Expressed emotion in couples facing breast cancer in women is associated with psychological distress in the first year after surgery

Depression, anxiety and stress among metastatic breast cancer patients on chemotherapy in China

OBJECTIVE

This study aimed to assess the level of depression, anxiety and stress among metastatic breast cancer (MBC) patients undergoing chemotherapy (CT) in Beijing, China.

METHODS

A cross-sectional study was conducted on 176 MBC women receiving CT, selected by purposive sampling. Data were collected using self-administered questionnaires that included participants' socio-demographic status, DASS-21 and Brief COPE. Data were analyzed using descriptive statistics and general linear regression analysis.

RESULTS

The incidence of depression, anxiety and stress among MBC women were 52.3%, 60.2% and 36.9%, respectively. General linear regression showed that age, marital status, monthly income, physical functioning, emotional functioning, pain, dyspnea, and appetite loss were associated with depression. All variance determined the depression (R²) was 35.6%. Marital status, self-blame and behavioral disengagement were the predictors of stress and accounted for a 35.4% stress variance in MBC women.

CONCLUSION

Our study demonstrated depression, anxiety, and stress prevalence are high in MBC women. Assessment of psychological distress (depression, anxiety, and stress) is important to recognise MBC patients who need help and further medical and mental help support. This study's findings can increasingly highlight that depression, anxiety, and stress are substantial problems in MBC patients. Therefore, psychological interventions are needed to reduce depression, anxiety, and stress for MBC patients.

Relationship quality and psychophysiological distress for underserved breast cancer patients and their caregiver before treatment

OBJECTIVE

Breast cancer patients and caregivers experience biobehavioral reactivity (e.g., depression, anxiety, pain, fatigue) during breast cancer treatment which predicts cancer recurrence and mortality. High quality patient-caregiver relationships can mitigate this distress during treatment, but this association is unclear pre-treatment. Identifying early interventions that target high risk Appalachian patients could impact biobehavioral reactivity.

METHODS

We recruited 55 breast cancer patient-caregiver dyads to complete a self-report survey after diagnosis but before treatment. We used a series of Actor-Partner Interdependence Models to test the hypotheses that both patient and caregiver relationship quality would be linked to their own and their partners' biobehavioral reactivity.

RESULTS

Caregiver reported marital quality lower caregiver anxiety, patient anxiety, caregiver depression, patient depression, caregiver pain, and caregiver fatigue. Interestingly, patient-reported marital quality was linked with higher caregiver anxiety, higher patient anxiety, lower patient depression, and lower patient pain. Patients reported family quality was linked to lower patient and caregiver pain.

CONCLUSIONS

This study demonstrates that pre-treatment marital and family quality levels are directly related to psychophysiological measures in both the caregiver and the patient, though sometimes in unexpected directions. Additionally, our findings potentially reveal an opportunity to intervene at the time of diagnosis to improve relationship quality, impacting patient and caregiver psychophysiological outcomes.

Expressed Emotion Research in India: A Narrative Review

BACKGROUND

Expressed emotion (EE) is detrimental to patients with schizophrenia, mood disorders, eating disorders and many other psychiatric and neurological disorders. However, majority of the EE literature is generated from the west, and the results of those studies may have limited application in Indian setting. Hence, we conducted this review with the main aim of understanding EE research in India and its potential role in the course and outcome of psychiatric disorders and other chronic illnesses.

METHODS

Using keywords, we performed searches of electronic databases (PubMed, IndMed, PsychInfo, Science-Direct and Google Scholar) and internet sources and a manual search in the bibliography of the retrieved articles to identify potential original research articles on EE in India.

RESULTS

As per the selection criteria, 19 reports of 16 studies were included and reviewed. The sample size of the EE studies ranged from 20 to 200, and majority of the studies were conducted in psychosis/schizophrenia, followed by obsessive compulsive disorder and epilepsy. Although high EE was found in most of the studies, the impact of EE on illness outcome is not well explored and only two studies examined the relationship between EE and relapse.

DISCUSSION AND CONCLUSION

There is a dearth of studies on EE, especially its relationship with relapse or clinical outcomes in the Indian context. We recommend more studies in these areas which may be helpful for clinical decisions and advancement of context knowledge in EE.