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Lemieux M, Telles R, Goodheart M, Dahmoush L, Hagemann I, Penedo FJ, Nandakumar R, Cole SW, Sood AK, Lutgendorf SK, Thaker PH. Quality of life and survivorship in patients with low-grade ovarian cancer. Gynecol Oncol 2024; 190:96-103. [PMID: 39173565 DOI: 10.1016/j.ygyno.2024.08.010] [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: 03/17/2024] [Revised: 08/07/2024] [Accepted: 08/09/2024] [Indexed: 08/24/2024]
Abstract
OBJECTIVE High-grade (HGOC) and low-grade ovarian carcinoma (LGOC) are distinct malignancies with different biological features, treatment paradigms, and life expectancies. However, differences in quality of life (QOL), sleep, and depressive symptoms have not been examined by grade, and neither have inflammatory profiles associated with these symptoms. We aim to characterize QOL and biomarkers by OC grade. METHODS Participants included patients with HGOC (N = 578) or LGOC (N = 85). Participants completed baseline assessments of psychosocial factors prior to primary surgery or neoadjuvant chemotherapy and contributed saliva for cortisol and blood for interleukin-6 (IL-6) quantification. Samples were collected intraoperatively to quantify tumor cortisol. General linear models were used to examine differences in biological and psychological variables by grade. RESULTS At baseline, patients with LGOC reported less depression (p = 0.018) and sleep disturbances (p = 0.014), but no significant difference in depressive mood (p = 0.11) or QOL (p = 0.51) compared to patients with HGOC, adjusting for age and disease stage. There were trends towards lower tumor cortisol levels (p = 0.078) in LGOC compared to HGOC. One-year post-diagnosis, we found a significant improvement in QOL and fatigue, and a decrease in vegetative depression and IL-6 levels irrespective of grade. CONCLUSIONS We present the first characterization of psychosocial experiences of patients with LGOC. Despite having a better disease prognosis, patients with LGOC were just as likely to have mood disturbances as those with HGOC. There was a trend towards differences in tumor cortisol by grade. Our findings highlight the need to address well-being in patients with both low- and high-grade ovarian malignancies.
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Affiliation(s)
- Mackenzie Lemieux
- Washington University School of Medicine, St. Louis, MO, United States of America
| | - Rachel Telles
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, United States of America
| | - Michael Goodheart
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, United States of America; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, United States of America
| | - Laila Dahmoush
- Department of Pathology, University of Iowa, Iowa City, IA, United States of America
| | - Ian Hagemann
- Department of Pathology, Washington University School of Medicine, St. Louis, MO, United States of America
| | - Frank J Penedo
- Departments of Psychology and Medicine, University of Miami, Coral Gables, FL, United States of America
| | - Renu Nandakumar
- Irving Institute for Clinical and Translational Research, Columbia University Medical Center, New York, NY, United States of America
| | - Steve W Cole
- Department of Hematology/Oncology, David Geffen School of Medicine, University of California, Los Angeles, CA, United States of America
| | - Anil K Sood
- Department of Gynecologic Oncology & Reproductive Medicine, University of Texas M.D. Anderson Cancer Center, Houston, TX, United States of America
| | - Susan K Lutgendorf
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, United States of America; Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Iowa, Iowa City, IA, United States of America; Holden Comprehensive Cancer Center, University of Iowa, Iowa City, IA, United States of America
| | - Premal H Thaker
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, MO, United States of America; Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, United States of America.
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Elamin N, Althebity N, Alkhamisi TA, Al-Foheidi M. Sleep quality and psychological disorders in breast cancer female patients receiving radiotherapy at a tertiary oncology center in West Saudi Arabia. Support Care Cancer 2024; 32:163. [PMID: 38367029 DOI: 10.1007/s00520-024-08368-8] [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: 01/18/2023] [Accepted: 02/11/2024] [Indexed: 02/19/2024]
Abstract
PURPOSE Breast cancer is the most prevalent type of cancer among women worldwide. Many recently diagnosed and treated breast cancer patients complain about sleep disorders, depression, anxiety, stress, and fatigue. This study aimed to evaluate sleep quality among breast cancer patients and to assess its association with psychological disorders, and socio-demographic and clinical characteristics of patients. METHODS This cross-sectional study was conducted among women who received radiotherapy for breast cancer (stage 1-3) at King Abdul-Aziz Medical City-Jeddah from January to August 2021. Each participant completed a personal information form, the Pittsburgh Sleep Quality Index (PSQI), the Depression, Anxiety, and Stress Scale-21 (DASS-21), and the International Physical Activity Questionnaire (IPAQ). Clinical data were collected from the medical records to evaluate certain risk factors. Descriptive statistics were used for participant characteristics, and analyses of variance were used to assess associations between the qualitative variables. RESULTS Fifty-six women with a mean age of 50.1 years and an average of 10 months after cancer diagnosis were included. Poor sleep quality was present in 58% of respondents. Symptomatic depression, anxiety, and stress were found in 34%, 32%, and 30% of women, respectively. Poor sleep quality was associated with depression (p = 0.031), anxiety (p = 0.03), and stress (p = 0.024) and was independently associated with hot flashes. In multivariate analysis, patients with depression or with cancer for more than 6 months were less likely to have good sleep after controlling other variables (21.74 and 14.71 times, respectively). CONCLUSION Poor sleep quality was present in 58% of women with breast cancer receiving radiotherapy and was significantly associated with depression, anxiety, stress, and hot flashes. Depression level and cancer duration were significant predictors of sleep quality. Early identification and proper management of psychological and sleep disorders are necessary to improve the quality of life and survival of breast cancer patients.
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Affiliation(s)
- Nadia Elamin
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, 21423, Jeddah, Saudi Arabia.
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
| | - Nisreen Althebity
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, 21423, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Taif A Alkhamisi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, 21423, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Meteb Al-Foheidi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Ministry of National Guard Health Affairs, 21423, Jeddah, Saudi Arabia
- Oncology Center of Princess Norah, King Abdul-Aziz Medical City, Jeddah, Saudi Arabia
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Benallel K, El Kilali R, Benjelloun R, Kadiri M. Depression and Breast Cancer in Morocco: Prevalence and Associated Factors. Int J Breast Cancer 2023; 2023:3277929. [PMID: 38054202 PMCID: PMC10695691 DOI: 10.1155/2023/3277929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 10/22/2023] [Accepted: 10/27/2023] [Indexed: 12/07/2023] Open
Abstract
Background Depression is frequently associated with breast cancer. However, its prevalence and impact on patients' quality of life are negligible. Depression is often underdiagnosed and less treated. Objectives Our study is aimed at estimating the prevalence of depression in breast cancer patients, describing their sociodemographic and clinical profile, and determining the factors associated with this depression. Material and Methods. We carried out a cross-sectional, descriptive, and analytical study, conducted from January to March 2018 at Mohammed V Military Hospital in Rabat. The survey included 100 breast cancer patients. It was conducted using an anonymous questionnaire, the Mini International Neuropsychiatric Interview test (MINI test) to diagnose depression and the Beck Depression Inventory (BDI) to assess its severity. Results The major depressive episode was diagnosed in 26% of breast cancer patients. Age under 40, psychiatric history, metastatic breast cancer, refusal of treatment, heavier treatment, and spousal alteration were the factors most associated with higher depression prevalence in these patients. Discussion and Conclusion. The high prevalence of depression in breast cancer patients, as well as the influence of personal characteristics and treatment in the occurrence of this ailment, has been confirmed by several authors. It is recommended to improve the psychooncological care of patients with breast cancer, to prevent the occurrence of depression in this vulnerable population.
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Affiliation(s)
- Khadija Benallel
- Psychiatry Department, Mohammed V Military Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| | - Rajae El Kilali
- Ibn Sina University Hospital of Rabat, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
| | - Roukaya Benjelloun
- Psychiatry Department, Cheikh Khalifa International University Hospital, Mohammed IV University of Health Sciences, Casablanca, Morocco
| | - Mohamed Kadiri
- Psychiatry Department, Mohammed V Military Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University, Rabat, Morocco
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Shin Y, Kim H, Lee T, Kim S, Lee SB, Kim J, Chung IY, Ko BS, Lee JW, Son BH, Ahn SH, Kim HW, Kim HJ. Factors in Parenting Stress in Young Patients With Breast Cancer and Implications for Children's Emotional Development: The PSYCHE Study. JAMA Netw Open 2023; 6:e2344835. [PMID: 38015505 PMCID: PMC10685886 DOI: 10.1001/jamanetworkopen.2023.44835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/06/2023] [Indexed: 11/29/2023] Open
Abstract
Importance The number of patients with breast cancer who have children is substantial. However, the emotional burden of this disease and its implication for childhood development remain largely unknown. Objective To investigate the clinical factors in parenting stress in mothers with breast cancer and the association of maternal depression and parenting stress with their children's emotional development. Design, Setting, and Participants This cross-sectional study involved a survey of females with stage 0 to 3 breast cancer and was conducted from June 2020 to April 2021 in Seoul, South Korea. Participants were aged 20 to 45 years and completed the Center for Epidemiologic Studies Depression-Revised scale and basic questionnaires on demographic and clinical characteristics. Participants with children completed the Korean Parenting Stress Index Short Form (K-PSI-SF), Child Behavior Checklist, Junior Temperament and Character Inventory, and Children's Sleep Habits Questionnaire. Exposure Having children in patients with breast cancer. Main Outcomes and Measures Multivariable logistic and linear regression analyses were performed to investigate the association between maternal depression and parenting stress. Results A total of 699 females (mean [SD] age, 39.6 [4.6] years) were included, of whom 499 had children (mean [SD] age of children, 8.0 [2.7] years). Depression was more common in patients with children (odds ratio [OR], 2.25; 95% CI, 1.01-5.05) and patients who had gonadotropin-releasing hormone treatment (OR, 1.68; 95% CI, 1.15-2.44). Disease duration was inversely associated with depression (OR, 0.85; 95% CI, 0.76-0.96). Cancer-related factors were not associated with the K-PSI-SF score. Having children aged 6 years or older (β = 3.09; 95% CI, 0.19-5.99); being the sole primary caregiver (β = -3.43; 95% CI, -5.87 to -0.99); and reporting certain temperament (eg, novelty seeking: β = 0.58; 95% CI, 0.46-0.71), emotional problems (eg, anxious/depressed: β = 8.09; 95% CI, 3.34-12.83), and sleeping pattern (eg, bedtime resistance: β = 0.57; 95% CI, 0.15-0.99) subscale scores in their children were associated with parenting stress. Depression and parenting stress were correlated (β = 0.56; 95% CI, 0.45-0.66; P < .001). The emotional challenges encountered by children of mothers with breast cancer were not significantly different from reference values. Conclusions and Relevance This study found that in patients with breast cancer, child-related factors and depression were significantly associated with parenting stress, but breast cancer-related factors were not correlated. The findings suggest that mothers with breast cancer are susceptible to both depression and parenting stress and that tailored counseling and support are needed.
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Affiliation(s)
- Yungil Shin
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Harin Kim
- Department of Neuropsychiatry, Chamjoeun Hospital, Gyeonggi-do, Korea
| | - Taeyeop Lee
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Seonok Kim
- Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Sae Byul Lee
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Jisun Kim
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Il Yong Chung
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Beom Seok Ko
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Jong Won Lee
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Byung Ho Son
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Sei Hyun Ahn
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Hyo-Won Kim
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Hee Jeong Kim
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
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Lan B, Lv D, Yang M, Sun X, Zhang L, Ma F. Psychological distress and quality of life in Chinese early-stage breast cancer patients throughout chemotherapy. JOURNAL OF THE NATIONAL CANCER CENTER 2022; 2:155-161. [PMID: 39036454 PMCID: PMC11256606 DOI: 10.1016/j.jncc.2022.06.002] [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: 11/06/2021] [Revised: 06/11/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022] Open
Abstract
Background Breast cancer survivors with psychological problems have higher mortality than those without. Therefore, it is important to monitor and manage their psychological status. This study mainly aimed to dynamically estimate the prevalence of anxiety and depression and to clarify the factors associated with anxiety and depression of patients undergoing adjuvant chemotherapy. The secondary objective was to investigate the relationship between depression and anxiety and quality of life (QOL) in Chinese early-stage breast cancer patients. Methods In a prospective observational single-center cohort study with early-stage breast cancer patients (n = 290), depression and anxiety severity, QOL, and social support were measured using the Hospital Anxiety and Depression Scale (HADS), the Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) scale, and the Chinese version of the Social Support Rating Scale (SSRS), respectively. Canonical correlations were applied to identify correlates between anxiety and depression and demographic and clinical variables. One-way repeated measure analysis of covariance (RMANCOVA) was used to analyze dynamic changes in anxiety, depression, and QOL. Relationships between anxiety and depression and QOL were analyzed using two-way RMANCOVA. Results The overall anxiety and depression prevalence rates were 35.2% and 44.1%, respectively. Age (P = 0.042), surgical method (P = 0.009), social support (P = 0.001), and breast cancer family history (P = 0.045) were significantly associated with depression. The number of children (P = 0.048) was significantly associated with anxiety. FACT-B scores differed between anxiety and depression and nonanxiety and depression groups, and patients with higher HADS depression and anxiety scores had lower FACT-B scores during chemotherapy (P < 0.001). Conclusions We observed dynamic changes in anxiety and depression and QOL and associated factors of anxiety and depression. These findings can provide guidance for psychological monitoring and support for breast cancer patients during the postoperative chemotherapy period.
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Affiliation(s)
- Bo Lan
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Dan Lv
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Min Yang
- Comprehensive Oncology Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaoying Sun
- Department of Medical Oncology, Cancer Hospital of Huanxing Chaoyang District, Beijing, China
| | - Li Zhang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China
| | - Fei Ma
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Cieślak M, Kozaka J, Golińska PB, Bidzan M. Mentalization and Its Relation to Life Satisfaction and the Level of Mental Adjustment to Illness in Women with Breast Cancer-A Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10323. [PMID: 36011957 PMCID: PMC9408050 DOI: 10.3390/ijerph191610323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 06/15/2023]
Abstract
This study's aim was assessing of the relationship between mentalization and life satisfaction and the level of adaptation to oncological disease in patients with breast cancer. The study involved 41 women (M = 59.88; SD = 8.81) with breast cancer who completed their treatments and participated in a cancer rehabilitation program. In the study, we used the Mentalization Questionnaire (MZQ), the Satisfaction Life Scale (SWLS), and the Mini-Mental Adjustment to Cancer Scale (Mini-MAC). The mean of declared level of mentalization was 45.54 (SD = 11.65). The significant correlation between mentalization (its general value and individual dimensions) and satisfaction with life/mental adjustment to cancer was observed. The strongest positive correlations were noted between refusing self-reflection, helplessness-hopelessness, and anxious preoccupation and the negative correlation between mentalization and satisfaction with life. Mentalization was a predictor of satisfaction with life and mental adjustment to illness. Mentalization was related with life satisfaction and adjustment to cancer in patients with breast cancer, which is in line with previous studies suggesting the crucial role of subjective psychological factors in maintaining mental health.
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Affiliation(s)
- Mariusz Cieślak
- Institute of Psychology, University of Lodz, 90-136 Lodz, Poland
| | - Joanna Kozaka
- Private Counseling Services Joanna Kozaka, 80-414 Gdansk, Poland
| | | | - Mariola Bidzan
- Department of Clinical and Health Psychology, University of Gdansk, 80-309 Gdansk, Poland
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Risk factors for psychological morbidity and the protective role of coping self-efficacy in young women with breast cancer early in diagnosis: a national multicentre cohort study. Breast Cancer Res Treat 2022; 194:91-102. [DOI: 10.1007/s10549-022-06576-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/17/2022] [Indexed: 11/02/2022]
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8
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Breast-conserving surgery with whole breast radiation therapy has a subsequent lower mood disorder incidence rate than total mastectomy in early-stage breast cancer patients: a nationwide population-based longitudinal study. Breast Cancer Res Treat 2022; 193:659-667. [DOI: 10.1007/s10549-022-06579-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/24/2022] [Indexed: 11/25/2022]
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9
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Ganz PA, Bower JE, Partridge AH, Wolff AC, Thorner ED, Joffe H, Irwin MR, Petersen L, Crespi CM. Screening for Depression in Younger Breast Cancer Survivors: Outcomes From Use of the 9-item Patient Health Questionnaire. JNCI Cancer Spectr 2021; 5:pkab017. [PMID: 34164605 PMCID: PMC8216636 DOI: 10.1093/jncics/pkab017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/18/2021] [Accepted: 01/21/2021] [Indexed: 12/12/2022] Open
Abstract
Background Major cancer organizations recommend depression screening in patients and survivors. The 9-item Patient Health Questionnaire (PHQ-9) is often suggested, with limited information about its use. Methods Enrollment data collected from younger breast cancer survivors participating in a behavioral intervention trial were used to examine the relationship between PHQ-9 scores (range = 0-27), patient characteristics, and responses to standardized psychosocial assessment tools. Major depressive disorder criterion was met if responses to the first 2 PHQ-9 items (range = 0-6) were 3 or greater. The sample was categorized by total PHQ-9 scores: less than 5 (minimal depressive symptoms), 5-9 (mild to moderate depressive symptoms), and 10 or greater (moderate to severe depression). PHQ-9 category associations with medical, demographic, psychosocial, and behavioral characteristics were examined using analysis of variance for continuous variables and χ2 tests for categorical variables. Results A total of 231 women met the study prescreening eligibility criterion of mild depressive symptoms and enrolled in the study. On average, they were 45.2 years old and 2.6 years since diagnosis. At enrollment, 22.1% met the screening criterion for possible major depressive disorder; among those with PHQ-9 scores of 10 or greater, 58.3% met this criterion. Anxiety, fatigue, insomnia, and intrusive thoughts about cancer were frequent and were associated with depressive symptom severity (all P < .001). In contrast, neither demographic nor cancer treatment characteristics were associated with depressive symptoms. Conclusions Depressive symptoms in this selected sample of younger breast cancer survivors were independent of demographic characteristics or cancer treatment history, suggesting that depression screening is necessary to detect uncontrolled depressive symptoms.
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Affiliation(s)
- Patricia A Ganz
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA.,Department of Medicine (Hematology-Oncology), David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.,UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Julienne E Bower
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine and Semel Institute, Los Angeles, CA, USA.,Department of Psychology, UCLA, Los Angeles, CA, USA.,Cousins Center for Psychoneuroimmunology, UCLA, Los Angeles, CA, USA
| | - Ann H Partridge
- Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Antonio C Wolff
- The Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Elissa D Thorner
- The Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Hadine Joffe
- Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, USA.,Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA.,Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Michael R Irwin
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine and Semel Institute, Los Angeles, CA, USA.,Cousins Center for Psychoneuroimmunology, UCLA, Los Angeles, CA, USA
| | - Laura Petersen
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA
| | - Catherine M Crespi
- UCLA Jonsson Comprehensive Cancer Center, Los Angeles, CA, USA.,Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, CA, USA
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Marinkovic M, Djordjevic N, Djordjevic L, Ignjatovic N, Djordjevic M, Karanikolic V. Assessment of the quality of life in breast cancer depending on the surgical treatment. Support Care Cancer 2020; 29:3257-3266. [PMID: 33099655 DOI: 10.1007/s00520-020-05838-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 10/16/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE The objective of the study is to describe QoL in women who have undergone surgical treatment for breast cancer (BC). The focus of the description is the differences in QoL between women treated by modified radical mastectomy (MRM) and women who underwent breast-conserving surgery (BCS) at the Breast and Endocrine Surgery Department of the Clinical Center of Niš, Serbia. METHOD From January 1, 2014, until December 31, 2017, 300 patients were treated with BCS and 300 patients with MRM. To assess the QOL, a total of 600 BC patients completed the WHOQOL-BREF questionnaires. The results were analyzed using the t test and chi-square test. WHOQOL produces a quality of life profile. It derives four domain scores: physical health, psychological, social relationships, and environment. Social and demographic factors (age, education, marital status) were collected in both groups. RESULT In all four domains, patients treated with conserving surgeries scored higher than patients treated with radical mastectomy. This result was controlled for a set of demographic variables. The differences in QoL scores are present on all levels of controlling variables. CONCLUSION According to the results of this study, the QoL in women after an MRM is significantly lower than the QoL in women after BCS. It is especially true for the environment domain. Conserving surgery should be recommended and specific, and patient-centered interventions for increasing QoL of the patients who opted for radical mastectomy should be designed. The intervention should focus on social and environmental domains.
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Affiliation(s)
- Mirjana Marinkovic
- Faculty of Medicine, University of Niš, Brace Ignjatovica 29, Niš, 18000, Serbia.
- Clinic for Endocrine Surgery and Breast Surgery Clinical Center Niš, Niš, Serbia.
| | - Nebojsa Djordjevic
- Faculty of Medicine, University of Niš, Brace Ignjatovica 29, Niš, 18000, Serbia
- Clinic for Endocrine Surgery and Breast Surgery Clinical Center Niš, Niš, Serbia
| | - Lidija Djordjevic
- Clinic for Endocrine Surgery and Breast Surgery Clinical Center Niš, Niš, Serbia
| | - Nebojsa Ignjatovic
- Faculty of Medicine, University of Niš, Brace Ignjatovica 29, Niš, 18000, Serbia
| | - Miodrag Djordjevic
- Clinic for Endocrine Surgery and Breast Surgery Clinical Center Niš, Niš, Serbia
| | - Vesna Karanikolic
- Faculty of Medicine, University of Niš, Brace Ignjatovica 29, Niš, 18000, Serbia
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11
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Ruiz-Casado A, Álvarez-Bustos A, de Pedro CG, Méndez-Otero M, Romero-Elías M. Cancer-related Fatigue in Breast Cancer Survivors: A Review. Clin Breast Cancer 2020; 21:10-25. [PMID: 32819836 DOI: 10.1016/j.clbc.2020.07.011] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/12/2020] [Accepted: 07/21/2020] [Indexed: 02/06/2023]
Abstract
Fatigue has been the most distressing and frequent symptom in breast cancer (BC) survivors after treatment. Although fatigue can occur in other cancer survivors, women with a history of BC might share some distinctive features. The present study aimed to recapitulate the knowledge about risk factors and correlates of cancer-related fatigue (CRF) in BC survivors after oncologic therapy. An electronic data search was conducted in PubMed using the terms "fatigue," "breast," "cancer," and "survivors." Records were included if they were original articles, available in English, had used a quantitative scale, had > 100 participants, and had excluded women with BC relapse. BC survivors were required to have finished their treatments ≥ 2 months before, except for hormonal therapy. The physiopathology and other interventions were considered beyond the scope of our review. The correlates were subsequently classified into 7 main categories: (1) sociodemographic data, (2) physical variables, (3) tumor- and treatment-related variables, (4) comorbidities, (5) other symptoms, (6) psychological issues, and (7) lifestyle factors. Fatigue was consistently greater in younger, obese, and diabetic women. Women reporting fatigue often communicated symptoms such as pain, depression, insomnia, and cognitive dysfunction. Coping strategies such as catastrophizing could play an important role in the persistence of fatigue. However, tumor characteristics, previous treatments received, and physical activity were not consistently reported. CRF was a strong predictor of the quality of life of BC survivors after treatment. In conclusion, we found CRF was a frequent and serious symptom that severely affects the quality of life of BC survivors after treatment. Health practitioners require more awareness and information about CRF.
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Affiliation(s)
- Ana Ruiz-Casado
- Department of Medical Oncology, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain.
| | | | - Cristina G de Pedro
- Department of Medical Oncology, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | - Marta Méndez-Otero
- Department of Medical Oncology, University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
| | - María Romero-Elías
- Department of Sport Sciences, Sport Research Centre, Miguel Hernandez University of Elche, Alicante, Spain
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12
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Optimism and coping: do they influence health outcomes in women with breast cancer? A systemic review and meta-analysis. Breast Cancer Res Treat 2020; 183:495-501. [DOI: 10.1007/s10549-020-05800-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 07/11/2020] [Indexed: 01/14/2023]
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13
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Hallet J, Davis LE, Isenberg-Grzeda E, Mahar AL, Zhao H, Zuk V, Moody L, Coburn NG. Gaps in the Management of Depression Symptoms Following Cancer Diagnosis: A Population-Based Analysis of Prospective Patient-Reported Outcomes. Oncologist 2020; 25:e1098-e1108. [PMID: 32100906 DOI: 10.1634/theoncologist.2019-0709] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 01/23/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND One of the most common psychological morbidities of cancer is depression. Routine depression symptoms screening (DSS) is recommended, but its ability to lead to psychosocial interventions in clinical practice is limited. We examined the use of and factors associated with psychosocial interventions for positive DSS following cancer diagnosis. MATERIALS AND METHODS We conducted a population-based cohort study of patients with diagnoses from 2010 to 2017 who reported ≥1 patient-reported Edmonton Symptom Assessment System (ESAS) score. Positive DSS was defined as ESAS ≥2 out of 10 for the depression item within 6 months of diagnosis. Outcomes were psychosocial interventions around the time of positive DSS: palliative care assessment, psychiatry/psychology assessment, social work referral, and antidepressant therapy (in patients ≥65 years of age with universal drug coverage). We examined reduction in depression symptom score (≥1 point) following intervention. Modified Poisson regression examined factors associated with interventions. RESULTS Of 142,270 patients, 65,424 (46.0%) reported positive DSS at a median of 66 days (interquartile range: 34-105) after diagnosis. Of those with depression symptoms, 17.1% received palliative assessment, 1.7% psychiatry/psychology assessment, 8.4% social work referral, and 4.3% antidepressant therapy. Depression symptom score decreased in 67.2% who received palliative assessment, 63.7% with psychiatry/psychology assessment, 67.3% with social work referral, and 71.4% with antidepressant therapy. On multivariable analysis, patients with older age, rural residence, lowest income quintile, and genitourinary or oropharyngeal cancer were more likely to not receive intervention other than palliative care. CONCLUSION The proportion of patients reporting positive DSS after cancer diagnosis receiving psychosocial intervention is low. We identified patients vulnerable to not receiving interventions, who may benefit from additional support. These data represent a call to action to modify practice and optimize the usefulness of systematic symptom screening. IMPLICATIONS FOR PRACTICE Patient-reported depression symptoms screening should be followed by targeted interventions to improve symptoms and patient-centered management.
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Affiliation(s)
- Julie Hallet
- Division of Surgical Oncology, Odette Cancer Centre - Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Research Institute, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
| | - Laura E Davis
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Elie Isenberg-Grzeda
- Division of Psycho-Social Services, Odette Cancer Centre - Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Alyson L Mahar
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Victoria Zuk
- Sunnybrook Research Institute, Toronto, Ontario, Canada
| | | | - Natalie G Coburn
- Division of Surgical Oncology, Odette Cancer Centre - Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Research Institute, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Cancer Care Ontario, Toronto, Ontario, Canada
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14
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Naik H, Leung B, Laskin J, McDonald M, Srikanthan A, Wu J, Bates A, Ho C. Emotional distress and psychosocial needs in patients with breast cancer in British Columbia: younger versus older adults. Breast Cancer Res Treat 2020; 179:471-477. [PMID: 31630293 DOI: 10.1007/s10549-019-05468-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 10/08/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE This study evaluates the prevalence of emotional distress and psychosocial needs in young adult (YA, age 18-39) patients at the time of their breast cancer diagnosis compared to older patients. METHODS Through a province-wide program, BC Cancer patients complete the PsychoSocial Scan for CANcer-Revised (PSSCAN-R) questionnaire, which screens for the presence of symptoms of anxiety and depression and assesses psychosocial needs using the Canadian Problem Checklist (CPC). The study population comprised all breast cancer patients who completed the questionnaire within 6 months of their cancer diagnosis between 2011 and 2016. Clinical information was retrospectively collected from electronic health records. Univariate and multivariate analyses using the X2, Fisher's exact test, and logistical regression were used to compare patient age groups. RESULTS The cohort included 10,734 breast cancer patients: median age 62, 4% YA, 99% female, and 96% presented with non-metastatic disease. After adjusting for clinical and demographic variables, YA patients were more likely to report depression (33.6% vs. 25.5%, OR 1.47, p = 0.001) and anxiety symptoms (58.6% vs. 35.7%, OR 2.49, p < 0.001) than older patients. Psychosocial needs regarding work/school (OR 3.79, p < 0.001), intimacy/sexuality (OR 2.82, p < 0.001), and finances (OR 2.78, p < 0.001) were more common among YA than older adults. CONCLUSIONS After a breast cancer diagnosis, YAs have higher levels of emotional distress compared to older patients. Differences in specific psychosocial needs likely reflect differences in life stage between these age groups. The data suggest that YAs warrant specific attention with respect to early psychosocial assessment and tailored intervention.
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Affiliation(s)
- Hiten Naik
- University of British Columbia, Vancouver, Canada
| | - Bonnie Leung
- Department of Medical Oncology, BC Cancer, 600 10th Avenue West, Vancouver, BC, V5Z 4E6, Canada
| | - Janessa Laskin
- University of British Columbia, Vancouver, Canada
- Department of Medical Oncology, BC Cancer, 600 10th Avenue West, Vancouver, BC, V5Z 4E6, Canada
| | - Melanie McDonald
- Department of Psychosocial Oncology, BC Cancer, Vancouver, Canada
| | - Amirrtha Srikanthan
- Department of Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, Canada
| | - Jonn Wu
- University of British Columbia, Vancouver, Canada
- Department of Radiation Oncology, BC Cancer, Vancouver, Canada
| | - Alan Bates
- University of British Columbia, Vancouver, Canada
- Department of Psychosocial Oncology, BC Cancer, Vancouver, Canada
| | - Cheryl Ho
- University of British Columbia, Vancouver, Canada.
- Department of Medical Oncology, BC Cancer, 600 10th Avenue West, Vancouver, BC, V5Z 4E6, Canada.
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15
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Caregiving burden and self-efficacy mediate the association between individual characteristics and depressive symptoms among husbands of Chinese breast cancer patients. Support Care Cancer 2019; 28:3125-3133. [DOI: 10.1007/s00520-019-05102-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 09/23/2019] [Indexed: 10/25/2022]
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16
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Cohen M, Levkovich I, Pollack S, Fried G. Stability and change of postchemotherapy symptoms in relation to optimism and subjective stress: A prospective study of breast cancer survivors. Psychooncology 2019; 28:2017-2024. [DOI: 10.1002/pon.5185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Revised: 07/18/2019] [Accepted: 07/21/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Miri Cohen
- School of Social WorkUniversity of Haifa Haifa Israel
| | | | - Shimon Pollack
- Institute of Clinical Immunology, Allergy and AIDSRambam Health Care Campus Haifa Israel
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17
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Vorn R, Touch S, Ryu E. Depression and health-related quality of life among Cambodian patients with cancer. Int J Health Plann Manage 2019; 34:e1747-e1759. [PMID: 31414509 DOI: 10.1002/hpm.2888] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 08/06/2019] [Accepted: 08/07/2019] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Symptom assessment and quality of life (QoL) are considered two of the most important factors in the overall care of cancer patients. Although cancer is one of the leading causes of death after communicable disease in Cambodia, the QoL of Cambodian cancer patients has not been examined previously. This study aimed to describe the QoL of cancer patients in Cambodia. METHODS A cross-sectional study was conducted with cancer patients who visited Khmer-Soviet Friendship Hospital in Phnom Penh. Two hundred patients participated in this study. The inventory comprised two previously validated scales: the Center for Epidemiological Studies Depression Scale-10 (CESD-10) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C30. Descriptive analyses, independent samples t-tests, and Pearson's correlation analysis were performed to examine the differences and relationship between study variables. RESULTS The mean global health score was 51.62, and 58.5% of the participants had depressive symptom. The global health score was statistically significantly lower in depressive patients. The QoL was negatively correlated with depression, but positively and significant correlated with physical function, role function, emotional function, cognitive function, and social function. CONCLUSION This study is the first to describe the QoL of Cambodian cancer patients. Our findings suggest that more attention should be paid to psychological concerns and symptom management in Cambodian cancer patients. Appropriate management could be effective in improving the QoL of cancer patients.
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Affiliation(s)
- Rany Vorn
- Chung-Ang University School of Graduate, Seoul, Republic of Korea.,Chung-Ang University, Department of Nursing, Seoul, Republic of Korea
| | - Socheat Touch
- Khmer-Soviet Friendship Hospital and Clinical Lecturer at University of Health Sciences, Phnom Penh, Cambodia
| | - Eunjung Ryu
- Chung-Ang University, Department of Nursing, Seoul, Republic of Korea
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18
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Kim J, Paik HJ, Jung Y, Kim DI, Jo H, Lee S, Kim H. A Prospective Longitudinal Study about Change of Sleep, Anxiety, Depression, and Quality of Life in Each Step of Breast Cancer Patients. Oncology 2019; 97:245-253. [DOI: 10.1159/000500724] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 04/30/2019] [Indexed: 11/19/2022]
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19
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Coping strategies and depressive symptoms in cancer patients. Clin Transl Oncol 2019; 22:330-336. [DOI: 10.1007/s12094-019-02123-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 04/19/2019] [Indexed: 10/26/2022]
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20
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Yeung NCY, Zhang Y, Ji L, Lu G, Lu Q. Correlates of sexual quality of life among husbands of Chinese breast cancer survivors. Eur J Oncol Nurs 2019; 40:63-70. [PMID: 31229208 DOI: 10.1016/j.ejon.2019.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 03/27/2019] [Accepted: 03/31/2019] [Indexed: 11/15/2022]
Abstract
PURPOSE Western studies found that sexual quality of life (QoL) among husbands of breast cancer survivors was associated with their stress and coping processes. However, little is known about how breast cancer caregiving might be associated with those husbands' sexual QoL in the Chinese cultural context. Guided by the Stress and Coping model, we examined the psychosocial correlates of sexual QoL among husbands of Chinese breast cancer survivors. METHOD Husbands of Chinese breast cancer survivors (N = 176) recruited from two hospitals in Weifang, China completed a cross-sectional survey. Their individual characteristics, caregiving-related stressors, cognitive appraisals, coping resources and strategies, and sexual QoL were measured. RESULTS After controlling for covariates, hierarchical regression results showed that lower caregiving burden (β = -0.34, p < .001), higher marital satisfaction (β = 0.20, p < .001), and lower harm/threat appraisals (β from -0.22 to -0.20, p < .001) were associated with better sexual QoL. Moreover, ambivalence over emotional expression (AEE; inner conflict concerning the desire to express emotions yet failing to do so) was found to moderate between protective buffering and sexual QoL (β = 0.20, p < .01), such that the negative association between protective buffering and sexual QoL was only significant among those with higher AEE (β = -0.38, p < .003). CONCLUSIONS Both the stress and coping variables and their interactions with individual characteristics could be important determinants of those husbands' sexual QoL. Our findings implied that reducing husbands' caregiving burden, increasing their marital satisfaction, helping them reevaluate the negative impact of breast cancer, and reducing barriers for expressing emotions and concerns may increase their sexual well-being.
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Affiliation(s)
- Nelson C Y Yeung
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, PR China
| | - Yiwei Zhang
- Department of Medical Nursing, Weifang Medical University, China
| | - Lili Ji
- Department of Medical Nursing, Weifang Medical University, China
| | - Guohua Lu
- Department of Medical Nursing, Weifang Medical University, China.
| | - Qian Lu
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, United States.
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21
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Biopsychosocial Correlates of Adjustment to Cancer during Chemotherapy: The Key Role of Health-Related Quality of Life. ScientificWorldJournal 2019; 2019:9750940. [PMID: 30983914 PMCID: PMC6431483 DOI: 10.1155/2019/9750940] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 02/21/2019] [Indexed: 12/18/2022] Open
Abstract
Background Patients adjust to cancer in a continuous process that follows the course of the disease. Previous research has considered several illness-related variables and demographics, quality of life, personality, and social factors as predictors of adjustment to cancer, which can be maladaptive (e.g., helplessness-hopelessness and anxious preoccupation) or adaptive (e.g., fighting spirit). Aims Assuming a biopsychosocial view, we test an empirical model in which disease stage, patient's age, and gender are viewed as the distal antecedents of positive and negative adjustment to cancer for chemotherapy patients. Health-related quality of life (HRQoL) has a key role, interposing between the distal antecedents and adaptational outcomes. Social support and positive thinking are also included in the model as related to adjustment. Methods One-hundred-sixty-two consecutive cancer patients receiving adjuvant or standard chemotherapy participated in the study. Patients completed the Mini-Mental Adjustment to Cancer, the Brief-COPE, the Social Provision Scale, and the SF-12 Health Survey. Partial least squares structural equation modeling (PLS-SEM) was applied for model building and hypotheses testing. Results We found a negative association between advanced stage and physical functioning, a strong positive link between physical functioning and mental health, and significant relations between mental health and helpless-hopelessness, anxious preoccupation, and cognitive avoidance. Social support and positive thinking were related to fighting spirit and fatalism. Cancer stage and female gender were indirectly associated with adaptational outcomes through HRQoL. The patient's age had no significant relationships in the model. Discussion HRQoL (both physical and mental) is a key factor for preventing maladjustment in chemotherapy patients. Social support and positive thinking coping style fosters fighting spirit and fatalism on health outcomes. Two potential lines of action seem promising: preventing maladaptive and promoting adaptive adjustments working on patient's mental health individually and involving significant others in supportive care, respectively.
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22
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Newlands RSN, Ntessalen M, Clark J, Fielding S, Hoddinott P, Heys SD, McNeill G, Craig LCA. Pilot randomised controlled trial of Weight Watchers® referral with or without dietitian-led group support for weight loss in women treated for breast cancer: the BRIGHT (BReast cancer weIGHT loss) trial. Pilot Feasibility Stud 2019; 5:24. [PMID: 30805199 PMCID: PMC6373055 DOI: 10.1186/s40814-019-0405-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 01/24/2019] [Indexed: 12/24/2022] Open
Abstract
Background Being overweight or obese following breast cancer diagnosis can increase cancer recurrence and mortality, so effective interventions for weight loss in this group could enhance survival. A pilot randomised controlled trial was conducted to assess whether a weight loss programme comprising generic Weight Watchers® referral offered to women treated for breast cancer with or without additional breast cancer-tailored dietetic support is feasible and shows promise for improving weight and quality of life (QoL). Methods Participants were randomly allocated to 3 groups: Weight Watchers® referral (for 12 sessions of meetings and digital tools) plus 5 breast cancer-tailored dietitian-led group support sessions (WW Plus: n = 14), Weight Watchers® referral only (WW: n = 16) or control (Weight Watchers® referral after 3 months, n = 15). Feasibility was assessed based on retention rate, recruitment and randomisation process, meeting attendance, suitability of the setting and outcome measurement tools, unintended consequences, cost and observations of the dietetic sessions. Outcomes were measured at 0, 3 (‘trial exit’) and 12 months post intervention. Results The response rate to the invitation was 43% (140/327) of whom 58 were eligible and 45 (median age 61.0 years; body mass index 30.2 kg/m2) were randomised. Data from 38 (84%) and 30 (67%) participants were available at trial exit and 12 months respectively. Feasibility issues included slow recruitment process, lack of blinding throughout, weighing scales not measuring > 150 kg, lack of clear instructions for completing QoL questionnaire and workload and time pressures in delivering dietetic sessions. Participants had good attendance rate at group meetings and no serious unintended consequences were reported. WW Plus was most expensive to run. Mean (95% CI) weight change at trial exit was − 3.67 kg (− 5.67, − 2.07) in WW Plus, − 6.03 kg (− 7.61, − 4.44) in WW group and + 0.19 kg (− 1.45, + 1.83) in control group. About 40% of the WW Plus, 64% of the WW group and 56% of the control group lost ≥ 5% of their baseline weight by 12 months. All groups showed promise for improving QoL at trial exit but only the WW group maintained significant improvements from baseline at 12 months. Conclusions The trial procedures were feasible, with some modifications. This pilot trial indicates the benefits of providing free WW vouchers for weight loss maintenance and improving QoL but provided no evidence that including additional dietetic support would add any extra value. Further research with WW with long-term follow-up should be undertaken to assess weight loss sustainability and benefit on health outcomes in this patient group. Trial registration ISRCTN-29623418. Electronic supplementary material The online version of this article (10.1186/s40814-019-0405-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Rumana S N Newlands
- 1Health Services Research Unit, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, 3rd floor Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD UK
| | - Maria Ntessalen
- 1Health Services Research Unit, Institute of Applied Health Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, 3rd floor Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD UK
| | - Julia Clark
- 2NHS Grampian Department of Nutrition and Dietetics, Aberdeen, UK
| | - Shona Fielding
- 3Medical Statistics Team, Institute of Applied Health Sciences, School of Medicine and Dentistry, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD UK
| | - Pat Hoddinott
- 4Nursing Midwifery and Allied Health Professions Research Unit, University of Stirling, Stirling, FK9 4LA UK
| | - Steven D Heys
- 5School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD UK.,6NHS Grampian, Scotland, UK
| | - Geraldine McNeill
- 7Institute of Applied Health Sciences & The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD UK
| | - Leone C A Craig
- 7Institute of Applied Health Sciences & The Rowett Institute, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD UK
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23
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Bower JE, Asher A, Garet D, Petersen L, Ganz PA, Irwin MR, Cole SW, Hurvitz SA, Crespi CM. Testing a biobehavioral model of fatigue before adjuvant therapy in women with breast cancer. Cancer 2018; 125:633-641. [PMID: 30561795 DOI: 10.1002/cncr.31827] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 08/23/2018] [Accepted: 10/01/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Fatigue is one of the most common and disabling side effects of cancer and its treatment. Although research typically has focused on fatigue that occurs during and after treatment, patients may experience fatigue even before treatment onset. The current study was designed to identify biobehavioral risk factors associated with fatigue before adjuvant therapy in women with early-stage breast cancer. METHODS Patients with stage 0 to stage IIIA breast cancer (270 women) were recruited before the onset of adjuvant or neoadjuvant therapy with radiotherapy, chemotherapy, and/or endocrine therapy. Host factors that may influence fatigue were identified from an empirically based, biobehavioral model and assessed using self-report questionnaires, medical record review, and blood collection (for genetic data). Fatigue was assessed by questionnaire. Linear regression analyses were used to evaluate the association between host factors and dimensions of fatigue, with general fatigue as the primary dimension of interest. RESULTS Fatigue was elevated at the pretreatment assessment compared with published controls. Bivariate analyses identified demographic, cancer-related, and biobehavioral correlates of fatigue. In the multivariable model, predictors of general fatigue included younger age, lower educational level, lower cancer stage, and history of childhood maltreatment (all P values <.05), with the full model accounting for approximately 18.4% of the variance in fatigue. Secondary analyses identified common and specific predictors of emotional, mental, and physical dimensions of fatigue. CONCLUSIONS Among women who have not yet initiated treatment of breast cancer, demographic and psychosocial factors are associated with elevated fatigue and could be used to identify at-risk patients for early intervention.
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Affiliation(s)
- Julienne E Bower
- Department of Psychology, University of California at Los Angeles, Los Angeles, California.,Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California.,Norman Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California.,Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California
| | - Arash Asher
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, California
| | - Deborah Garet
- Norman Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California
| | - Laura Petersen
- Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California
| | - Patricia A Ganz
- Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California.,School of Medicine, University of California at Los Angeles, Los Angeles, California.,School of Public Health, University of California at Los Angeles, Los Angeles, California
| | - Michael R Irwin
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California.,Norman Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California
| | - Steve W Cole
- Department of Psychiatry and Biobehavioral Sciences, University of California at Los Angeles, Los Angeles, California.,Norman Cousins Center for Psychoneuroimmunology, University of California at Los Angeles, Los Angeles, California.,Department of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Sara A Hurvitz
- Department of Medicine, University of California at Los Angeles, Los Angeles, California
| | - Catherine M Crespi
- Jonsson Comprehensive Cancer Center, University of California at Los Angeles, Los Angeles, California.,Department of Biostatistics, University of California at Los Angeles, Los Angeles, California
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24
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Buscariollo DL, Cronin AM, Borstelmann NA, Punglia RS. Impact of pre-diagnosis depressive symptoms and health-related quality of life on treatment choice for ductal carcinoma in situ and stage I breast cancer in older women. Breast Cancer Res Treat 2018; 173:709-717. [PMID: 30406869 DOI: 10.1007/s10549-018-5006-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 10/09/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To examine whether pre-diagnosis patient-reported health-related quality of life (HRQOL) and depressive symptoms are associated with local treatment for older women with ductal carcinoma in situ (DCIS) and stage I breast cancer (BC). METHODS Using the SEER-MHOS dataset, we identified women ≥ 65 years old with DCIS or stage I BC diagnosed 1998-2011 who completed surveys ≤ 24 months before diagnosis. Depressive symptoms were measured by major depressive disorder (MDD) risk and HRQOL was measured by Physical and Mental Component Summary scores (PCS and MCS, respectively) of the SF-36/VR-12. Associations with treatment choice (breast-conserving surgery [BCS] and radiation therapy [RT], BCS alone, mastectomy) were assessed with multivariable multinomial logistic regression, controlling for patient characteristics. RESULTS We identified 425 women with DCIS and 982 with stage I BC. Overall, 20.4% endorsed depressive symptoms placing them at risk for MDD pre-diagnosis; mean MCS and PCS scores were 52.3 (SD = 10.1) and 40.5 (SD = 11.5), respectively. Among women with DCIS, those at risk for MDD were more likely to receive BCS (adjusted odds ratio [AOR] 2.04, 95% CI 1.04-4.00, p = 0.04) or mastectomy (AOR 1.88, 95% CI 0.91-3.86, p = 0.09) compared to BCS + RT. For DCIS, MCS score was not associated with treatment; higher PCS score was associated with decreased likelihood of receiving mastectomy versus BCS + RT (AOR 0.71 per 10-point increase, 95% CI 0.54-0.95, p = 0.02). For BC, none of the measures were significantly associated with treatment. CONCLUSION Older women at risk for MDD before DCIS diagnosis were less likely to receive RT after BCS, compared to BCS alone or mastectomy.
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Affiliation(s)
- Daniela L Buscariollo
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Angel M Cronin
- Center for Outcomes and Policy Research, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Nancy A Borstelmann
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Rinaa S Punglia
- Department of Radiation Oncology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, 450 Brookline Avenue, Boston, MA, 02215, USA.
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25
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Pačarić S, Kristek J, Mirat J, Kondža G, Turk T, Farčić N, Orkić Ž, Nemčić A. The quality of life of Croatian women after mastectomy: a cross-sectional single-center study. BMC Public Health 2018; 18:999. [PMID: 30097040 PMCID: PMC6086072 DOI: 10.1186/s12889-018-5929-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 08/02/2018] [Indexed: 12/31/2022] Open
Abstract
Background Measuring the quality of life (QoL) of women with breast cancer is an important aspect of measuring treatment success. In Croatia, no QoL studies have been carried out with a focus on patients after mastectomy. The aim of this study was to examine QoL 1 month and 1 year after mastectomy. Methods This cross-sectional single-center study of quality of life was conducted in 101 patients, 50 of whom had undergone a mastectomy 1 month prior, and 51 of whom had undergone a mastectomy 1 year prior. The study was conducted from July 2015 to June 2016. The questionnaires used in the study were developed by the European Organisation for Research and Treatment of Cancer (EORTC). The questionnaire EORTC QLQ-C30 assesses the QoL of cancer patients, and the questionnaire EORTC QLQ-BR23 is a disease-specific breast cancer module. A chi square test, Fisher’s exact test, Kolmogorov-Smirnov test, Student’s t-test and Mann-Whitney U test were performed in the statistical analysis using the statistical program SPSS (Inc. Released 2008. SPSS Statistics for Windows, Version 17.0. Chicago: SPSS Inc.). Results Patients who had undergone a mastectomy a year earlier placed a higher value on their health state than did those who had undergone a mastectomy a month earlier. The most affected values of functional status on the EORTC QLQ-C30 scale were emotional functioning (37.5 [95% CI 33.3–61.6]) and sexual functioning (16.67 [95% CI 0–33.3]) 1 month and 1 year after mastectomy, respectively. The most affected symptoms on the EORTC QLQ-C30 scale were hair loss 66.67 [95% CI 33.3–100]) and fatigue 33.33 [95% CI 24–44]) 1 month and 1 year after mastectomy, respectively. Conclusion In our study, both functional and symptom scales were more affected in women 1 month after mastectomy. QoL was considerably improved in women 1 year after the surgery compared to 1 month after mastectomy. The results of this study could contribute to the public awareness of the QoL of breast cancer patients.
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Affiliation(s)
- Stana Pačarić
- Department of Surgery, Faculty of Medicine, University of Osijek, Osijek, Croatia. .,Department of Surgery, University Hospital Osijek, Huttlerova 4, 31000, Osijek, Croatia.
| | - Jozo Kristek
- Department of Surgery, Faculty of Medicine, University of Osijek, Osijek, Croatia.,Department of Surgery, University Hospital Osijek, Huttlerova 4, 31000, Osijek, Croatia
| | - Jure Mirat
- Faculty of Medicine, University of Osijek, Cara Hadrijana 10/E, HR, 31000, Osijek, Croatia
| | - Goran Kondža
- Department of Surgery, Faculty of Medicine, University of Osijek, Osijek, Croatia.,Department of Surgery, University Hospital Osijek, Huttlerova 4, 31000, Osijek, Croatia
| | - Tajana Turk
- Department of Biophysics and Radiology, Faculty of Medicine, University of Osijek, Osijek, Croatia.,Department of Diagnostic and Interventional Radiology, University Hospital Osijek, Huttlerova 4, 31000, Osijek, Croatia
| | - Nikolina Farčić
- Department of Surgery, University Hospital Osijek, Huttlerova 4, 31000, Osijek, Croatia.,Department of Nursing, Medical Ethics and Palliative Medicine, Faculty of Medicine, University of Osijek, Osijek, Croatia
| | - Želimir Orkić
- Department of Surgery, Faculty of Medicine, University of Osijek, Osijek, Croatia.,Department of Surgery, University Hospital Osijek, Huttlerova 4, 31000, Osijek, Croatia
| | - Ana Nemčić
- Department of Surgery, Faculty of Medicine, University of Osijek, Osijek, Croatia.,Department of Surgery, University Hospital Osijek, Huttlerova 4, 31000, Osijek, Croatia
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Wong RL, El-Jawahri A, D'Arpino SM, Fuh CX, Johnson PC, Lage DE, Irwin KE, Pirl WF, Traeger L, Cashavelly BJ, Jackson VA, Greer JA, Ryan DP, Hochberg EP, Temel JS, Nipp RD. Use of Antidepressant Medications Moderates the Relationship Between Depressive Symptoms and Hospital Length of Stay in Patients with Advanced Cancer. Oncologist 2018; 24:117-124. [PMID: 30082486 PMCID: PMC6324633 DOI: 10.1634/theoncologist.2018-0096] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Accepted: 05/31/2018] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Among patients with cancer, depressive symptoms are associated with worse clinical outcomes, including greater health care utilization. As use of antidepressant medications can improve depressive symptoms, we sought to examine relationships among depressive symptoms, antidepressant medications, and hospital length of stay (LOS) in patients with advanced cancer. MATERIALS AND METHODS From September 2014 to May 2016, we prospectively enrolled patients with advanced cancer who had an unplanned hospitalization. We performed chart review to obtain information regarding documented depressive symptoms in the 3 months prior to admission and use of antidepressant medications at the time of admission. We compared differences in hospital LOS by presence or absence of depressive symptoms and used adjusted linear regression to examine if antidepressant medications moderated these outcomes. RESULTS Of 1,036 patients, 126 (12.2%) had depressive symptoms documented prior to admission, and 288 (27.8%) were taking antidepressant medications at the time of admission. Patients with depressive symptoms experienced longer hospital LOS (7.25 vs. 6.13 days; p = .036). Use of antidepressant medications moderated this relationship; among patients not on antidepressant medications, depressive symptoms were associated with longer hospital LOS (7.88 vs. 6.11 days; p = .025), but among those on antidepressant medications, depressive symptoms were not associated with hospital LOS (6.57 vs. 6.17 days; p = .578). CONCLUSION Documented depressive symptoms prior to hospital admission were associated with longer hospital LOS. This effect was restricted to patients not on antidepressant medications. Future studies are needed to investigate if use of antidepressant medications decreases LOS for patients hospitalized with advanced cancer and the mechanisms by which this may occur. IMPLICATIONS FOR PRACTICE This study investigated the prevalence of documented depressive symptoms in patients with advanced cancer in the 3 months prior to an unplanned hospitalization and the prevalence of use of antidepressant medications at time of hospital admission. The relationship of these variables with hospital length of stay was also examined, and it was found that documented depressive symptoms were associated with prolonged hospital length of stay. Interestingly, antidepressant medications moderated the relationship between depressive symptoms and hospital length of stay. These findings support the need to recognize and address depressive symptoms among patients with advanced cancer, with potential implications for optimizing health care utilization.
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Affiliation(s)
- Risa L Wong
- Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Areej El-Jawahri
- Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Sara M D'Arpino
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Charn-Xin Fuh
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - P Connor Johnson
- Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel E Lage
- Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Kelly E Irwin
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - William F Pirl
- Department of Psychiatry, Sylvester Comprehensive Cancer Center and University of Miami, Miami, Florida, USA
| | - Lara Traeger
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Barbara J Cashavelly
- Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Vicki A Jackson
- Division of Palliative Care, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Joseph A Greer
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - David P Ryan
- Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Ephraim P Hochberg
- Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Jennifer S Temel
- Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Ryan D Nipp
- Division of Hematology & Oncology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Lee SS, Rim HD, Won SH, Woo J. Avoidant Insecure Attachment as a Predictive Factor for Psychological Distress in Patients with Early Breast Cancer: A Preliminary 1-Year Follow-Up Study. Psychiatry Investig 2018; 15:805-810. [PMID: 30086610 PMCID: PMC6111221 DOI: 10.30773/pi.2018.06.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 06/07/2018] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE To identify attachment insecurity as an associative factor with unresolved psychological distress 1 year after surgery in the early breast cancer (BC) population. METHODS One-hundred fourteen participants completed the Hospital Anxiety and Depression Scale (HADS) and the Experiences in Close Relationship (ECR-M36) questionnaire within 1 week (baseline) and at 1-year post-surgery (follow-up). Participants were categorized into the distress and the non-distress groups based on a HADS-total score cut-off of 15. Logistic regression analysis revealed predictive factors of distress at follow-up. RESULTS At baseline, 53 (46.5%) participants were found to be in the distress group. The degree of distress decreased over 1 year (p= 0.003); however, 43 (37.7%) showed significant remaining distress at follow-up. Baseline scores of the ECR-M36 avoidance [odds ratio (OR)=1.045, 95% confidence interval (CI)=1.002-1.090] and HADS-total (OR=1.138, 95% CI=1.043-1.241) were predictors of distress at follow-up. CONCLUSION A substantial proportion of early BC patients suffer distress even one-year after surgery. Avoidant attachment appeared to be an influential factor on distress in early BC patients. Moreover, the finding that initial distress level could predict one at 1-year postoperation warrant a screening and management of distress along with BC treatment.
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Affiliation(s)
- Sang-Shin Lee
- Department of Psychiatry, Kosin University College of Medicine, Busan, Republic of Korea
| | - Hyo-Deog Rim
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Seung-Hee Won
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Jungmin Woo
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
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Depression Induced by Total Mastectomy, Breast Conserving Surgery and Breast Reconstruction: A Systematic Review and Meta-analysis. World J Surg 2018; 42:2076-2085. [DOI: 10.1007/s00268-018-4477-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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29
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Syrowatka A, Motulsky A, Kurteva S, Hanley JA, Dixon WG, Meguerditchian AN, Tamblyn R. Predictors of distress in female breast cancer survivors: a systematic review. Breast Cancer Res Treat 2017; 165:229-245. [PMID: 28553684 PMCID: PMC5543195 DOI: 10.1007/s10549-017-4290-9] [Citation(s) in RCA: 152] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 05/10/2017] [Indexed: 12/12/2022]
Abstract
Purpose Unmanaged distress has been shown to adversely affect survival and quality of life in breast cancer survivors. Fortunately, distress can be managed and even prevented with appropriate evidence-based interventions. Therefore, the objective of this systematic review was to synthesize the published literature around predictors of distress in female breast cancer survivors to help guide targeted intervention to prevent distress. Methods Relevant studies were located by searching MEDLINE, Embase, PsycINFO, and CINAHL databases. Significance and directionality of associations for commonly assessed candidate predictors (n ≥ 5) and predictors shown to be significant (p ≤ 0.05) by at least two studies were summarized descriptively. Predictors were evaluated based on the proportion of studies that showed a significant and positive association with the presence of distress. Results Forty-two studies met the target criteria and were included in the review. Breast cancer and treatment-related predictors were more advanced cancer at diagnosis, treatment with chemotherapy, longer primary treatment duration, more recent transition into survivorship, and breast cancer recurrence. Manageable treatment-related symptoms associated with distress included menopausal/vasomotor symptoms, pain, fatigue, and sleep disturbance. Sociodemographic characteristics that increased the risk of distress were younger age, non-Caucasian ethnicity, being unmarried, and lower socioeconomic status. Comorbidities, history of mental health problems, and perceived functioning limitations were also associated. Modifiable predictors of distress were lower physical activity, lower social support, and cigarette smoking. Conclusions This review established a set of evidence-based predictors that can be used to help identify women at higher risk of experiencing distress following completion of primary breast cancer treatment. Electronic supplementary material The online version of this article (doi:10.1007/s10549-017-4290-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ania Syrowatka
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada. .,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
| | - Aude Motulsky
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.,Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Siyana Kurteva
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - James A Hanley
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada
| | - William G Dixon
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK.,Health eResearch Centre, Farr Institute, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK
| | - Ari N Meguerditchian
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.,Department of Surgery, McGill University Health Centre, Montreal, QC, Canada.,Department of Oncology, McGill University Health Centre, Montreal, QC, Canada
| | - Robyn Tamblyn
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada
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Kus T, Aktas G, Ekici H, Elboga G, Djamgoz S. Illness perception is a strong parameter on anxiety and depression scores in early-stage breast cancer survivors: a single-center cross-sectional study of Turkish patients. Support Care Cancer 2017; 25:3347-3355. [PMID: 28550444 DOI: 10.1007/s00520-017-3753-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Accepted: 05/16/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Illness perception has been suggested to have a significant effect on anxiety and depression in cancer patients. In this cross-sectional study, we aimed to evaluate this on Turkish breast cancer patients with follow-up periods up to 12 years. PATIENTS AND METHODS A total of 225 patients (with 6 months to 12 years follow-up) were recruited in this cross-sectional study. The patients were divided into three groups of follow-up: 6 months-2 years, 2-5 years, and >5 years. Beck Depression Inventory, Beck Anxiety Inventory, Duke-University of North Carolina Functional Social Support Questionnaire, and Brief Illness Perception Questionnaire were used to assess the depression, anxiety, functional social support (FSS), and illness perception, respectively. Statistical significance of the associations was analyzed using Spearman correlation, Student's t, Mann-Whitney U, and ANOVA tests. RESULTS Rates of moderate-severe anxiety and depression scores were not correlated with follow-up period and disease stage, whereas all these parameters were associated significantly with FSS and age. Parameters of illness perception were also not correlated with follow-up period and stage of disease. However, illness perception scores were noticeably better with increments in FSS. Also, the parameters of illness perception were strongly associated with the depression/anxiety score. CONCLUSION Illness perception is an important determinant of the depression/anxiety score in Turkish breast cancer patients.
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Affiliation(s)
- Tulay Kus
- Department of Internal Medicine, Division of Medical Oncology, Gaziantep Oncology Hospital, University of Gaziantep, TR-27310, Gaziantep, Turkey.
| | - Gokmen Aktas
- Department of Internal Medicine, Division of Medical Oncology, Gaziantep Oncology Hospital, University of Gaziantep, TR-27310, Gaziantep, Turkey
| | - Hatice Ekici
- Department of Psychological Counseling and Guidance, Near East University, 99138, Nicosia, Turkish Republic of Northern Cyprus
| | - Gulcin Elboga
- Department of Psychiatry, Ersin Arslan Training and Research Hospital, TR-27010, Gaziantep, Turkey
| | - Sabire Djamgoz
- Department of Psychological Counseling and Guidance, Pro Cancer Research Fund, London, N22 8NQ, UK
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31
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Ambivalence over emotional expression, intrusive thoughts, and posttraumatic stress symptoms among Chinese American breast cancer survivors. Support Care Cancer 2017; 25:3281-3287. [DOI: 10.1007/s00520-017-3744-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 05/04/2017] [Indexed: 10/19/2022]
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32
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Leach CR, Troeschel AN, Wiatrek D, Stanton AL, Diefenbach M, Stein KD, Sharpe K, Portier K. Preparedness and Cancer-Related Symptom Management among Cancer Survivors in the First Year Post-Treatment. Ann Behav Med 2017; 51:587-598. [DOI: 10.1007/s12160-017-9880-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Sleep duration and breast cancer prognosis: perspectives from the Women's Healthy Eating and Living Study. Breast Cancer Res Treat 2017; 162:581-589. [PMID: 28190251 DOI: 10.1007/s10549-017-4140-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 02/02/2017] [Indexed: 10/20/2022]
Abstract
PURPOSE To examine whether baseline sleep duration or changes in sleep duration are associated with breast cancer prognosis among early-stage breast cancer survivors in the multi-center Women's Healthy Eating and Living Study. METHODS Data were collected from 1995 to 2010. Analysis included 3047 women. Sleep duration was self-reported at baseline and follow-up intervals. Cox proportional hazard models were used to investigate whether baseline sleep duration was associated with breast cancer recurrence, breast cancer-specific mortality, and all-cause mortality. Time-varying models investigated whether changes in sleep duration were associated with breast cancer prognosis. RESULTS Compared to women who slept 7-8 h/night at baseline, sleeping ≥9 h/night was associated with a 48% increased risk of breast cancer recurrence (Hazard ratio [HR] 1.48, 95% Confidence interval [CI] 1.01, 2.00), a 52% increased risk of breast cancer-specific mortality (HR 1.52, 95% CI 1.09, 2.13), and a 43% greater risk of all-cause mortality (HR 1.43, 95% CI 1.07, 1.92). Time-varying models showed analogous increased risk in those who inconsistently slept ≥9 h/night (all P < 0.05), but not in those who consistently slept ≥9 h/night. CONCLUSIONS Consistent long or short sleep, which may reflect inter-individual variability in the need for sleep, does not appear to influence prognosis among early-stage breast cancer survivors.
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Schapmire TJ, Faul AC. Depression symptoms in older adults with cancer: A multilevel longitudinal study. J Psychosoc Oncol 2017; 35:260-277. [DOI: 10.1080/07347332.2017.1286698] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Tara J. Schapmire
- School of Medicine, University of Louisville, Louisville, KY, USA
- Kent School of Social Work, University of Louisville, Louisville, KY, USA
| | - Anna C. Faul
- Kent School of Social Work, University of Louisville, Louisville, KY, USA
- Department of Social Work, University of the Free State, Bloemfontein, South Africa
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Sharma N, Purkayastha A. Impact of Radiotherapy on Psychological, Financial, and Sexual Aspects in Postmastectomy Carcinoma Breast Patients: A Prospective Study and Management. Asia Pac J Oncol Nurs 2017; 4:69-76. [PMID: 28217733 PMCID: PMC5297236 DOI: 10.4103/2347-5625.199075] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 10/11/2016] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess the impact of radiotherapy (RT) on psychological, financial, and sexual aspects in postmastectomy carcinoma breast patients affecting their quality of life (QOL) before, during, and after RT with a strong emphasis on their management and rehabilitation aspects. METHODS A cross-sectional study carried out in a specialized institution, comprising sixty women. Two standardized questionnaires European Organization for Research and Treatment of Cancer (EORTC) 30-item Quality of Life Questionnaire and Quality of Life Questionnaire breast cancer-23 (QLQ-BR23) for health-related quality, translated and validated for the Hindi language were used. The scores' manual of the EORTC was used to calculate the domain scores of the questionnaires. RESULTS According to the first questionnaire, the emotional function was most affected even at onset of RT treatment and it was worst at the completion of RT treatment with a mean score of 63.75. The global QOL score was also worst at the end of radiation treatment with a mean score of 32.36, while the score 3 months after completion of treatment was 68.16. The symptoms with the highest scores were insomnia with a worst scoring at completion of treatment (29.99), fatigue (26.57), and pain (23.05). According to the QLQ-BR23, the mean score for side effects such as sexual functioning was minimum 0.55 at the completion of RT, which improved to 11.66 on the first follow-up after 3 months. Mean future perspective score which was 57.22 before the start of RT which was reduced to 50.55 at completion, which means that many women experience side effects of RT and impaired sexual satisfaction. CONCLUSIONS Women with breast cancer showed changes in the following domains: financial, emotional, sexual satisfaction, and future prospects. The most frequently mentioned symptoms were fatigue, insomnia, and pain.
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Affiliation(s)
- Neelam Sharma
- Department of Radiation Oncology, Army Hospital Research and Referral, New Delhi, India
| | - Abhishek Purkayastha
- Department of Radiation Oncology, Army Hospital Research and Referral, New Delhi, India
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Baeza-Velasco C, Baguet F, Allart P, Aguerre C, Sultan S, Ninot G, Soubeyran P, Cousson-Gelie F. Major depressive disorder and associated factors in elderly patients with non-Hodgkin’s lymphoma. Health Psychol Behav Med 2016. [DOI: 10.1080/21642850.2016.1264879] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Carolina Baeza-Velasco
- Institut de Psychologie, Université Paris Descartes, Sorbonne Paris Cité, Laboratoire de Psychopathologie et Processus de Santé EA, Paris, France
| | - Fanny Baguet
- Institut Régional du Cancer de Montpellier, Epidaure Pôle Prévention, Montpellier, France
- Université Montpellier 1 & 3, Laboratory Epsylon EA, Dynamics of Human Abilities and Health Behaviors, Montpellier, France
| | - Priscilla Allart
- Université de Bordeaux, Laboratoire Psychologie Santé et Qualité de Vie EA, Bordeaux, France
| | - Colette Aguerre
- Université François Rabelais, Laboratoire Psychologie des Ages de la Vie EA, Tours, France
| | - Serge Sultan
- Université de Montréal, CHU Sainte-Justine, QC, Canada
| | - Gregory Ninot
- Université Montpellier 1 & 3, Laboratory Epsylon EA, Dynamics of Human Abilities and Health Behaviors, Montpellier, France
| | - Pierre Soubeyran
- Departement d'Oncologie Médicale, Institut Bergonié, Bordeaux, France
| | - Florence Cousson-Gelie
- Institut Régional du Cancer de Montpellier, Epidaure Pôle Prévention, Montpellier, France
- Université Montpellier 1 & 3, Laboratory Epsylon EA, Dynamics of Human Abilities and Health Behaviors, Montpellier, France
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Yang H, Brand JS, Fang F, Chiesa F, Johansson ALV, Hall P, Czene K. Time-dependent risk of depression, anxiety, and stress-related disorders in patients with invasive and in situ breast cancer. Int J Cancer 2016; 140:841-852. [PMID: 27859142 DOI: 10.1002/ijc.30514] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 10/25/2016] [Indexed: 11/07/2022]
Abstract
Despite concerns about the mental health of breast cancer patients, little is known regarding the temporal risk pattern and risk factors of common mental disorders among these patients. We estimated standardized incidence ratios (SIRs) of depression, anxiety and stress-related disorders in a Swedish nationwide cohort of 40,849 women with invasive and 4,402 women with in situ breast cancer (2001-2010, median follow-up = 4.5 years). The impact of patient, tumor and treatment characteristics was analyzed using flexible parametric survival models in a regional cohort of 7,940 invasive breast cancer patients (2001-2013, median follow-up = 7.5 years). Women with invasive breast cancer showed increased rates of depression, anxiety and stress-related disorders [overall SIR (95% CI) = 1.57 (1.46-1.69), 1.55 (1.43-1.68) and 1.77 (1.60-1.95), respectively]. SIRs were highest shortly after diagnosis, but remained increased up to 5 years. Younger age at diagnosis, comorbidity, higher-grade disease, lymph node involvement and chemotherapy were independently associated with the risk of depression and anxiety in invasive cancer patients, with chemotherapy and higher-grade disease conferring short-term risk only, while comorbidities were mainly associated with late-onset events. No clinical risk factors were identified for stress-related disorders except for a greater risk associated with younger age. Patients with in situ cancer only showed an increased incidence of stress-related disorders during the first 6 months after diagnosis [SIR (95% CI) = 2.76 (1.31-5.79)]. The time-dependent risk profile of invasive cancer patients may guide health care professionals for timely and targeted psycho-oncologic interventions.
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Affiliation(s)
- Haomin Yang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Judith S Brand
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Fang Fang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Flaminia Chiesa
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna L V Johansson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Sullivan DR, Forsberg CW, Ganzini L, Au DH, Gould MK, Provenzale D, Slatore CG. Longitudinal Changes in Depression Symptoms and Survival Among Patients With Lung Cancer: A National Cohort Assessment. J Clin Oncol 2016; 34:3984-3991. [PMID: 27996350 PMCID: PMC5477833 DOI: 10.1200/jco.2016.66.8459] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Purpose Depression symptoms are common among patients with lung cancer; however, longitudinal changes and their impact on survival are understudied. Methods This was a prospective, observational study from the Cancer Care Outcomes Research and Surveillance Consortium from five US geographically defined regions from September 2003 through December 2005. Patients enrolled within 3 months of their lung cancer diagnosis were eligible. The eight-item Center for Epidemiologic Studies Depression scale was administered at diagnosis and 12 months' follow-up. The main outcome was survival, which was evaluated using Kaplan-Meyer curves and adjusted Cox proportional hazards modeling. Results Among 1,790 participants, 681 (38%) had depression symptoms at baseline and an additional 105 (14%) developed new-onset depression symptoms during treatment. At baseline, depression symptoms were associated with increased mortality (hazard ratio [HR], 1.17; 95% CI, 1.03 to 1.32; P = .01). Participants were classified into the following four groups based on longitudinal changes in depression symptoms from baseline to follow-up: never depression symptoms (n = 640), new-onset depression symptoms (n = 105), depression symptom remission (n = 156), and persistent depression symptoms (n = 254) and HRs were calculated. Using the never-depression symptoms group as a reference group, HRs were as follows: new-onset depression symptoms, 1.50 (95% CI, 1.12 to 2.01; P = .006); depression symptom remission, 1.02 (95% CI, 0.79 to 1.31; P = .89), and persistent depression symptoms, 1.42 (95% CI, 1.15 to 1.75; P = .001). At baseline, depression symptoms were associated with increased mortality among participants with early-stage disease (stages I and II; HR, 1.61; 95% CI, 1.26 to 2.04), but not late-stage disease (stages III and IV; HR, 1.05; 95% CI, 0.91 to 1.22). At follow-up, depression symptoms were associated with increased mortality among participants with early-stage disease (HR, 1.71; 95% CI, 1.27 to 2.31) and those with late-stage disease (HR, 1.32; 95% CI, 1.04 to 1.69). Conclusion Among patients with lung cancer, longitudinal changes in depression symptoms are associated with differences in mortality, particularly among patients with early-stage disease. Symptom remission is associated with a similar mortality rate as never having had depression.
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Affiliation(s)
- Donald R. Sullivan
- Donald R. Sullivan, Christopher G. Slatore, and Linda Ganzini, Oregon Health & Science University; Donald R. Sullivan, Christopher W. Forsberg, Linda Ganzini, and Christopher G. Slatore, Veterans Affairs Portland Health Care System, Portland, OR; David H. Au, Veterans Affairs Puget Sound Health Care System David H. Au, University of Washington, Seattle, WA; Michael K. Gould, Kaiser Permanente Southern California, Pasadena; Michael K. Gould, University of Southern California, Los Angeles, CA; Dawn Provenzale, Durham VA Medical Center; and Dawn Provenzale, Duke University, Durham, NC
| | - Christopher W. Forsberg
- Donald R. Sullivan, Christopher G. Slatore, and Linda Ganzini, Oregon Health & Science University; Donald R. Sullivan, Christopher W. Forsberg, Linda Ganzini, and Christopher G. Slatore, Veterans Affairs Portland Health Care System, Portland, OR; David H. Au, Veterans Affairs Puget Sound Health Care System David H. Au, University of Washington, Seattle, WA; Michael K. Gould, Kaiser Permanente Southern California, Pasadena; Michael K. Gould, University of Southern California, Los Angeles, CA; Dawn Provenzale, Durham VA Medical Center; and Dawn Provenzale, Duke University, Durham, NC
| | - Linda Ganzini
- Donald R. Sullivan, Christopher G. Slatore, and Linda Ganzini, Oregon Health & Science University; Donald R. Sullivan, Christopher W. Forsberg, Linda Ganzini, and Christopher G. Slatore, Veterans Affairs Portland Health Care System, Portland, OR; David H. Au, Veterans Affairs Puget Sound Health Care System David H. Au, University of Washington, Seattle, WA; Michael K. Gould, Kaiser Permanente Southern California, Pasadena; Michael K. Gould, University of Southern California, Los Angeles, CA; Dawn Provenzale, Durham VA Medical Center; and Dawn Provenzale, Duke University, Durham, NC
| | - David H. Au
- Donald R. Sullivan, Christopher G. Slatore, and Linda Ganzini, Oregon Health & Science University; Donald R. Sullivan, Christopher W. Forsberg, Linda Ganzini, and Christopher G. Slatore, Veterans Affairs Portland Health Care System, Portland, OR; David H. Au, Veterans Affairs Puget Sound Health Care System David H. Au, University of Washington, Seattle, WA; Michael K. Gould, Kaiser Permanente Southern California, Pasadena; Michael K. Gould, University of Southern California, Los Angeles, CA; Dawn Provenzale, Durham VA Medical Center; and Dawn Provenzale, Duke University, Durham, NC
| | - Michael K. Gould
- Donald R. Sullivan, Christopher G. Slatore, and Linda Ganzini, Oregon Health & Science University; Donald R. Sullivan, Christopher W. Forsberg, Linda Ganzini, and Christopher G. Slatore, Veterans Affairs Portland Health Care System, Portland, OR; David H. Au, Veterans Affairs Puget Sound Health Care System David H. Au, University of Washington, Seattle, WA; Michael K. Gould, Kaiser Permanente Southern California, Pasadena; Michael K. Gould, University of Southern California, Los Angeles, CA; Dawn Provenzale, Durham VA Medical Center; and Dawn Provenzale, Duke University, Durham, NC
| | - Dawn Provenzale
- Donald R. Sullivan, Christopher G. Slatore, and Linda Ganzini, Oregon Health & Science University; Donald R. Sullivan, Christopher W. Forsberg, Linda Ganzini, and Christopher G. Slatore, Veterans Affairs Portland Health Care System, Portland, OR; David H. Au, Veterans Affairs Puget Sound Health Care System David H. Au, University of Washington, Seattle, WA; Michael K. Gould, Kaiser Permanente Southern California, Pasadena; Michael K. Gould, University of Southern California, Los Angeles, CA; Dawn Provenzale, Durham VA Medical Center; and Dawn Provenzale, Duke University, Durham, NC
| | - Christopher G. Slatore
- Donald R. Sullivan, Christopher G. Slatore, and Linda Ganzini, Oregon Health & Science University; Donald R. Sullivan, Christopher W. Forsberg, Linda Ganzini, and Christopher G. Slatore, Veterans Affairs Portland Health Care System, Portland, OR; David H. Au, Veterans Affairs Puget Sound Health Care System David H. Au, University of Washington, Seattle, WA; Michael K. Gould, Kaiser Permanente Southern California, Pasadena; Michael K. Gould, University of Southern California, Los Angeles, CA; Dawn Provenzale, Durham VA Medical Center; and Dawn Provenzale, Duke University, Durham, NC
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Sullivan DR, Forsberg CW, Ganzini L, Au DH, Gould MK, Provenzale D, Lyons KS, Slatore CG. Depression symptom trends and health domains among lung cancer patients in the CanCORS study. Lung Cancer 2016; 100:102-109. [PMID: 27597288 PMCID: PMC5015687 DOI: 10.1016/j.lungcan.2016.08.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 08/09/2016] [Accepted: 08/14/2016] [Indexed: 01/19/2023]
Abstract
OBJECTIVES Among lung cancer patients depression symptoms are common and impact outcomes. The aims of this study were to determine risk factors that contribute to persistent or new onset depression symptoms during lung cancer treatment, and examine interactions between depression symptoms and health domains that influence mortality. MATERIALS AND METHODS Prospective observational study in five healthcare systems and 15 Veterans Affairs medical centers. Patients in the Cancer Care Outcomes Research and Surveillance (CanCORS) Consortium with lung cancer were eligible. The 8-item Center for Epidemiologic Studies Depression (CES-D) scale was administered at baseline and follow-up. Scores ≥4 indicated elevated depressive symptoms. Health domains were measured using validated instruments. We applied logistic regression and Cox proportional hazards modeling to explore the association between depression symptoms, health domains, and mortality. RESULTS Of 1790 participants, 38% had depression symptoms at baseline and among those still alive, 31% at follow-up. Risk factors for depression symptoms at follow-up included younger age (OR=2.81), female sex (OR=1.59), low income (OR=1.45), not being married (OR=1.74) and current smoking status (OR=1.80); high school education was associated with reduced odds of depression symptoms at follow-up, compared with lesser educational attainment (OR=0.74) (all p values <0.05). Patients with depression symptoms had worse health-related quality of life, vitality, cancer-specific symptoms, and social support than patients without depression symptoms (all p<0.001). The association between depression symptoms and increased mortality is greater among patients with more lung cancer symptoms (p=0.008) or less social support (p=0.04). CONCLUSIONS Patient risk factors for depression symptoms at follow-up were identified and these subgroups should be targeted for enhanced surveillance. Patients with depression symptoms suffer across all health domains; however, only more lung cancer symptoms or less social support are associated with worse mortality among these patients. These potentially modifiable health domains suggest targets for possible intervention in future studies.
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Affiliation(s)
- D R Sullivan
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health and Science University, Portland, OR, United States; Health Services Research and Development, Veterans Affairs Portland Health Care System, Portland, OR, United States.
| | - C W Forsberg
- Health Services Research and Development, Veterans Affairs Portland Health Care System, Portland, OR, United States
| | - L Ganzini
- Health Services Research and Development, Veterans Affairs Portland Health Care System, Portland, OR, United States; Division of Geriatric Psychiatry, Department of Psychiatry, Oregon Health and Science University, Portland, OR, United States
| | - D H Au
- Health Services Research and Development Service, Veterans Affairs Puget Sound Health Care System, and Department of Medicine, University of Washington, Seattle, WA, United States
| | - M K Gould
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States; Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - D Provenzale
- VA Cooperative Studies Program Epidemiology Center-Durham, Durham VA Medical Center, and Duke University, Durham, NC, United States
| | - K S Lyons
- School of Nursing, Oregon Health and Science University, Portland, OR, United States
| | - C G Slatore
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Oregon Health and Science University, Portland, OR, United States; Health Services Research and Development, Veterans Affairs Portland Health Care System, Portland, OR, United States; Section of Pulmonary and Critical Care Medicine, Veterans Affairs Portland Health Care System, Portland, OR, United States
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Lang MJ, David V, Giese-Davis J. The Age Conundrum: A Scoping Review of Younger Age or Adolescent and Young Adult as a Risk Factor for Clinical Distress, Depression, or Anxiety in Cancer. J Adolesc Young Adult Oncol 2016; 4:157-73. [PMID: 26697266 DOI: 10.1089/jayao.2015.0005] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
This scoping review was conducted to understand the extent, range, and nature of current research on adolescents and young adults (AYA) with cancer and distress, depression, and anxiety (DDA). This information is necessary to find and aggregate valuable data on the AYA population embedded in generalized studies of DDA. Keyword searches of six relevant electronic databases identified 2156 articles, with 316 selected for abstract review and 40 for full text review. Full-text reviews and data extraction resulted in 34 studies being included, which ranged widely in design, sample size, age-range categorization, analysis methods, DDA measurement tool, overall study rigor, and quality of evidence. Studies very seldom reported using theory to guide their age categorization, with only four studies giving any rationale for their age-group definitions. All 34 studies found a significant association between at least one DDA construct and the younger age group relative to the older age groups at some point along the cancer trajectory. However, age as an independent risk factor for DDA is still unclear, as the relationship could be confounded by other age-related factors. Despite the wide range of definitions and effect sizes in the studies included in this review, one thing is clear: adolescents and young adults, however defined, are a distinct group within the cancer population with an elevated risk of DDA. Widespread adoption of a standard AYA age-range definition will be essential to any future meta-analytical psycho-oncology research in this population.
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Affiliation(s)
- Michael J Lang
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary , Alberta, Canada . ; Provincial Integrated Survivorship Program, Provincial Practices, Alberta Health Services-Cancer Control , Alberta, Canada
| | - Victoria David
- Undergraduate Medical Education, Cumming School of Medicine, University of Calgary , Alberta, Canada
| | - Janine Giese-Davis
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary , Alberta, Canada . ; Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services-Cancer Control , Alberta, Canada . ; Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary , Alberta, Canada
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Wang JB, Pierce JP, Ayala GX, Cadmus-Bertram LA, Flatt SW, Madanat H, Newman VA, Nichols JF, Natarajan L. Baseline Depressive Symptoms, Completion of Study Assessments, and Behavior Change in a Long-Term Dietary Intervention Among Breast Cancer Survivors. Ann Behav Med 2016; 49:819-27. [PMID: 26091977 PMCID: PMC4633436 DOI: 10.1007/s12160-015-9716-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background Depressive symptoms can lower adherence and change in dietary studies. Behavioral activation may reduce these effects. Purpose This study aims to assess relationships among depressive symptoms on adherence and dietary change in the Women’s Healthy Eating and Living (WHEL) Study Methods Secondary analyses from the WHEL Study, which achieved major dietary change in breast cancer survivors (N = 2817), were conducted. Logistic regressions were undertaken of baseline depressive symptoms (six-item Center for Epidemiologic Studies Depression Scale (CES-D)) with (1) completion of 1- and 4-year study assessments and (2) validated change in dietary behavior in the intervention group. Results In the comparison group (vs. intervention), depressive symptoms lowered completion of dietary recalls and clinic visits [4 years: odds ratio (OR) = 2.0; 95 % confidence interval (CI) = 1.4–3.0]. The behaviorally oriented intervention achieved major change in those furthest from study targets, although changes were lower in those with depressive symptoms: fruit/vegetable (+37.2 %), fiber (+49.0 %), and fat (−22.4 %). Conclusions Behavioral activation in dietary change interventions can overcome the impact of depressive symptoms.
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Affiliation(s)
- Julie B Wang
- University of California, San Diego, 530 Parnassus Avenue, Library Room 366, San Francisco, CA,, 94143, USA
| | - John P Pierce
- University of California, San Diego, Family Medicine and Public Health, 9500 Gilman Drive, MC 0901, La Jolla, 92093-0901, CA, USA. .,University of California, San Diego, Moores Cancer Center 3855 Health Sciences Drive, MC 0901, La Jolla, CA,, 92093-0901, USA.
| | - Guadalupe X Ayala
- San Diego State University, Graduate School of Public Health, 5500 Campanile, MC 4124, San Diego, CA, 92182-4124, USA.,San Diego State University, Institute for Behavioral And Community Health, 9245 Sky Park Court, Ste. 221, San Diego, CA 92123-4311, USA
| | - Lisa A Cadmus-Bertram
- University of Wisconsin - Madison, Department of Kinesiology, 2000 Observatory Drive, Madison, WI, 53706, USA
| | - Shirley W Flatt
- University of California, San Diego, Moores Cancer Center 3855 Health Sciences Drive, MC 0901, La Jolla, CA,, 92093-0901, USA
| | - Hala Madanat
- San Diego State University, Institute for Behavioral And Community Health, 9245 Sky Park Court, Ste. 221, San Diego, CA 92123-4311, USA.,San Diego State University, Graduate School of Public Health, 5500 Campanile MC 4162, San Diego, CA, 92182-4162, USA
| | - Vicky A Newman
- University of California, San Diego, Moores Cancer Center 3855 Health Sciences Drive, MC 0901, La Jolla, CA,, 92093-0901, USA
| | - Jeanne F Nichols
- San Diego State University, Institute for Behavioral And Community Health, 9500 Gilman Drive, MC 0811, La Jolla, CA, 92093-0811, USA
| | - Loki Natarajan
- University of California, San Diego, Family Medicine and Public Health, 9500 Gilman Drive, MC 0901, La Jolla, 92093-0901, CA, USA.,University of California, San Diego, Moores Cancer Center 3855 Health Sciences Drive, MC 0901, La Jolla, CA,, 92093-0901, USA
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O'Hea EL, Monahan BR, Cutillo A, Person SD, Grissom G, Boudreaux ED. Predictors of psychological distress and interest in mental health services in individuals with cancer. J Health Psychol 2016; 21:1145-56. [PMID: 25205777 PMCID: PMC5103309 DOI: 10.1177/1359105314547752] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Identifying risk factors for psychological distress in patients with cancer may help providers more efficiently screen, identify, and manage distress. This article presents predictors of psychological distress in a large heterogeneous sample of cancer patients. In total, 836 patients were enrolled in a large randomized control trial and completed computerized psychosocial assessments Mental Health Assessment and Dynamic Referral for Oncology. Multivariate regressions examined predictors of distress and interest in mental health services. Final models suggest that psychological distress was related to six variables, and interest in mental health services was related to previous history of mental health counseling, total number of cancer-related symptoms, and race/ethnicity. Results may be used to identify high-risk patients who may benefit from proactive psychosocial interventions.
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Affiliation(s)
- Erin L O'Hea
- Stonehill College, USA University of Massachusetts Medical School, USA
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Socio-demographic and clinical variables associated with psychological distress 1 and 3 years after breast cancer diagnosis. Support Care Cancer 2016; 24:4017-23. [PMID: 27129841 DOI: 10.1007/s00520-016-3242-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 04/24/2016] [Indexed: 01/06/2023]
Abstract
PURPOSE A large group of women (20-30 %) report psychological distress shortly after breast cancer diagnosis, and some experience continued or increased symptoms over time. The aim of this study was to investigate socio-demographic and clinical variables associated with sustained psychological distress in this patient group. METHODS Women with breast cancer (n = 833) completed self-report questionnaires regarding socio-demographic and clinical variables shortly after (T1) and 3 years after diagnosis (T2) while data on illness severity were collected from a quality register. The Hospital Anxiety and Depression Scale was used as a measure of psychological distress at both time points. RESULTS The number of participants who reported elevated levels of anxiety was 231 (28 %) at T1 and 231 (28 %) at T2 while elevated depressive symptoms was reported by 119 (14 %) women at T1 and 92 (11 %) at T2. Despite non-significant differences in mean scores over time, 91 (15 %) participants reported increased anxiety symptoms and 47 (7 %) reported increased depressive symptoms. Poor financial situation, lack of social support, previous psychiatric treatment, and high levels of fatigue were associated with both anxiety and depressive symptoms. Reporting high levels of fatigue was the variable most strongly associated with increased psychological distress over time. CONCLUSION Most participants reported decreased psychological distress over time, but there were subgroups of women who experienced sustained or increased symptoms of anxiety or depression. Participants with poor financial status, previous psychological problems, or high levels of fatigue may be at increased risk of psychological distress. Such individuals may benefit most from psychosocial interventions.
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Depressive symptom trajectories in women affected by breast cancer and their male partners: a nationwide prospective cohort study. J Cancer Surviv 2016; 10:915-26. [PMID: 27084710 DOI: 10.1007/s11764-016-0538-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 03/21/2016] [Indexed: 12/21/2022]
Abstract
PURPOSE The purpose of this study was to identify subgroups of breast cancer patients and their partners based on distinct trajectories of depressive symptoms, to examine how relationship quality and medical and sociodemographic factors were associated with these trajectories, and to explore whether patients and partners had similar trajectories. METHODS A nationwide, population-based cohort of couples dealing with breast cancer was established in Denmark. Participants completed the Center for Epidemiologic Studies-Depression Scale at baseline and 5 and 12 months later. Sociodemographic and medical characteristics were retrieved from registers. A trajectory finite mixture model was used to identify trajectories. RESULTS The trajectories of depressive symptoms over time were analyzed in 546 patients and 508 partners. Among patients, 13 % had a high stable trajectory, 38 % an intermediate decreasing trajectory, and 49 % a low trajectory. Similar trajectories were found for partners (11, 22, and 67 %, respectively). Compared to the low trajectory, trajectories with higher depressive symptoms were associated with poorer relationship quality and previous use of antidepressants for patients and partners and with younger age, comorbidity, basic education, and chemotherapy for patients. The trajectories of patients and their partners were weakly correlated. CONCLUSIONS A considerable minority of patients and partners had a persistently high level of depressive symptoms. Poorer relationship quality and previous antidepressant use most consistently characterized patients and partners with higher depressive symptom trajectories. IMPLICATIONS FOR CANCER SURVIVORS In clinical practice, attention to differences in depressive symptom trajectories is important to identify and target patients and partners who might need support.
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Champagne AL, Brunault P, Huguet G, Suzanne I, Senon JL, Body G, Rusch E, Magnin G, Voyer M, Réveillère C, Camus V. Personality disorders, but not cancer severity or treatment type, are risk factors for later generalised anxiety disorder and major depressive disorder in non metastatic breast cancer patients. Psychiatry Res 2016; 236:64-70. [PMID: 26747215 DOI: 10.1016/j.psychres.2015.12.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 10/06/2015] [Accepted: 12/25/2015] [Indexed: 01/06/2023]
Abstract
This study aimed to determine whether personality disorders were associated with later Major Depressive Disorder (MDD) or Generalised Anxiety Disorder (GAD) in breast cancer patients. This longitudinal and multicentric study included 120 French non-metastatic breast cancer patients. After cancer diagnosis (T1) and 7 months after diagnosis (T3), we assessed MDD and GAD (Mini International Neuropsychiatric Interview 5.0). We assessed personality disorders 3 months after diagnosis (VKP). We used multiple logistic regression analysis to determine what were the factors associated with GAD and MDD at T3. At T3, prevalence rate was 10.8% for MDD and 19.2% for GAD. GAD at T3 was significantly and independently associated with GAD at T1 and with existence of a personality disorder, no matter the cluster type. MDD at T3 was significantly and independently associated with MDD at T1 and with the existence of a cluster C personality disorder. Initial cancer severity and the type of treatment used were not associated with GAD or MDD at T3. Breast cancer patients with personality disorders are at higher risk for GAD and MDD at the end of treatment. Patients with GAD should be screened for personality disorders. Specific interventions for patients with personality disorders could prevent psychiatric disorders.
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Affiliation(s)
- Anne-Laure Champagne
- CHRU de Tours, Clinique Psychiatrique Universitaire, 2 Boulevard Tonnellé, 37042 Tours Cedex 9, France
| | - Paul Brunault
- CHRU de Tours, Clinique Psychiatrique Universitaire, 2 Boulevard Tonnellé, 37042 Tours Cedex 9, France; CHRU de Tours, Équipe de Liaison et de Soins en Addictologie, 2 Boulevard Tonnellé, 37042 Tours Cedex 9, France; Université François Rabelais de Tours, Département de Psychologie, EA 2114 « Psychologie des Âges de la Vie », 3 rue des Tanneurs BP 4103, 37041 Tours Cedex 1, France.
| | - Grégoire Huguet
- CHRU de Tours, Clinique Psychiatrique Universitaire, 2 Boulevard Tonnellé, 37042 Tours Cedex 9, France
| | - Isabelle Suzanne
- CHRU de Tours, Clinique Psychiatrique Universitaire, 2 Boulevard Tonnellé, 37042 Tours Cedex 9, France
| | - Jean-Louis Senon
- Centre Hospitalier Henri-Laborit, Service de Psychiatrie, 370 Avenue Jacques Cœur, 86021 Poitiers, France
| | - Gilles Body
- CHRU de Tours, Service de Gynécologie Obstétrique, 2 Boulevard Tonnellé, 37042 Tours Cedex 9, France
| | - Emmanuel Rusch
- CHRU de Tours, Service d'Information Médicale, Epidémiologie et Economie de la Santé, 2 Boulevard Tonnellé, 37042 Tours Cedex 9, France
| | - Guillaume Magnin
- CHU de Poitiers, Service de Gynécologie Obstétrique, 2 rue de la Milétrie, 86021 Poitiers, France
| | - Mélanie Voyer
- Centre Hospitalier Henri-Laborit, Service de Psychiatrie, 370 Avenue Jacques Cœur, 86021 Poitiers, France
| | - Christian Réveillère
- Université François Rabelais de Tours, Département de Psychologie, EA 2114 « Psychologie des Âges de la Vie », 3 rue des Tanneurs BP 4103, 37041 Tours Cedex 1, France
| | - Vincent Camus
- CHRU de Tours, Clinique Psychiatrique Universitaire, 2 Boulevard Tonnellé, 37042 Tours Cedex 9, France; UMR INSERM U930, 2 boulevard Tonnellé, 37044 Tours Cedex, France; Université François Rabelais de Tours, 3 rue des Tanneurs BP 4103, 37041 Tours Cedex 1, France
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Prevalence of depressive syndrome in patients with breast cancer treated with or without aromatase inhibitors. ONCOLOGIE 2015. [DOI: 10.1007/s10269-015-2573-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Wada S, Shimizu K, Inoguchi H, Shimoda H, Yoshiuchi K, Akechi T, Uchida M, Ogawa A, Fujisawa D, Inoue S, Uchitomi Y, Matsushima E. The Association Between Depressive Symptoms and Age in Cancer Patients: A Multicenter Cross-Sectional Study. J Pain Symptom Manage 2015; 50:768-77. [PMID: 26300022 DOI: 10.1016/j.jpainsymman.2015.07.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 07/04/2015] [Accepted: 07/13/2015] [Indexed: 11/17/2022]
Abstract
CONTEXT There is controversy around the association between depressive symptoms and age in adult cancer patients. OBJECTIVES The aim of this study was to evaluate the following hypotheses: 1) cancer patients' depressive symptoms decrease with age, and 2) in individuals aged 65 years or older, depressive symptoms increase because of the effect of somatic symptoms. METHODS We retrospectively analyzed a database of 356 cancer patients who were consecutively recruited in a previous multicenter cross-sectional study. Depressive symptoms were assessed by the Patient Health Questionnaire-9 (PHQ-9), and correlations with age and other factors were assessed by hierarchical multivariate regression analysis. Age was entered as the dependent variable in the first step, patient characteristics and cancer-related variables were entered in the second step, and somatic symptoms were entered in the last step. We analyzed this model for both the total sample and the subpopulation aged 65 years or older. RESULTS In the total sample, the PHQ-9 score was significantly associated with lower age, fatigue, and shortness of breath (adjusted R(2) 14.2%). In the subpopulation aged 65 years or older, no factor was associated with the PHQ-9 score (adjusted R(2) 7.3%). CONCLUSION The finding that depressive symptoms in cancer patients decreased with age was concordant with our first hypothesis, but the second hypothesis was not supported. Younger cancer patients were vulnerable to depressive symptoms and should be monitored carefully. Further studies using more representative samples are needed to examine in detail the association between depressive symptoms and age in older cancer patients.
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Affiliation(s)
- Saho Wada
- Department of Psycho-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Section of Liaison, Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Ken Shimizu
- Department of Psycho-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.
| | - Hironobu Inoguchi
- Department of Psycho-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan
| | - Haruki Shimoda
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira-shi, Tokyo, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tatsuo Akechi
- Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya-shi, Aichi, Japan; Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya-shi, Aichi, Japan
| | - Megumi Uchida
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya-shi, Aichi, Japan
| | - Asao Ogawa
- Division of Psycho-Oncology, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa-shi, Chiba, Japan; Department of Psycho-Oncology Service, National Cancer Center Hospital East, Kashiwa-shi, Chiba, Japan
| | - Daisuke Fujisawa
- Division of Psycho-Oncology, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa-shi, Chiba, Japan; Department of Psycho-Oncology Service, National Cancer Center Hospital East, Kashiwa-shi, Chiba, Japan
| | - Shinichirou Inoue
- Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama-shi, Okayama, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center, Chuo-ku, Tokyo, Japan
| | - Eisuke Matsushima
- Section of Liaison, Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
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48
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Stanton AL, Wiley JF, Krull JL, Crespi CM, Hammen C, Allen JJB, Barrón ML, Jorge A, Weihs KL. Depressive episodes, symptoms, and trajectories in women recently diagnosed with breast cancer. Breast Cancer Res Treat 2015; 154:105-15. [PMID: 26420401 PMCID: PMC6453702 DOI: 10.1007/s10549-015-3563-4] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 09/01/2015] [Indexed: 01/20/2023]
Abstract
Depression carries serious psychosocial, physical, and economic consequences for cancer survivors. Study goals were to characterize patterns and predictors of depressive symptoms and major depressive episodes in recently diagnosed breast cancer patients. Consecutively recruited women (N = 460) completed a validated interview (CIDI) and questionnaire measure (CES-D) of depression within 4 months after invasive breast cancer diagnosis and at six additional assessments across 12 months. Outcomes were major depressive episodes, continuous symptom scores, and latent symptom trajectory classes. Across 12 months, 16.6 % of women met criteria for a major depressive episode. Unemployment predicted depressive episodes after other correlates were controlled. Distinct trajectory classes were apparent: an estimated 38 % of women had chronically elevated symptoms (High trajectory), 20 % recovered from elevated symptoms (Recovery), and 43 % had lower symptoms (Low and Very Low trajectories). Although 96 % of episodes occurred in the High or Recovery classes, 66 % of women in the High trajectory did not have an episode. Women in the Low (vs High) trajectory were more likely to be older, retired, more affluent, and have fewer comorbid diseases and briefer oncologic treatment. Women in the Recovery trajectory (vs High) were more likely to be married and more affluent and have fewer comorbid diseases. Assuming available therapeutic resources, assessment of both depressive symptoms and episodes over several months after diagnosis is important. Identification of patients at risk for persistently high depressive symptoms (e.g., younger, longer treatment course) opens targeted opportunities to prevent and promote rapid recovery from depression.
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Affiliation(s)
- Annette L Stanton
- Department of Psychology, University of California, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA.
- Departments of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA.
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, USA.
| | - Joshua F Wiley
- Department of Psychology, University of California, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Jennifer L Krull
- Department of Psychology, University of California, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - Catherine M Crespi
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, USA
- Department of Biostatistics, University of California, Los Angeles, USA
| | - Constance Hammen
- Department of Psychology, University of California, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
| | - John J B Allen
- Department of Psychology, University of Arizona, Tucson, USA
- University of Arizona Cancer Center, Tucson, USA
| | - Martha L Barrón
- Departments of Psychiatry and Family & Community Medicine, University of Arizona, Tucson, USA
- University of Arizona Cancer Center, Tucson, USA
| | - Alexandra Jorge
- Department of Psychology, University of California, 1285 Franz Hall, Box 951563, Los Angeles, CA, 90095-1563, USA
- Departments of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA
| | - Karen L Weihs
- Departments of Psychiatry and Family & Community Medicine, University of Arizona, Tucson, USA
- University of Arizona Cancer Center, Tucson, USA
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49
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Kim YS, Do H, Lee JW, Jeong J, Shin YW, Yi K, Kim J, Lee SB, Sohn G, Yang N, Oh Y, Kim L, Kim Y, Yu JH, Ko BS, Kim HJ, Son BH, Ahn SH. Patient reporting pain intensity immediately after surgery can be associated with underlying depression in women with breast cancer. Psychooncology 2015; 25:308-15. [DOI: 10.1002/pon.3919] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 06/22/2015] [Accepted: 06/24/2015] [Indexed: 11/10/2022]
Affiliation(s)
- Yoo Seok Kim
- Department of Surgery; Chosun University College of Medicine; Gwangju Korea
| | - Hyuigyung Do
- Department of Nursing; Asan Medical Center; Seoul Korea
| | - Jong Won Lee
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Jaesim Jeong
- Department of Nursing; University of Ulsan College of Medicine; Ulsan Korea
| | - Yong Wook Shin
- Department of Psychiatry; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Kikyoung Yi
- Department of Psychiatry; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Jisun Kim
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Sae Byul Lee
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Guiyun Sohn
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Nuri Yang
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Youngkyung Oh
- Department of Nursing; Asan Medical Center; Seoul Korea
| | - Leeyoung Kim
- Department of Nursing; Asan Medical Center; Seoul Korea
| | - Yeonhee Kim
- Department of Nursing; Asan Medical Center; Seoul Korea
| | - Jong Han Yu
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Beom Seok Ko
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Hee Jeong Kim
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Byung Ho Son
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
| | - Sei Hyun Ahn
- Department of Surgery; University of Ulsan College of Medicine, Asan Medical Center; Seoul Korea
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50
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Canoui-Poitrine F, Reinald N, Laurent M, Guery E, Caillet P, David JP, Tournigand C, Lagrange JL, Bastuji-Garin S, Lemogne C, Paillaud E. Geriatric assessment findings independently associated with clinical depression in 1092 older patients with cancer: the ELCAPA Cohort Study. Psychooncology 2015; 25:104-11. [PMID: 26123351 DOI: 10.1002/pon.3886] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 05/04/2015] [Accepted: 05/26/2015] [Indexed: 01/03/2023]
Abstract
OBJECTIVE We aim to assess the prevalence and associated factors of clinical depression in older patients with cancer. METHODS We studied a prospective cohort of cancer patients aged ≥ 70 years and referred to geriatric oncology clinics between 2007 and 2012. A multidimensional geriatric assessment was performed before choosing the cancer-treatment strategy. Clinical depression was diagnosed by senior geriatricians by a semi-structured interview. It encompassed criteria of the Diagnostic and Statistical Manual of Mental Disorders (fourth edition) and of the International Classification of Diseases (10th edition). Multivariate logistic regression was performed. RESULTS Of 1121 consecutive patients, 1092 had available data (mean age, 80.4 years; women, 48.8%; metastases, 51.3%; cancer location: colorectal 21.1%, breast 16.8%, kidney, bladder or urinary tract 14.0%, and prostate 11.4%). The overall prevalence of clinical depression was 28.4% (95% confidence interval, 25.7-31.2). Factors independently associated with clinical depression by multivariate analysis adjusting for all following factors plus gender, and metastasis were impaired mobility (adjusted odds ratio [aOR], 2.35; 1.59-3.46), impaired functional status defined as Eastern Cooperative Oncology Group Performance Status ≥ 2 (aOR, 2.39; 1.66-3.43) or as activities of daily living < 6 (aOR, 2.43; 1.73-3.41), inpatient status (aOR, 1.68; 1.20-2.37), inadequate social support (aOR, 1.66; 1.16-2.37), cognitive impairment (aOR, 1.76; 1.24-2.49), polypharmacy defined as five or more non-antidepressant drugs (aOR, 1.65; 1.14-2.38), multimorbidity (aOR additional CIRS-G point , 1.08; 1.04-1.12), and cancer-related pain (aOR, 1.76; 1.26-2.46). CONCLUSION In older patients with as-yet untreated cancer at various sites and stages, clinical depression was highly prevalent. Clinical depression was independently associated with several geriatric assessment findings (impaired mobility and function, inadequate social support, cognitive impairment, polypharmacy, and multimorbidity) independently from gender, tumor site, and metastatic status.
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Affiliation(s)
- Florence Canoui-Poitrine
- APHP, Hôpital Henri-Mondor, Service de Santé Publique, F-94000, Créteil, France.,Université Paris-Est, UPEC, DHU A-TVB, IMRB, EA493 CEpiA (Clinical Epidemiology And Ageing), F-94000, Créteil, France
| | - Nicoleta Reinald
- Université Paris-Est, UPEC, DHU A-TVB, IMRB, EA493 CEpiA (Clinical Epidemiology And Ageing), F-94000, Créteil, France.,APHP, Hôpital Henri-Mondor, Département de Gériatrie, Unité de Coordination en Onco-Gériatrie UCOG Sud Val-de-Marne, F-94000, Créteil, France
| | - Marie Laurent
- Université Paris-Est, UPEC, DHU A-TVB, IMRB, EA493 CEpiA (Clinical Epidemiology And Ageing), F-94000, Créteil, France.,APHP, Hôpital Henri-Mondor, Département de Gériatrie, Unité de Coordination en Onco-Gériatrie UCOG Sud Val-de-Marne, F-94000, Créteil, France
| | - Esther Guery
- APHP, Hôpital Henri-Mondor, Service de Santé Publique, F-94000, Créteil, France.,Université Paris-Est, UPEC, DHU A-TVB, IMRB, EA493 CEpiA (Clinical Epidemiology And Ageing), F-94000, Créteil, France.,APHP, Hôpital Henri-Mondor, Unité de Recherche Clinique (URC-Mondor), F-94000, Créteil, France
| | - Philippe Caillet
- Université Paris-Est, UPEC, DHU A-TVB, IMRB, EA493 CEpiA (Clinical Epidemiology And Ageing), F-94000, Créteil, France.,APHP, Hôpital Henri-Mondor, Département de Gériatrie, Unité de Coordination en Onco-Gériatrie UCOG Sud Val-de-Marne, F-94000, Créteil, France
| | - Jean-Philippe David
- Université Paris-Est, UPEC, DHU A-TVB, IMRB, EA493 CEpiA (Clinical Epidemiology And Ageing), F-94000, Créteil, France.,APHP, Hôpital Emile-Roux, Département de Gériatrie, F-94450, Limeil-Brévannes, France
| | - Christophe Tournigand
- APHP, Hôpital Henri-Mondor, Service d'Oncologie Médicale, F-94010, Créteil, France.,Université Paris Est, UPEC, DHU VIC, unité EC2M3, F-94000, Créteil, France
| | - Jean-Leon Lagrange
- APHP, Hôpital Henri-Mondor, Service de Radiothérapie, F-94000, Créteil, France.,Université Paris Est, UPEC, Faculté de Médecine, F-94000, Créteil, France
| | - Sylvie Bastuji-Garin
- APHP, Hôpital Henri-Mondor, Service de Santé Publique, F-94000, Créteil, France.,Université Paris-Est, UPEC, DHU A-TVB, IMRB, EA493 CEpiA (Clinical Epidemiology And Ageing), F-94000, Créteil, France.,APHP, Hôpital Henri-Mondor, Unité de Recherche Clinique (URC-Mondor), F-94000, Créteil, France
| | - Cedric Lemogne
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,APHP, Hôpitaux Universitaires Paris Ouest, Service de Psychiatrie de l'adulte et du sujet âgé, F-75015, Paris, France.,Inserm, U894, Centre Psychiatrie et Neurosciences, F-75015, Paris, France
| | - Elena Paillaud
- Université Paris-Est, UPEC, DHU A-TVB, IMRB, EA493 CEpiA (Clinical Epidemiology And Ageing), F-94000, Créteil, France.,APHP, Hôpital Henri-Mondor, Département de Gériatrie, Unité de Coordination en Onco-Gériatrie UCOG Sud Val-de-Marne, F-94000, Créteil, France
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