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Luo Y, Mao D, Zhang L, Zhu B, Yang Z, Miao J, Zhang L. Trajectories of depression and predictors in lung cancer patients undergoing chemotherapy: growth mixture model. BMC Psychiatry 2024; 24:578. [PMID: 39182063 PMCID: PMC11344456 DOI: 10.1186/s12888-024-06029-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Accepted: 08/20/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND Depression is prevalent among lung cancer patients undergoing chemotherapy, and the symptom cluster of fatigue-pain-insomnia may influence their depression. Identifying characteristics of patients with different depression trajectories can aid in developing more targeted interventions. This study aimed to identify the trajectories of depression and the fatigue-pain-insomnia symptom cluster, and to explore the predictive factors associated with the categories of depression trajectories. METHODS In this longitudinal study, 187 lung cancer patients who were undergoing chemotherapy were recruited and assessed at the first (T1), second(T2), and fourth(T3) months using the Patient Health Questionnaire-9 (PHQ-9), the Brief Pain Inventory (BPI), the Brief Fatigue Inventory (BFI), and the Athens Insomnia Scale (AIS). Growth Mixture Model (GMM) and Latent Class Analysis (LCA) were used to identify the different trajectories of the fatigue-pain-insomnia symptom cluster and depression. Binary logistic regression was utilized to analyze the predictive factors of different depressive trajectories. RESULTS GMM identified two depressive trajectories: a high decreasing depression trajectory (40.64%) and a low increasing depression trajectory (59.36%). LCA showed that 48.66% of patients were likely members of the high symptom cluster trajectory. Binary logistic regression analysis indicated that having a history of alcohol consumption, a higher symptom cluster burden, unemployed, and a lower monthly income predicted a high decreasing depression trajectory. CONCLUSIONS Depression and fatigue-pain-insomnia symptom cluster in lung cancer chemotherapy patients exhibited two distinct trajectories. When managing depression in these patients, it is recommended to strengthen symptom management and pay particular attention to individuals with a history of alcohol consumption, unemployed, and a lower monthly income.
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Affiliation(s)
- Yuanyuan Luo
- School of Nursing, Southern Medical University, No.1023, South Shatai Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Dongmei Mao
- School of Nursing, Southern Medical University, No.1023, South Shatai Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Le Zhang
- School of Nursing, Southern Medical University, No.1023, South Shatai Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Benxiang Zhu
- School of Nursing, Southern Medical University, No.1023, South Shatai Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Zhihui Yang
- School of Nursing, Southern Medical University, No.1023, South Shatai Road, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Jingxia Miao
- Department of Medical Oncology, Nanfang Hospital, Southern Medical University, No.1838, North Guangzhou Avenue, Baiyun District, Guangzhou, 510515, Guangdong, China
| | - Lili Zhang
- School of Nursing, Southern Medical University, No.1023, South Shatai Road, Baiyun District, Guangzhou, 510515, Guangdong, China.
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Dusel J, Meng K, Arnold H, Rabe A, Jentschke E. Effectiveness of structured psycho-oncological counseling for relatives of lung cancer patients based on the CALM approach-study protocol of a randomized controlled trial. Trials 2024; 25:115. [PMID: 38336739 PMCID: PMC10858519 DOI: 10.1186/s13063-024-07954-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
BACKGROUND The high incidence combined with the high lethality and bad prognosis of lung cancer highlight the need for psycho-oncological care for both patients and their relatives. While psychological interventions for relatives might be helpful, further research on the impact of specific interventions is necessary. Therefore, this trial aims to evaluate structured psycho-oncological counseling for relatives of lung cancer patients based on the Managing Cancer And Living Meaningfully (CALM) approach compared to usual care. In addition, we explore the impact of psycho-oncological support of relatives on the patients' mental health outcomes. METHODS The study is a single-center, prospective, randomized controlled trial with two measurement time points. Relatives of lung cancer patients and, thus, the patients themselves (i.e., dyads) are randomly allocated to the intervention group (IG) or the control group (CG) regardless of their disease or treatment stage. Relatives in the IG receive structured counseling based on the CALM approach (three to six sessions with psycho-oncologists). The CG receives usual psycho-oncological care. In addition, cancer patients in both study arms can request psycho-oncological support (usual care) as needed, but they will not get a specific intervention. Relatives and patients complete assessments at baseline (T0) and after the intervention/6 weeks (T1). The primary outcome for relatives is anxiety. Relatives' secondary outcomes include depressive symptoms, distress, supportive care needs, and quality of life. Patients' outcomes include anxiety, depression, and distress. All outcomes are assessed using self-report validated questionnaires. Intervention effects will be evaluated using analysis of covariance (ANCOVA) adjusting for baseline values. Power calculations reveal the need to enroll 200 subjects to detect an effect of d = 0.4. DISCUSSION The study will provide evidence for the effectiveness of the CALM intervention in relatives of lung cancer patients. Furthermore, study results will contribute to a better understanding of the effectiveness of a psycho-oncological intervention for highly impaired cancer patients and their relatives. If the CALM intervention positively affects the relatives' psychosocial outcome, it may be implemented in routine care. TRIAL REGISTRATION German Clinical Trials Register DRKS00030077. Retrospectively registered on 26 October 2022.
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Affiliation(s)
- Julia Dusel
- University Hospital Würzburg, Comprehensive Cancer Center Mainfranken, Josef-Schneider Str. 6, Würzburg, D-97080, Germany
| | - Karin Meng
- University Hospital Würzburg, Comprehensive Cancer Center Mainfranken, Josef-Schneider Str. 6, Würzburg, D-97080, Germany
| | - Hanna Arnold
- University Hospital Würzburg, Comprehensive Cancer Center Mainfranken, Josef-Schneider Str. 6, Würzburg, D-97080, Germany
| | - Antonia Rabe
- University Hospital Würzburg, Comprehensive Cancer Center Mainfranken, Josef-Schneider Str. 6, Würzburg, D-97080, Germany
| | - Elisabeth Jentschke
- University Hospital Würzburg, Comprehensive Cancer Center Mainfranken, Josef-Schneider Str. 6, Würzburg, D-97080, Germany.
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Yen YC, Huang CY, Chan HW, Wang YY, Changchien TC, Wang DW, Lin PC, Chang TT, Chiu YW. Longitudinal Association of Universal Screening and Treatment for Major Depressive Disorder with Survival in Cancer Patients. J Pers Med 2022; 12:jpm12081213. [PMID: 35893308 PMCID: PMC9331985 DOI: 10.3390/jpm12081213] [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: 05/08/2022] [Revised: 07/22/2022] [Accepted: 07/23/2022] [Indexed: 02/07/2023] Open
Abstract
Evidence for clinical screening and intervention for depression in cancer and the effect of this intervention on cancer prognosis is suboptimal. This study substantialized a complete model with universal screening and intervention for major depressive disorder (MDD) and explored its effect on survival in patients. This longitudinal study recruited cancer patients routinely screened for MDD with a two-stage model. Data including sex, age, cancer diagnosis, first diagnosis date, date of death, cancer stage, and MDD diagnosis and treatment were collected from medical records and the national registration system for cancer. Kaplan−Meier’s survival analysis and the Cox proportional hazards regression model were applied to analyze the effects of associated factors on survival. Further subgroup analysis for 14 types of cancer primary site was also performed. Overall, the hazard for patients adhering to psychiatric treatment for MDD before cancer diagnosis was not statistically different from that for patients without MDD (hazard ratio (HR) = 1.061, 95% CI: 0.889−1.267, p = 0.512). The hazard for patients adhering to psychiatric treatment after cancer diagnosis was significantly lower than that for patients without MDD (HR = 0.702, 95% CI: 0.607−0.812, p < 0.001). Those who were diagnosed with MDD after cancer diagnosis and adhered poorly to psychiatric treatment had the greatest hazard (HR = 1.829, 95% CI: 1.687−1.984, p < 0.001). The effect of intervention for MDD varied across different primary cancer types.
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Affiliation(s)
- Yung-Chieh Yen
- Department of Psychiatry, E-Da Hospital, Kaohsiung 824, Taiwan; (C.-Y.H.); (H.-W.C.); (Y.-Y.W.); (T.-C.C.); (D.-W.W.); (P.-C.L.); (T.-T.C.); (Y.-W.C.)
- School of Medicine, I-Shou University, Kaohsiung 824, Taiwan
- Correspondence:
| | - Chin-Yu Huang
- Department of Psychiatry, E-Da Hospital, Kaohsiung 824, Taiwan; (C.-Y.H.); (H.-W.C.); (Y.-Y.W.); (T.-C.C.); (D.-W.W.); (P.-C.L.); (T.-T.C.); (Y.-W.C.)
| | - Hsue-Wei Chan
- Department of Psychiatry, E-Da Hospital, Kaohsiung 824, Taiwan; (C.-Y.H.); (H.-W.C.); (Y.-Y.W.); (T.-C.C.); (D.-W.W.); (P.-C.L.); (T.-T.C.); (Y.-W.C.)
- School of Medicine, I-Shou University, Kaohsiung 824, Taiwan
| | - You-Yu Wang
- Department of Psychiatry, E-Da Hospital, Kaohsiung 824, Taiwan; (C.-Y.H.); (H.-W.C.); (Y.-Y.W.); (T.-C.C.); (D.-W.W.); (P.-C.L.); (T.-T.C.); (Y.-W.C.)
- School of Medicine, I-Shou University, Kaohsiung 824, Taiwan
| | - Te-Chang Changchien
- Department of Psychiatry, E-Da Hospital, Kaohsiung 824, Taiwan; (C.-Y.H.); (H.-W.C.); (Y.-Y.W.); (T.-C.C.); (D.-W.W.); (P.-C.L.); (T.-T.C.); (Y.-W.C.)
- School of Medicine, I-Shou University, Kaohsiung 824, Taiwan
| | - Deng-Wu Wang
- Department of Psychiatry, E-Da Hospital, Kaohsiung 824, Taiwan; (C.-Y.H.); (H.-W.C.); (Y.-Y.W.); (T.-C.C.); (D.-W.W.); (P.-C.L.); (T.-T.C.); (Y.-W.C.)
- School of Medicine, I-Shou University, Kaohsiung 824, Taiwan
| | - Po-Chun Lin
- Department of Psychiatry, E-Da Hospital, Kaohsiung 824, Taiwan; (C.-Y.H.); (H.-W.C.); (Y.-Y.W.); (T.-C.C.); (D.-W.W.); (P.-C.L.); (T.-T.C.); (Y.-W.C.)
- School of Medicine, I-Shou University, Kaohsiung 824, Taiwan
| | - Ting-Ting Chang
- Department of Psychiatry, E-Da Hospital, Kaohsiung 824, Taiwan; (C.-Y.H.); (H.-W.C.); (Y.-Y.W.); (T.-C.C.); (D.-W.W.); (P.-C.L.); (T.-T.C.); (Y.-W.C.)
- School of Medicine, I-Shou University, Kaohsiung 824, Taiwan
| | - Yu-Wen Chiu
- Department of Psychiatry, E-Da Hospital, Kaohsiung 824, Taiwan; (C.-Y.H.); (H.-W.C.); (Y.-Y.W.); (T.-C.C.); (D.-W.W.); (P.-C.L.); (T.-T.C.); (Y.-W.C.)
- School of Medicine, I-Shou University, Kaohsiung 824, Taiwan
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