CI = 1.26-1.97, and p < 0.001 in colon and rectum cancers; SMR = 3.07; 95% CI = 2.20-4.28, and p < 0.001 in bronchus, trachea and lung cancers; SMR = 1.24; 95% CI = 1.03-1.48, and p = 0.020 in breast cancer; SMR = 1.71; 95% CI = 1.38-2.12, and p < 0.001 in prostate cancer. Overall, there is an evaluated suicide mortality rate in cancer patients. There was some evidence of publication bias. Our findings indicate that cancer increases the risk of suicide. Given the results and co-morbidities between suicide-induced cancer and other psychological disorders, the development of psychological interventions can be useful in reducing the risk of suicide in these patients.
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20
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Ludolph P, Kunzler AM, Stoffers-Winterling J, Helmreich I, Lieb K. Interventions to Promote Resilience in Cancer Patients. DEUTSCHES ARZTEBLATT INTERNATIONAL 2019; 51-52:865-872. [PMID: 31941574 DOI: 10.3238/arztebl.2019.0865] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 06/24/2019] [Accepted: 07/30/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Resilience is the ability to maintain or rapidly regain mental health during or after stressful life experiences. Cancer is a major risk factor for stress- associated mental illness. In this review, we attempt to identify effective resilience- promoting interventions in adults with cancer. METHODS The analysis was restricted to randomized, controlled trials of resilience- promoting interventions in adults with cancer in which training was provided for at least one psychosocial resilience factor. A selective search, with systematic compo- nents, for relevant publications was carried out in the PubMed and CENTRAL data- bases. Effect sizes (Hedges' g) were calculated wherever a fully reported dataset for resilience or post-traumatic growth was available. RESULTS Twenty-two trials with a total of 2,912 patients were included in the analy- sis; the intervention was provided in an individual setting in five trials and in group format in 17. Beneficial effects on resilience and post-traumatic growth, some of them large, were observed in patients who were acutely ill with cancer and after in- terventions that were provided in more than 12 sessions. The effect size ranged from g = 0.33 to g = 1.45. Largely beneficial effects were achieved by interventions based on the concepts of positive psychology, supportive-expressive group therapy, behavioral therapy, or mindfulness, with considerable variation in individual effect sizes. CONCLUSION Interventions that promote resilience should be made available to inter- ested and motivated cancer patients. These interventions should be provided, in as soon as the diagnosis is made and should ex- tend over more than 12 sessions whenever possible.
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Affiliation(s)
- Paul Ludolph
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany; German Resilience Center (DRZ) Mainz, Mainz, Germany
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21
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Maria Alexandra Stanescu A, Totan A, Mircescu D, Diaconescu S, Gabriel Bratu O, Fekete L, László Fekete G, Boda D, Cristina Diaconu C. Assessment of suicidal behavior in dermatology (Review). Exp Ther Med 2019; 20:73-77. [PMID: 32508997 DOI: 10.3892/etm.2019.8145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 10/21/2019] [Indexed: 12/21/2022] Open
Abstract
Many diseases that affect physical health can also affect mental health. Many of these diseases are studied in terms of quality of life, depression and suicidal behavior. Dermatological disorders, although having a strong impact on the individual's life, are less studied with regard to suicidal behavior. There is a need to approach several dermatological diseases from the perspective of suicidal behavior in order to intervene early with specific treatment or to prevent suicide. Psoriasis, acne, melanoma, atopic dermatitis and urticaria are scarcely studied from the point of view of suicidal behavior. In addition to these diseases, there are others that require attention in terms of suicidal behavior, such as vitiligo or oculocutaneous albinism, most probably due to a small number of people suffering from these diseases, research is almost non-existent in these cases. We want to draw attention to the importance of early detection of suicidal behavior in dermatological practice and to highlight the need for several studies on this subject.
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Affiliation(s)
| | - Alexandra Totan
- University of Medicine and Pharmacy 'Carol Davila', 050474 Bucharest, Romania
| | - Daniela Mircescu
- University of Medicine and Pharmacy 'Carol Davila', 050474 Bucharest, Romania
| | - Smaranda Diaconescu
- II Pediatric Surgery Clinic, 'St. Mary' Children Emergency Hospital, 700309 Iasi, Romania
| | - Ovidiu Gabriel Bratu
- University of Medicine and Pharmacy 'Carol Davila', 050474 Bucharest, Romania.,Urology Department, Emergency University Central Military Hospital, 010825 Bucharest, Romania
| | | | - Gyula László Fekete
- University of Medicine and Pharmacy, Dermatology Clinic, 530136 Targu Mures, Romania
| | - Daniel Boda
- University of Medicine and Pharmacy 'Carol Davila', Department of Dermatology, 050474 Bucharest, Romania
| | - Camelia Cristina Diaconu
- University of Medicine and Pharmacy 'Carol Davila', 050474 Bucharest, Romania.,Clinical Emergency Hospital of Bucharest, 020322 Bucharest, Romania
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22
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Korhonen LM, Taskinen M, Rantanen M, Erdmann F, Winther JF, Bautz A, Feychting M, Mogensen H, Talbäck M, Malila N, Ryynänen H, Madanat-Harjuoja L. Suicides and deaths linked to risky health behavior in childhood cancer patients: A Nordic population-based register study. Cancer 2019; 125:3631-3638. [PMID: 31287570 DOI: 10.1002/cncr.32373] [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: 03/08/2019] [Revised: 05/27/2019] [Accepted: 06/09/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND Childhood cancer survivors have been reported to be vulnerable to psychiatric morbidities and risky health behavior. Suicides, substance abuse, accidents, and violence as causes of death can be regarded as an extreme manifestation of risky health behavior. In the current study, the authors studied the risk of suicide and other risky health behavior-related deaths among childhood cancer patients in Denmark, Finland, and Sweden. METHODS Using linkage between national cancer, population, and cause-of-death registries, the authors investigated the causes of death in 29,285 patients diagnosed with cancer before age 20 years between 1971 and 2009 compared with a cohort of 146,282 age-matched, sex-matched, and country-matched population comparisons. Rate ratios (RRs) with 95% CIs were estimated using Poisson regression models, adjusting for demographic factors. RESULTS The overall risk of dying of a risky health behavior was found to be increased among childhood cancer patients (RR, 1.25; 95% CI, 1.06-1.47) when compared with population comparisons. The elevated risk was statistically significant among patients with central nervous system tumors (RR, 1.49; 95% CI, 1.08-2.05) and patients diagnosed at ages 5 to 9 years and 15 to 19 years (RR, 1.50 [95% CI, 1.01-2.24] and RR, 1.31 [95% CI, 1.03-1.67], respectively). The overall risk of suicide was found to be increased (RR, 1.37; 95% CI, 1.02-1.83), and statistically significantly so when patients were diagnosed between ages 15 and 19 years (RR, 1.61; 95% CI, 1.09-2.39). CONCLUSIONS Childhood cancer patients appear to have an increased risk of risky health behavior-related causes of death compared with the general population. The results of the current study suggest the importance of integrating psychosocial support into the follow-up care of these individuals.
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Affiliation(s)
- Liisa M Korhonen
- Finnish Cancer Registry, Helsinki, Finland.,Pediatric Research Center, Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Mervi Taskinen
- Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | | | - Friederike Erdmann
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jeanette Falck Winther
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark.,Department of Clinical Medicine, Faculty of Health, Aarhus University Hospital, Aarhus University, Aarhus, Denmark
| | - Andrea Bautz
- Childhood Cancer Research Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Maria Feychting
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Hanna Mogensen
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Mats Talbäck
- Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
| | - Nea Malila
- Finnish Cancer Registry, Helsinki, Finland
| | | | - Laura Madanat-Harjuoja
- Finnish Cancer Registry, Helsinki, Finland.,Pediatric Research Center, Children's Hospital, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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23
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Harashima S, Fujimori M, Akechi T, Matsuda T, Saika K, Hasegawa T, Inoue K, Yoshiuchi K, Miyashiro I, Uchitomi Y, Matsuoka YJ. Suicide, other externally caused injuries and cardiovascular death following a cancer diagnosis: study protocol for a nationwide population-based study in Japan (J-SUPPORT 1902). BMJ Open 2019; 9:e030681. [PMID: 31278108 PMCID: PMC6615787 DOI: 10.1136/bmjopen-2019-030681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
INTRODUCTION A growing body of literature has demonstrated that cancer patients have a higher risk of suicide and cardiovascular mortality compared with the general population, especially immediately after a cancer diagnosis. Using data from the National Cancer Registry in Japan launched in January 2016, we will conduct the first nationwide population-based study in Japan to compare incidence of death by suicide, other externally caused injuries (ECIs) and cardiovascular disease following a cancer diagnosis with that of the general population in Japan. We will also aim to identify the patient subgroups and time periods associated with particularly high risk. METHODS AND ANALYSIS Our study subjects will consist of cancer cases diagnosed between 1 January 2016 and 31 December 2016 in Japan and they will be observed until 31 December 2018. We will calculate standardised mortality ratios (SMRs) and excess absolute risks (EARs) for suicide, other ECIs and cardiovascular death compared with the general population in Japan, after adjustment for sex, age and prefecture. SMRs and EARs will be calculated separately in relation to a number of factors: sex; age at diagnosis; time since cancer diagnosis; prefecture of residence at diagnosis; primary tumour site; behaviour code of tumour; extension of tumour; whether definitive surgery of the primary site was performed; and presence/absence of multiple primary tumours. ETHICS AND DISSEMINATION The study protocol was approved by the institutional review board and ethics committee of the National Cancer Center Japan and Nagoya City University Graduate School of Medical Sciences. The findings will be disseminated through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER UMIN000035118; Pre-results.
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Affiliation(s)
- Saki Harashima
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
- Department of Stress Sciences and Psychosomatic Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Maiko Fujimori
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tomohiro Matsuda
- Center for Cancer Registries, Center for Cancer Control and Information Services, National Cancer Center Japan, Tokyo, Japan
| | - Kumiko Saika
- Center for Cancer Registries, Center for Cancer Control and Information Services, National Cancer Center Japan, Tokyo, Japan
| | - Takaaki Hasegawa
- Division of Psycho-Oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
| | - Keisuke Inoue
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Yosuke Uchitomi
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Yutaka J Matsuoka
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
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24
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Negative life events as triggers on suicide attempt in rural China: a case-crossover study. Psychiatry Res 2019; 276:100-106. [PMID: 31035109 DOI: 10.1016/j.psychres.2019.04.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/03/2019] [Accepted: 04/03/2019] [Indexed: 11/24/2022]
Abstract
This study aims to investigate the potential triggering of negative life events (NLEs) on suicide attempt in rural China. A case-crossover design was used to study 1200 suicide attempters aged 15-70 years. NLEs were assessed by a modification of Paykel's Interview for Recent Life Events. NLEs had significant triggering effects on the day of and month of suicide attempt. Marriage/love, family/home, and friend/relationship were the types of NLEs found to trigger suicide attempt when occurring on the day and month of suicide attempt. Specifically, increased risk of suicide attempt was associated with quarreling with a partner or family member on the day and month of suicide attempt. Being disappointed in a love affair, fighting with a partner, family poverty and loss of face during the month of attempts were linked to increase odds of suicide attempt. Further, when month of suicide attempt was assigned as the case period, the impact of NLEs on suicide attempt was greater among those who were younger and without mental disorders. These findings provide knowledge of the triggering of NLEs on suicide attempt, especially among the young and those without mental disorders. Further, family conflicts should be a greater focus of attention in suicide prevention.
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25
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Na EJ, Lee H, Myung W, Fava M, Mischoulon D, Paik JW, Hong JP, Choi KW, Kim H, Jeon HJ. Risks of Completed Suicide of Community Individuals with ICD-10 Disorders Across Age Groups: A Nationwide Population-Based Nested Case-Control Study in South Korea. Psychiatry Investig 2019; 16:314-324. [PMID: 31042694 PMCID: PMC6504769 DOI: 10.30773/pi.2019.02.19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 02/19/2019] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Suicide is the leading cause of death in 10-39-year-olds in South Korea, and the second highest rate among the OECD countries. However, few studies have investigated the particularity of completed suicide in South Korea. METHODS Study subjects consisted of 2,838 suicide cases and 56,758 age and sex matched living controls from a national representative sample of 1,025,340 South Koreans. They were obtained from the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC) with follow-up up to 12 years. We obtained information on primary diagnosis of any ICD-10 disorder along with suicide cases during their lifetime. RESULTS Among ICD-10 disorders, depression was the most common disorder (19.10%, n=542), found in victims of completed suicides except for common medical disorders such as hypertensive crisis, respiratory tract infection or arthropathies. After adjusting for sex, age, economic status, disability, and disorders, schizophrenia showed the strongest association with suicide (AOR: 28.56, 95% CI: 19.58-41.66) among all ICD-10 disorders, followed by psoriasis, multiple body injury, epilepsy, sleep disorder, depression, and bipolar disorder. For age groups, ≤19 years was associated with anxiety disorder (AOR=80.65, 95% CI: 13.33-487.93), 20-34 years with epilepsy (AOR=134.92, 95% CI: 33.69-540.37), both 35-49 years (AOR=108.57, 95% CI: 37.17-317.09) and 50-65 years (AOR=189.41 95% CI: 26.59-1349.31), with schizophrenia, and >65 years (AOR=44.7, 95% CI: 8.93-223.63) with psoriasis. CONCLUSION Psychiatric and physical disorders carried greatly increased risks and numbers of suicides in South Korea. Schizophrenia was the strongest risk factor, especially 35-65 years, and depression was the most common in suicide victims among ICD-10 disorders in South Korea.
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Affiliation(s)
- Eun Jin Na
- Korea Psychological Autopsy Center (KPAC), Seoul, Republic of Korea.,Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Hyewon Lee
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea.,Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Woojae Myung
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Maurizio Fava
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - David Mischoulon
- Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Jong-Woo Paik
- Department of Psychiatry, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kwan Woo Choi
- Department of Psychiatry, Anam Hospital, Korea University College of Medicine and School of Medicine, Seoul, Republic of Korea
| | - Ho Kim
- Institute of Health and Environment, Seoul National University, Seoul, Republic of Korea.,Department of Public Health Science Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Hong Jin Jeon
- Korea Psychological Autopsy Center (KPAC), Seoul, Republic of Korea.,Department of Psychiatry, Depression Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Health Sciences & Technology, Department of Medical Device Management & Research, and Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea
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26
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Jin S, Liu Y, Hennessy DA, Sun L, Zang Y, Si M, Zhang J. Physical Illnesses and Medically Serious Suicide Attempts in Rural China. CRISIS 2019; 41:15-23. [PMID: 30888227 DOI: 10.1027/0227-5910/a000597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Background: Physical illness is a strong correlate of suicidal behavior. However, its impact on attempted suicide in rural China is under-studied. Aims: This study was designed to assess the influence of physical illness on risk of suicide attempts and to identify distinguishing characteristics among medically serious suicide attempters with physical illnesses from those without. Method: Participants were medically serious suicide attempters identified through hospital emergency rooms (n = 659) as well as age- and gender-matched community controls (n = 659) from Shandong Province, China. Face-to-face interviews with the respondents were conducted with a semistructured protocol that included sociodemographic and psychological measures. Results: Physical illness was a significant risk factor for medically serious suicide attempts (OR = 1.739, 95% CI = 1.182-2.560). Older age was a significant risk factor, while female gender, no religion, and non-peasant occupations were significant protective factors for suicide attempts with physical illness. Limitations: Samples from only one province may not completely represent all serious suicide attempters in China. Furthermore, we did not assess the severity and the degree to which their physical illness limited the functioning of the individual. Conclusion: Physical illness is an important risk factor for suicide attempts in rural China. More efforts are needed to specifically target older people, males, those with religious beliefs, and peasant workers with physical illness.
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Affiliation(s)
- Shenghua Jin
- Fuzhou University Institute of Psychological and Cognitive Sciences and Center for China Social Trust Research, Fuzhou, Fujian Province, China
| | - Yanzheng Liu
- Shandong University School of Public Health Center for Suicide Prevention Research, Jinan, Shandong Province, China
| | - Dwight A Hennessy
- Department of Psychology, State University of New York Buffalo State, New York, USA
| | - Long Sun
- Shandong University School of Public Health, Jinan, Shandong Province, China
| | - Yuli Zang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, China
| | - Min Si
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, China
| | - Jie Zhang
- Shandong University School of Public Health Center for Suicide Prevention Research, Jinan, Shandong Province, China.,Department of Sociology, State University of New York Buffalo State, New York, USA
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27
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Lagergren P, Schandl A, Aaronson NK, Adami HO, de Lorenzo F, Denis L, Faithfull S, Liu L, Meunier F, Ulrich C. Cancer survivorship: an integral part of Europe's research agenda. Mol Oncol 2019; 13:624-635. [PMID: 30552794 PMCID: PMC6396379 DOI: 10.1002/1878-0261.12428] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 11/30/2018] [Indexed: 12/11/2022] Open
Abstract
Cancer survivorship has traditionally received little prioritisation and attention. For a long time, the treatment of cancer has been the main focus of healthcare providers’ efforts. It is time to increase the amount of attention given to patients’ long‐term well‐being and their ability to return to a productive and good life. This article describes the current state of knowledge and identifies research areas in need of development to enable interventions for improved survivorship for all cancer patients in Europe. The article is summed up with 11 points in need of further focus.
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Affiliation(s)
- Pernilla Lagergren
- Surgical Care Science, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Department of Surgery and Cancer, Imperial College London, UK
| | - Anna Schandl
- Surgical Care Science, Department of Molecular medicine and Surgery, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.,Department of Quality and Patient Safety, Karolinska University Hospital, Stockholm, Sweden
| | - Neil K Aaronson
- Division of Psychosocial Research & Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Hans-Olov Adami
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Clinical Effectiveness Research Group, Institute of Health and Society, University of Oslo, Norway
| | - Francesco de Lorenzo
- European Cancer Patient Coalition, Brussels, Belgium.,Italian Federation of Cancer Patients Organisations, Rome, Italy
| | | | - Sara Faithfull
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Lifang Liu
- Fédération of European Academies of Medicine, Brussels, Belgium
| | | | - Cornelia Ulrich
- Huntsman Cancer Institute, Salt Lake City, UT, USA.,Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
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28
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Mallet J, Huillard O, Goldwasser F, Dubertret C, Le Strat Y. Mental disorders associated with recent cancer diagnosis: Results from a nationally representative survey. Eur J Cancer 2018; 105:10-18. [DOI: 10.1016/j.ejca.2018.09.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 09/25/2018] [Accepted: 09/27/2018] [Indexed: 01/09/2023]
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29
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Sansom‐Daly UM, Wakefield CE, Bryant RA, Patterson P, Anazodo A, Butow P, Sawyer SM, McGill BC, Evans HE, Cohn RJ. Feasibility, acceptability, and safety of the Recapture Life videoconferencing intervention for adolescent and young adult cancer survivors. Psychooncology 2018; 28:284-292. [DOI: 10.1002/pon.4938] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 10/05/2018] [Accepted: 11/04/2018] [Indexed: 12/28/2022]
Affiliation(s)
- Ursula M. Sansom‐Daly
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
- Nelune Comprehensive Cancer CentrePrince of Wales Hospital Sydney Australia
| | - Claire E. Wakefield
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
| | | | - Pandora Patterson
- Research, Evaluation and Social Policy UnitCanTeen Newtown Australia
- Cancer Nursing Research Unit, Sydney Nursing SchoolThe University of Sydney Sydney Australia
| | - Antoinette Anazodo
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
- Nelune Comprehensive Cancer CentrePrince of Wales Hospital Sydney Australia
| | - Phyllis Butow
- Centre for Medical Psychology and Evidence‐based Decision‐making (CeMPED), School of PsychologyUniversity of Sydney Sydney Australia
| | - Susan M. Sawyer
- Department of PaediatricsUniversity of Melbourne Melbourne Australia
- Murdoch Children's Research Institute Melbourne Australia
- Royal Children's Hospital Centre for Adolescent Health Melbourne Australia
| | - Brittany C. McGill
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
| | - Holly E. Evans
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
| | - Richard J. Cohn
- School of Women's and Children's HealthUNSW Sydney Sydney Australia
- Behavioural Sciences Unit, Kids Cancer CentreSydney Children's Hospital Sydney Australia
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30
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Lathren C, Bluth K, Campo R, Tan W, Futch W. Young adult cancer survivors' experiences with a mindful self-compassion (MSC) video-chat intervention: A qualitative analysis. SELF AND IDENTITY 2018; 17:646-665. [PMID: 30774563 DOI: 10.1080/15298868.2018.1451363] [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] [Indexed: 12/30/2022]
Abstract
Young adult cancer survivors (YACS) are a vulnerable population that reports high anxiety, social isolation, and feelings of inadequacy after cancer treatment completion. Mindful self-compassion (MSC) provides strategies for coping with suffering. We explored how MSC practices addressed the psychosocial needs of a nationally recruited YACS sample (N=20, all female, age M=27.00, various cancer types) that participated in an 8-week MSC video-chat intervention. Descriptive qualitative analysis of the intervention recordings revealed three YACS' psychosocial needs: peer isolation, body concerns, and health-related anxiety. MSC practices addressed these in a number of ways including: self-reliance for emotional support, common humanity within the YACS community, gratitude, self-kindness, and acceptance. Meanwhile, the body scan practice initially triggered distress for some; implications are discussed.
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Affiliation(s)
- Christine Lathren
- Department of Physical Medicine and Rehabilitation University of North Carolina at Chapel Hill, CB7200, Chapel Hill, NC 27514
| | - Karen Bluth
- Department of Physical Medicine and Rehabilitation University of North Carolina at Chapel Hill, CB7200, Chapel Hill, NC 27514
| | - Rebecca Campo
- Department of Physical Medicine and Rehabilitation University of North Carolina at Chapel Hill, CB7200, Chapel Hill, NC 27514
| | - Winfield Tan
- Department of Psychiatry University of North Carolina at Chapel Hill, 101 Manning Drive, Chapel Hill, NC 27514
| | - Will Futch
- Department of Physical Medicine and Rehabilitation University of North Carolina at Chapel Hill, CB7200, Chapel Hill, NC 27514
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31
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Chalmers JA, Sansom-Daly UM, Patterson P, McCowage G, Anazodo A. Psychosocial Assessment Using Telehealth in Adolescents and Young Adults With Cancer: A Partially Randomized Patient Preference Pilot Study. JMIR Res Protoc 2018; 7:e168. [PMID: 30158103 PMCID: PMC6135966 DOI: 10.2196/resprot.8886] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 03/05/2018] [Accepted: 04/26/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adolescent and young adults with cancer are at increased risk of psychosocial difficulties relative to their healthy peers. Current models of inpatient face-to-face psychosocial care might limit the capacity for clinicians to provide timely and personalized assessment and intervention for this group. Telehealth offers a promising alternative toward increasing access to the provision of evidence-based psychosocial assessment and treatment for adolescent and young adults with cancer. OBJECTIVE This pilot study aimed to assess the feasibility and acceptability for both patients and clinicians of providing a psychosocial assessment via telehealth to adolescents and young adults currently receiving treatment for cancer, relative to face-to-face delivery. METHODS We included patients who were aged 15-25 years, currently receiving treatment, could speak English well, and medically stable. Patients were recruited from oncology clinics or wards from 5 hospitals located across Sydney and Canberra, Australia, and allocated them to receive psychosocial assessment (Adolescent and Young Adult Oncology Psychosocial Assessment Measure) with a clinical psychologist or social worker through face-to-face or telehealth modalities using a partially randomized patient preference model. Patients completed a pre- and postassessment questionnaire comprising validated and purposely designed feasibility and acceptability indices, including the impact of technical difficulties, if patients had their own devices; number of patients who were content with their group allocation; self-reported preference of modality; Treatment Credibility and Expectations Questionnaire; and Working Alliance Inventory. Clinicians also completed a postassessment questionnaire rating their impressions of the acceptability and feasibility of intervention delivery by each modality. RESULTS Of 29 patients approached, 23 consented to participate (response rate: 79%). Participants were partially randomized to either telehealth (8/23, 35%; mean age 16.50 years, range 15-23 years; females: 4/8, 50%) or face-to-face (11/23, 62%; mean age 17 years, range 15-22 years; females: 8/11, 72%) conditions. Four participants withdrew consent because of logistical or medical complications (attrition rate: 17.4%). Most participants (6/8, 75%) in the telehealth group used their computer or iPad (2 were provided with an iPad), with minor technical difficulties occurring in 3 of 8 (37.5%) assessments. Participants in both groups rated high working alliance (Working Alliance Inventory; median patient response in the telehealth group, 74, range 59-84 and face-to-face group, 63, range 51-84) and reported positive beliefs regarding the credibility and expectations of their treatment group. Postassessment preferences between face-to-face or telehealth modalities varied. Most patients in the telehealth group (5/8, 63%) reported no preference, whereas 6 of 11 (55%) in the face-to-face group reported a preference for the face-to-face modality. CONCLUSIONS Telehealth is acceptable as patient comfort was comparable across modalities, with no significant technological barriers experienced. However, patients varied in their preferred interview modality, highlighting the need to tailor the treatment to patient preference and circumstances. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12614001142628; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366609 (Archived by WebCite at http://www.webcitation.org/721889HpE).
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Affiliation(s)
| | - Ursula Margaret Sansom-Daly
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, Australia.,Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, Australia.,Sydney Youth Cancer Service, Prince of Wales Hospitals, Randwick, Australia
| | - Pandora Patterson
- Department of Research, Evaluation & Social Policy, CanTeen Australia, Newtown, Australia.,Cancer Nursing Research Unit, University of Sydney, Sydney, Australia
| | - Geoffrey McCowage
- Cancer Centre for Children, Children's Hospital at Westmead, Westmead, Australia
| | - Antoinette Anazodo
- Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, Sydney, Australia.,Nelune Comprehensive Cancer Centre, Prince of Wales Hospitals, Randwick, Australia.,Kids Cancer Centre, Sydney Children's Hospital, Sydney, Australia
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32
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What determines the timing of discussions on forgoing anticancer treatment? A national survey of medical oncologists. Support Care Cancer 2018; 27:1375-1382. [DOI: 10.1007/s00520-018-4423-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Accepted: 08/13/2018] [Indexed: 11/27/2022]
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33
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Kim H, Park J, Kweon K, Ahn J. Short- and Long-term Effects of Case Management on Suicide Prevention among Individuals with Previous Suicide Attempts: a Survival Analysis. J Korean Med Sci 2018; 33:e203. [PMID: 30079004 PMCID: PMC6070468 DOI: 10.3346/jkms.2018.33.e203] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Accepted: 05/08/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND This study examined the long-term preventive effects of a case management service on suicide reattempts, and clarified the factors related to suicide reattempts. METHODS We reviewed the medical records of suicide attempters who visited the emergency department of Ulsan University Hospital from August 28, 2013 to July 31, 2017. A 4-week case management service was provided to consenting participants, either face-to-face or by telephone. Using survival analysis, we analyzed differences in the time to the next emergency department visit for a suicide attempt according to whether participants completed the case management service. We also assessed which characteristics of participants were associated with suicide reattempts. RESULTS We found no overall difference in time to suicide reattempt between case-managed participants and controls over the entire observation period (median period: 19 months). However, in the first 24 weeks after the initial suicide attempt, the case-managed group showed a longer time to reattempt than did the control group (log-rank test = 4.243; P = 0.039). A higher risk of reattempt was found among participants with the medical benefit type of health insurance compared to those with national health insurance (hazard ratio [HR], 5.134; P < 0.001) and among participants aged 20-39 compared to those aged ≥ 60 (HR, 3.502; P = 0.05). CONCLUSION Case management had only short-term benefits (within 24 weeks of initial suicide attempt). Risk factors for suicide reattempts were having a medical benefit health insurance and being aged 20-39 years.
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Affiliation(s)
- Hyeonjae Kim
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Jangho Park
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Kukju Kweon
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Joonho Ahn
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
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Wang SM, Chang JC, Weng SC, Yeh MK, Lee CS. Risk of suicide within 1 year of cancer diagnosis. Int J Cancer 2018; 142:1986-1993. [PMID: 29250783 DOI: 10.1002/ijc.31224] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 11/26/2017] [Accepted: 12/04/2017] [Indexed: 12/29/2022]
Abstract
The association of the risk of suicide with cancer at different time points after a new cancer diagnosis is unclear. This study explored the suicide hazard at different time points after a first cancer diagnosis during the 1-year period before suicide. This case-crossover study included 2,907 suicide cases from 2002 to 2012 in Taiwan and compared the odds of suicide risk at different time points during one year after any cancer diagnosis with self-matched periods. The 13th month preceding the suicide date was used as the control period, and the hazard period was the duration from the 1st to 12th month in the conditional logistic regression for case-crossover comparisons. Among major groups of cancers, group of lip, oral cavity and pharynx cancers tended to have higher risk of suicide than other groups of cancers. The first month of cancer diagnosis was associated with the highest risk of suicide compared with the 13th month before suicide. The odds ratio (OR) of suicide were significantly in the first six months after cancer diagnosis but declined afterwards. For example, the adjusted OR was 3.47 [95% confidence interval (CI) = 2.60-4.62] in the first month and 1.53 (95% CI = 1.11-2.12) in the sixth month following cancer diagnosis. These findings provide clinicians with a vital reference period during which sufficient support and necessary referral to mental health support should be provided to reduce the risk of suicide among patients with newly diagnosed cancer morbidity.
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Affiliation(s)
- Shun-Mu Wang
- Department of Public Health, China Medical University, Taichung, Taiwan.,Department of Health Services Administration, China Medical University, Taichung, Taiwan.,Department of Biotechnology and Pharmaceutical Technology, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Jung-Chen Chang
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
| | - Shu-Chuan Weng
- Bachelor's Degree Program of Golden-Age Well-being Management, Yuanpei University of Medical Technology, Hsinchu, Taiwan
| | - Ming-Kung Yeh
- Graduate Institute of Medical Science and School of Pharmacy, National Defense Medical Center, Taiwan
| | - Chau-Shoun Lee
- Department of Medicine, Mackay Medical College, New Taipei City, Taiwan.,Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
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35
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Hashmi AM, Han JY, Demla V. Intensive Care and its Discontents: Psychiatric Illness in the Critically Ill. Psychiatr Clin North Am 2017; 40:487-500. [PMID: 28800804 DOI: 10.1016/j.psc.2017.05.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Critically ill patients can develop a host of cognitive and psychiatric complaints during their intensive care unit (ICU) stay, many of which persist for weeks or months following discharge from the ICU and can seriously affect their quality of life, including their ability to return to work. This article describes some common psychiatric problems encountered by clinicians in the ICU, including their assessment and management. A comprehensive approach is needed to decrease patient suffering, improve morbidity and mortality, and ensure that critically ill patients can return to the highest quality of life after an ICU stay.
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Affiliation(s)
- Ali M Hashmi
- Department of Psychiatry and Behavioral Sciences, King Edward Medical University/Mayo Hospital, Neela Gumbad, Lahore-54700, Pakistan.
| | - Jin Y Han
- Menninger Department of Psychiatry and Behavioral Sciences, Department of Family and Community Medicine, Baylor College of Medicine, 1502 Taub Loop NPC 2nd Floor, Houston, TX 77030, USA
| | - Vishal Demla
- Division of Critical Care Medicine, Department of Internal Medicine, University of Texas Health Science Center, 6431 Fannin, MSB 1.150, Houston, TX 77030, USA
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Abrol E, Groszmann M, Pitman A, Hough R, Taylor RM, Aref-Adib G. Exploring the digital technology preferences of teenagers and young adults (TYA) with cancer and survivors: a cross-sectional service evaluation questionnaire. J Cancer Surviv 2017. [PMID: 28634734 PMCID: PMC5671543 DOI: 10.1007/s11764-017-0618-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Purpose Digital technology has the potential to support teenagers and young adults (TYAs) with cancer from the onset of their disease into survivorship. We aimed to establish (1) the current pattern of use of TYA digital technologies within our service-user population, and (2) their preferences regarding digital information and support within the service. Methods A cross-sectional survey was administered as a paper and online self-completed questionnaire to TYAs aged 13–24 accessing outpatient, inpatient, and day care cancer services at a regional specialist centre over a 4-week period. Results One hundred two TYAs completed the survey (55.7% male; 39.8% female; 83.3% paper; 16.7% online; mean age 18.5 years [SD = 3.51]). Of the TYAs, 41.6% rated the importance of digital communication as “essential” to their lives. Half (51.0%) kept in contact with other patients they had met during treatment, and 12.0% contacted patients they had not met in person. Respondents wanted to receive clinical information online (66.3%) and use online chat rooms (54.3%). Future online services desired included virtual online groups (54.3%), online counselling or psychological support (43.5%), and receiving (66.3%) and sharing (48.9%) clinical information online. Conclusions Young people with cancer are digital natives. A significant subgroup expressed a desire for digital resources from oncology services, though existing resources are also highly valued. Digital resources have potential to improve patient experience and engagement. Implications for cancer survivors There is considerable scope to develop digital resources with which TYAs can receive information and connect with both professionals and fellow patients, following diagnosis, through treatment and survivorship.
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Affiliation(s)
- Esha Abrol
- Highgate Mental Health Centre, Camden and Islington NHS Foundation Trust, Dartmouth Park Hill, N19 5NX, London, UK
| | - Mike Groszmann
- Teenage & Young Adult Psych-Oncology Team, Psychological Medicine Dept. Paediatric & Adolescent Division, University College London Hospital NHS Foundation Trust; UCL Undergraduate Medical School, 6th Floor, 250 Euston Road, UCLH, NW1 2BU, London, UK.
| | - Alexandra Pitman
- Macmillan Cancer Psychological Support Team, St George's University Hospitals NHS Foundation Trust, London, UK.,Division of Psychiatry, University College London, 149 Tottenham Court Road, W1T 7NF, London, UK
| | - Rachael Hough
- Haematology and Stem Cell Transplantation, University College London Hospital NHS Foundation Trust, London, UK
| | - Rachel M Taylor
- University College London Hospital NHS Foundation Trust, London, UK
| | - Golnar Aref-Adib
- Division of Psychiatry, University College London, 149 Tottenham Court Road, W1T 7NF, London, UK.,Camden and Islington NHS Foundation Trust, St Pancras Hospital, 4th Floor, East Wing, 4 Saint Pancras Way, NW1 0PE, London, UK
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37
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Song H, Zhu J, Lu D, Fang F, Ye W, Lundell L, Johansson J, Lindblad M, Nilsson M. Psychiatric morbidity and its impact on surgical outcomes for esophageal and gastric cancer patients: A nationwide cohort study. Oncotarget 2017; 8:81305-81314. [PMID: 29113389 PMCID: PMC5655284 DOI: 10.18632/oncotarget.18347] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 05/20/2017] [Indexed: 01/07/2023] Open
Abstract
Background Due to the lack of detailed clinical information, existed evidence regarding a link between psychiatric factors and adverse cancer prognosis was inclusive. Results We identified 1,340 patients (48.8%) with perioperative psychiatric morbidity. Preoperative psychiatric morbidity was significantly associated with both general and surgical complications within 30 days (RR = 1.3, 95% confidence interval [CI] 1.1–1.5), and the risk of death within 90 days (RR = 1.6; 95% CI 1.1–2.2) after surgery. The hazards for mortality beyond 90 days was approximately 2-fold increased among patients with perioperative psychiatric morbidity (HR = 2.0, 95% CI 1.7–2.3 for overall mortality). Materials and Methods Based on the Swedish National Registry for Esophageal and Gastric cancer (NREV), we constructed a nationwide prospective cohort containing 2,745 surgically treated patients in 2006–2012. Perioperative psychiatric morbidity was defined as a clinical diagnosis of psychiatric disorder, from two years before to two years after surgery. Using propensity scores, we applied inverse probability of treatment weights (IPTW)-weighted Poisson regression model to evaluate relative risk (RR) of short-term surgical outcomes in relation to perioperative psychiatric morbidity. Further, IPTW-weighted Cox proportional hazards model was used to estimate hazard ratios (HRs) for mortality that occurred after 90 days of surgery. Conclusions Perioperative psychiatric morbidity could worsen both short-term and long-term surgical outcomes among patients with gastric or esophageal cancer.
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Affiliation(s)
- Huan Song
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jianwei Zhu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Donghao Lu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Fang Fang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Lars Lundell
- Division of Surgery, CLINTEC, Department of Surgical Gastroenterology, Karolinska Institute at Karolinska University Hospital, Stockholm, Sweden
| | - Jan Johansson
- Department of Surgery, Skåne University Hospital, Lund, Sweden
| | - Mats Lindblad
- Division of Surgery, CLINTEC, Department of Surgical Gastroenterology, Karolinska Institute at Karolinska University Hospital, Stockholm, Sweden
| | - Magnus Nilsson
- Division of Surgery, CLINTEC, Department of Surgical Gastroenterology, Karolinska Institute at Karolinska University Hospital, Stockholm, Sweden
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Larkin M, Boden Z, Newton E. If psychosis were cancer: a speculative comparison. MEDICAL HUMANITIES 2017; 43:118-123. [PMID: 28559369 PMCID: PMC5520006 DOI: 10.1136/medhum-2016-011091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/22/2017] [Indexed: 05/15/2023]
Abstract
Recently, health policy in the UK has begun to engage with the concept of 'parity of esteem' between physical and mental healthcare. This has led one recent initiative to improve service provision for first episode psychosis, which aims to bring it into line with some of the principles underpinning good practice in cancer care. In this paper, we consider some of the metaphorical consequences of likening psychosis to cancer. While we find the comparison unhelpful for clinical purposes, we argue that it can be a helpful lens through which to examine service provision for psychosis in young people. Through this lens, specialist community-based services would appear to compare reasonably well. Inpatient care for young people with psychosis, on the other hand, suffers very badly by comparison with inpatient facilities for teenage cancer care. We note some of the many positive features of inpatient cancer care for young adults, and-drawing upon previous research on inpatient psychiatric care-observe that many of these are usually absent from mental health facilities. We conclude that this metaphor may be a helpful rhetorical device for communicating the lack of 'parity of esteem' between mental and physical healthcare. This inequity must be made visible in health policy, in commissioning, and in service provision.
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Affiliation(s)
| | - Zoë Boden
- London South Bank University, London, UK
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40
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Kye SY, Park K. Suicidal ideation and suicidal attempts among adults with chronic diseases: A cross-sectional study. Compr Psychiatry 2017; 73:160-167. [PMID: 27992846 DOI: 10.1016/j.comppsych.2016.12.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 11/28/2016] [Accepted: 12/09/2016] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION About 14% of the global burden of disease has been attributed to neuropsychiatric disorders. The aim of this study was to show the general picture of suicidal ideation and behavior among Korean, and to test the hypothesis that there is a positive association between diseases and suicidality. METHOD A total of 19,599 individuals were asked if they had any chronic diseases, suicidal ideation and attempts. The data from the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V, 2010-2012) conducted by Korea Centers for Disease Control and Prevention (KCDC) were examined. RESULTS Stroke and osteoarthritis were associated with a 1.81 and 1.27 times increase in the odds of suicidal ideation, respectively (95% CI=1.24-2.65; 95% CI=1.09-1.48). Angina pectoris and osteoarthritis were associated with a 3.88 and 2.09 times increase in the odds of suicide attempts (95% CI=1.78-8.43; 95% CI=1.24-3.55). Having pulmonary tuberculosis increased the odds of a suicide attempt 12-fold (OR=12.47, 95% CI=1.12-138.66). Having renal failure was associated with a 4.92 times increase in the odds of suicide attempts (95% CI=1.25-19.30). Having lung cancer or cervical cancer increased the odds of suicide attempts more than 10-fold (OR=11.53, 95% CI=1.03-128.80; OR=17.66, 95% CI=1.58-197.01). CONCLUSIONS Various diseases were risk factors for suicidality. Physicians' communication skills for frank and clear discussions about suicidality should be developed through various training courses.
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Affiliation(s)
- Su-Yeon Kye
- Cancer Information and Education Branch, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
| | - Keeho Park
- Cancer Policy Branch, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
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41
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Campo RA, Bluth K, Santacroce SJ, Knapik S, Tan J, Gold S, Philips K, Gaylord S, Asher GN. A mindful self-compassion videoconference intervention for nationally recruited posttreatment young adult cancer survivors: feasibility, acceptability, and psychosocial outcomes. Support Care Cancer 2017; 25:1759-1768. [PMID: 28105523 DOI: 10.1007/s00520-017-3586-y] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 01/10/2017] [Indexed: 12/30/2022]
Abstract
PURPOSE Young adult (YA) cancer survivors report substantial distress, social isolation, and body image concerns that can impede successful reintegration into life years after treatment completion. Mindful Self-Compassion (MSC) interventions focus on developing mindfulness and self-compassion for managing distress, hardships, and perceived personal inadequacies. An MSC intervention would be beneficial in supporting YA survivors' management of psychosocial challenges that arise in survivorship; however, a telehealth intervention modality is essential for reaching this geographically dispersed population. We conducted a single-arm feasibility study of an MSC 8-week videoconference intervention for nationally recruited YA survivors (ages 18-29). METHODS The MSC intervention was group-based, 90-minute videoconference sessions, held weekly over 8 weeks, with audio-supplemented home practice. Feasibility and acceptability were assessed via attendance rate and an intervention satisfaction scale. Baseline to post-intervention changes in psychosocial outcomes (body image, anxiety, depression, social isolation, posttraumatic growth, resilience, self-compassion, mindfulness) were assessed using paired t tests and Cohen's d effect sizes. RESULTS Thirty-four participants were consented and 25 attended a videoconference group. Feasibility was established with 84% attending at least six of the eight sessions, and intervention acceptability was high (M = 4.36, SD = 0.40, score range = 1-5). All psychosocial outcomes, except for resilience, demonstrated significant changes (p < 0.002), with medium to large effect sizes (Cohen's d > 0.5). CONCLUSION YA survivors are interested in receiving an MSC videoconference intervention. Feasibility, acceptance, and potential psychosocial benefits of the intervention were demonstrated. Findings can be applied toward the design of an efficacy randomized controlled trial to improve quality of life for YA survivors in transition after cancer treatment.
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Affiliation(s)
- Rebecca A Campo
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
| | - Karen Bluth
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Sheila J Santacroce
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Sarah Knapik
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Julia Tan
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Stuart Gold
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Department of Pediatrics and Division of Pediatric Hematology-Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Kamaira Philips
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Susan Gaylord
- Program on Integrative Medicine, Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
| | - Gary N Asher
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
- Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA
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Gunnes MW, Lie RT, Bjørge T, Ghaderi S, Syse A, Ruud E, Wesenberg F, Moster D. Suicide and violent deaths in survivors of cancer in childhood, adolescence and young adulthood-A national cohort study. Int J Cancer 2016; 140:575-580. [DOI: 10.1002/ijc.30474] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 10/10/2016] [Indexed: 02/02/2023]
Affiliation(s)
- Maria W. Gunnes
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
- Department of Pediatrics; Haukeland University Hospital; Bergen Norway
| | - Rolv T. Lie
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
- Norwegian Institute of Public Health; Bergen Norway
| | - Tone Bjørge
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
- Cancer Registry of Norway; Oslo Norway
| | - Sara Ghaderi
- Norwegian Institute of Public Health; Bergen Norway
| | - Astri Syse
- Department of Research, Statistics Norway; Oslo Norway
| | - Ellen Ruud
- Department of Pediatric Medicine; Oslo University Hospital; Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; Norway
| | - Finn Wesenberg
- Cancer Registry of Norway; Oslo Norway
- Department of Pediatric Medicine; Oslo University Hospital; Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo; Norway
| | - Dag Moster
- Department of Global Public Health and Primary Care; University of Bergen; Bergen Norway
- Department of Pediatrics; Haukeland University Hospital; Bergen Norway
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Johnson RH, Macpherson CF, Smith AW, Block RG, Keyton J. Facilitating Teamwork in Adolescent and Young Adult Oncology. J Oncol Pract 2016; 12:1067-1074. [PMID: 27624944 DOI: 10.1200/jop.2016.013870] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A case of a young adult patient in the days immediately after a cancer diagnosis illustrates the critical importance of three interrelated core coordinating mechanisms-closed-loop communication, shared mental models, and mutual trust-of teamwork in an adolescent and young adult multidisciplinary oncology team. The case illustrates both the opportunities to increase team member coordination and the problems that can occur when coordination breaks down. A model for teamwork is presented, which highlights the relationships among these coordinating mechanisms and demonstrates how balance among them works to optimize team function and patient care. Implications for clinical practice and research suggested by the case are presented.
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Affiliation(s)
- Rebecca H Johnson
- Mary Bridge Hospital, MultiCare Health System, Tacoma, WA; Children's Hospital Los Angeles, Los Angeles, CA; National Cancer Institute, Bethesda, MD; Critical Mass: The Young Adult Cancer Alliance, Austin, TX; and North Carolina State University Raleigh, NC
| | - Catherine Fiona Macpherson
- Mary Bridge Hospital, MultiCare Health System, Tacoma, WA; Children's Hospital Los Angeles, Los Angeles, CA; National Cancer Institute, Bethesda, MD; Critical Mass: The Young Adult Cancer Alliance, Austin, TX; and North Carolina State University Raleigh, NC
| | - Ashley W Smith
- Mary Bridge Hospital, MultiCare Health System, Tacoma, WA; Children's Hospital Los Angeles, Los Angeles, CA; National Cancer Institute, Bethesda, MD; Critical Mass: The Young Adult Cancer Alliance, Austin, TX; and North Carolina State University Raleigh, NC
| | - Rebecca G Block
- Mary Bridge Hospital, MultiCare Health System, Tacoma, WA; Children's Hospital Los Angeles, Los Angeles, CA; National Cancer Institute, Bethesda, MD; Critical Mass: The Young Adult Cancer Alliance, Austin, TX; and North Carolina State University Raleigh, NC
| | - Joann Keyton
- Mary Bridge Hospital, MultiCare Health System, Tacoma, WA; Children's Hospital Los Angeles, Los Angeles, CA; National Cancer Institute, Bethesda, MD; Critical Mass: The Young Adult Cancer Alliance, Austin, TX; and North Carolina State University Raleigh, NC
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Abstract
Adolescents and young adults (AYAs) with cancer are at risk for depression due to disruptions in their developmental trajectory, greater physical symptom burden, and increased likelihood of developing aggressive disease. Rates of depression and other psychological disorders are substantially higher in AYAs with cancer when compared with older adults. Psychiatrists caring for these patients must consider the age-appropriate developmental context of these patients along with familial and medical factors that may influence the presentation and treatment of depression. Previous research suggests that psychosocial interventions specifically designed for AYA patients are promising, but studies of psychopharmacology treatments for depression are lacking. There is a pressing need for prospective studies and controlled clinical trials that evaluate the optimal strategies for treating depression in this patient group.
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Affiliation(s)
- Eliza M Park
- Department of Psychiatry University of North Carolina, Chapel Hill, North Carolina, USA
| | - Donald L Rosenstein
- Department of Psychiatry and Department of Medicine University of North Carolina, Chapel Hill, North Carolina, USA
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Daniel CL, Emmons KM, Fasciano K, Fuemmeler BF, Demark-Wahnefried W. Needs and Lifestyle Challenges of Adolescents and Young Adults With Cancer: Summary of an Institute of Medicine and Livestrong Foundation Workshop. Clin J Oncol Nurs 2015; 19:675-81. [PMID: 26583632 PMCID: PMC4795831 DOI: 10.1188/15.cjon.19-06ap] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Among adolescents and young adults (AYAs) in the United States, cancer is the leading cause of disease-related death. AYA survivors face numerous short- and long-term health and psychosocial issues, as well as increased risk for behavioral and lifestyle challenges, including poor diet, low physical activity (PA), and substance abuse. Many of these behaviors are modifiable, but gaps in care serve as barriers for AYA survivors. OBJECTIVES The purpose of this article is to (a) raise awareness of AYAs' increased risk for poor diet, low PA, and substance abuse; (b) examine previous interventions addressing these issues; and (c) provide recommendations for future directions. METHODS This article summarizes a workshop coordinated by the Institute of Medicine and the Livestrong Foundation to address AYA survivors' needs and ways to enhance their quality of care. FINDINGS Oncology nurses can promote the inclusion of lifestyle behaviors in survivorship care plans of AYA patients and serve as a valuable resource in improving AYA care on a larger scale. In addition, oncology nurse researchers may offer greater understanding of AYA patients' and survivors' needs and best practices by conducting much-needed research with this understudied population.
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46
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Chen R, Regodón Wallin A, Sjölander A, Valdimarsdóttir U, Ye W, Tiemeier H, Fall K, Almqvist C, Czene K, Fang F. Childhood injury after a parental cancer diagnosis. eLife 2015; 4. [PMID: 26519735 PMCID: PMC4749389 DOI: 10.7554/elife.08500] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Accepted: 10/27/2015] [Indexed: 12/22/2022] Open
Abstract
A parental cancer diagnosis is psychologically straining for the whole family. We investigated whether a parental cancer diagnosis is associated with a higher-than-expected risk of injury among children by using a Swedish nationwide register-based cohort study. Compared to children without parental cancer, children with parental cancer had a higher rate of hospital contact for injury during the first year after parental cancer diagnosis (hazard ratio [HR] = 1.27, 95% confidence interval [CI] = 1.22-1.33), especially when the parent had a comorbid psychiatric disorder after cancer diagnosis (HR = 1.41, 95% CI = 1.08-1.85). The rate increment declined during the second and third year after parental cancer diagnosis (HR = 1.10, 95% CI = 1.07-1.14) and became null afterwards (HR = 1.01, 95% CI = 0.99-1.03). Children with parental cancer also had a higher rate of repeated injuries than the other children (HR = 1.13, 95% CI = 1.12-1.15). Given the high rate of injury among children in the general population, our findings may have important public health implications. DOI:http://dx.doi.org/10.7554/eLife.08500.001 A diagnosis of cancer can be devastating for both a person and his or her family. Over the past 40 years, the number of individuals in Sweden diagnosed with cancer has more than doubled leaving growing numbers of families coping with the aftermath. Many individuals diagnosed with cancer have young children. Parents with cancer and their spouses often struggle to cope with disease and the demands of parenting simultaneously. In fact, previous research has shown children with a parent who has cancer have a greater risk of behavioral problems or distress than children with two healthy parents. Whether the stress of having a parent with cancer also affects the children’s physical wellbeing hasn’t been studied much. One concern in particular is whether these children may be at increased risk of injury. Injuries are the most common reason for a child to visit a hospital and in some cases lead to deaths. Children who are not well supervised or whose parents have poor mental health are at increased risk of injury. Coping with cancer and the mental anguish it causes may distract parents and possibly place their children at increased risk of injury. Based on data from nationwide population and health registers in Sweden, Chen, Regodón Wallin et al. now provide evidence that a child with a parent who has cancer is at a greater risk of injury than a child with two parents who are free of cancer. The analysis also revealed that the risk is particularly great if the parent with cancer also develops mental illness after the cancer diagnosis. The risk of injury is greatest in the first year after the parent’s diagnosis. Fortunately, the elevated risk of injury decreases overtime and is almost non-existing after the third year. The analyses suggest that providing extra support for parents with cancer might help to reduce the risk of injury in their children. DOI:http://dx.doi.org/10.7554/eLife.08500.002
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Affiliation(s)
- Ruoqing Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Amanda Regodón Wallin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Arvid Sjölander
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Unnur Valdimarsdóttir
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Weimin Ye
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.,Department of Child and Adolescent Psychiatry, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Katja Fall
- Clinical Epidemiology and Biostatistics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Lung and Allergy Unit, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Fang Fang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Mori M, Shimizu C, Ogawa A, Okusaka T, Yoshida S, Morita T. A National Survey to Systematically Identify Factors Associated With Oncologists' Attitudes Toward End-of-Life Discussions: What Determines Timing of End-of-Life Discussions? Oncologist 2015; 20:1304-11. [PMID: 26446232 DOI: 10.1634/theoncologist.2015-0147] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 07/27/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND End-of-life discussions (EOLds) occur infrequently until cancer patients become terminally ill. METHODS To identify factors associated with the timing of EOLds, we conducted a nationwide survey of 864 medical oncologists. We surveyed the timing of EOLds held with advanced cancer patients regarding prognosis, hospice, site of death, and do-not-resuscitate (DNR) status; and we surveyed physicians' experience of EOLds, perceptions of a good death, and beliefs regarding these issues. Multivariate analyses identified determinants of early discussions. RESULTS Among 490 physicians (response rate: 57%), 165 (34%), 65 (14%), 47 (9.8%), and 20 (4.2%) would discuss prognosis, hospice, site of death, and DNR status, respectively, "now" (i.e., at diagnosis) with a hypothetical patient with newly diagnosed metastatic cancer. In multivariate analyses, determinants of discussing prognosis "now" included the physician perceiving greater importance of autonomy in experiencing a good death (odds ratio [OR]: 1.34; p = .014), less perceived difficulty estimating the prognosis (OR: 0.77; p = .012), and being a hematologist (OR: 1.68; p = .016). Determinants of discussing hospice "now" included the physician perceiving greater importance of life completion in experiencing a good death (OR: 1.58; p = .018), less discomfort talking about death (OR: 0.67; p = .002), and no responsibility as treating physician at end of life (OR: 1.94; p = .031). Determinants of discussing site of death "now" included the physician perceiving greater importance of life completion in experiencing a good death (OR: 1.83; p = .008) and less discomfort talking about death (OR: 0.74; p = .034). The determinant of discussing DNR status "now" was less discomfort talking about death (OR: 0.49; p = .003). CONCLUSION Reflection by oncologists on their own values regarding a good death, knowledge about validated prognostic measures, and learning skills to manage discomfort talking about death is helpful for oncologists to perform appropriate EOLds. IMPLICATIONS FOR PRACTICE Oncologists' own perceptions about what is important for a "good death," perceived difficulty in estimating the prognosis, and discomfort in talking about death influence their attitudes toward end-of-life discussions. Reflection on their own values regarding a good death, knowledge about validated prognostic measures, and learning skills to manage discomfort talking about death are important for improving oncologists' skills in facilitating end-of-life discussions.
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Affiliation(s)
- Masanori Mori
- Department of Palliative Medicine, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
| | | | - Asao Ogawa
- Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa, Japan
| | | | - Saran Yoshida
- Center for Cancer Control and Information Services, National Cancer Center Hospital, Chuo-ku, Japan
| | - Tatsuya Morita
- Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan
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48
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Diaz-Frutos D, Baca-Garcia E, Mahillo-Fernandez I, Garcia-Foncillas J, Lopez-Castroman J. Suicide ideation among oncologic patients in a Spanish ward. PSYCHOL HEALTH MED 2015; 21:261-71. [DOI: 10.1080/13548506.2015.1058960] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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49
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Hassett AL, Aquino JK, Ilgen MA. The risk of suicide mortality in chronic pain patients. Curr Pain Headache Rep 2015; 18:436. [PMID: 24952608 DOI: 10.1007/s11916-014-0436-1] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Chronic pain has long been considered an important risk factor for suicidal behavior. Less well understood are the factors associated with the increased risk for suicide death within chronic pain populations. The purpose of this review is to examine recent research with regard to rates of and risk factors for suicide mortality in patients with chronic musculoskeletal pain. We conclude that patients with a number of chronic pain states are at increased risk for suicide death, and that this risk appears to be due, at least in part, to other well-known correlates of pain such as depression and substance use disorders. However, in all likelihood, there are aspects of chronic pain itself that add uniquely to an individual's suicide risk profile. Lastly, we address a theoretical perspective and offer recommendations for clinical practice.
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Affiliation(s)
- Afton L Hassett
- Chronic Pain & Fatigue Research Center, Department of Anesthesiology, University of Michigan, 24 Frank Lloyd Wright Avenue, Lobby M, Ann Arbor, MI, 48104, USA,
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50
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Zhu J, Lu D, Sveinsson O, Wirdefeldt K, Fall K, Piehl F, Valdimarsdóttir U, Fang F. Is a cancer diagnosis associated with subsequent risk of transient global amnesia? PLoS One 2015; 10:e0122960. [PMID: 25849383 PMCID: PMC4388478 DOI: 10.1371/journal.pone.0122960] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 02/16/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Psychological stress has been associated with transient global amnesia (TGA). Whether a cancer diagnosis, a severely stressful life event, is associated with subsequent risk of TGA has not been studied. METHODS Based on the Swedish Cancer Register and Patient Register, we conducted a prospective cohort study including 5,365,608 Swedes at age 30 and above during 2001-2009 to examine the relative risk of TGA among cancer patients, as compared to cancer-free individuals. Incidence rate ratios (IRRs) and their 95% confidence intervals (CIs) derived from Poisson regression were used as estimates of the association between cancer diagnosis and the risk of TGA. RESULTS During the study 322,558 individuals (6.01%) received a first diagnosis of cancer. We identified 210 cases of TGA among the cancer patients (incidence rate, 0.22 per 1000 person-years) and 4,887 TGA cases among the cancer-free individuals (incidence rate, 0.12 per 1000 person-years). Overall, after adjustment for age, sex, calendar year, socioeconomic status, education and civil status, cancer patients had no increased risk of TGA than the cancer-free individuals (IRR, 0.99; 95% CI, 0.86-1.13). The IRRs did not differ over time since cancer diagnosis or across individual cancer types. The null association was neither modified by sex, calendar period or age. CONCLUSION Our study did not provide support for the hypothesis that patients with a new diagnosis of cancer display a higher risk of TGA than cancer-free individuals.
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Affiliation(s)
- Jianwei Zhu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, China
- * E-mail:
| | - Donghao Lu
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Olafur Sveinsson
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Karin Wirdefeldt
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Katja Fall
- Clinical Epidemiology and Biostatistics Unit, Örebro University, Örebro, Sweden
| | - Fredrik Piehl
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | | | - Fang Fang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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