Incidence and risk factors for psychological distress in adult female patients with breast cancer: a systematic review and meta-analysis

Psychological distress among cancer patients in African countries: a systematic review and meta-analysis study

BACKGROUND

Cancer is a disease causing abnormal cell proliferation, and can cause stress, anxiety, and emotional reactions in patients. Despite studies in Africa showing psychological distress in cancer patients, a systematic review on this topic has not yet been conducted.

METHODS

To find papers, searches were conducted using PubMed, Scopus, Cochrane Library, Science Direct, African Journal Online, and Google Scholar. This systematic review and meta-analysis encompassed fifteen primary articles from seven African countries that underwent assessment and inclusion. A Microsoft Excel spreadsheet was used to extract the data, which were then transferred to STATA version 14 for analysis. The statistical heterogeneity was evaluated by using Cochran's Q and I2 statistics. Egger regression tests and funnel plot analysis were employed to look for publication bias. A sensitivity analysis and a subgroup analysis were performed.

RESULT

This systematic review and meta-analysis comprised a total of 1567 research participants from 15 different investigations. In Africa, 42.83% of cancer patients overall had a pooled prevalence of psychological distress (95% CI: 19.40, 66.27). Being a rural area (AOR = 2.30; 95% CI: 1.49 to 3.55), having no social support (AOR = 4.63; 95% CI: 2.18 to 9.86), being in stage II cancer (AOR = 2.72; 95% CI: 1.38 to 5.38), having a co-occurring chronic illness (AOR = 2.78; 95% CI: 1.34, 5.74), experiencing financial difficulties (AOR = 16.52; 3.56, 76.63), and experiencing difficult emotional life (AOR = 2.53; 1.07, 5.97) were associated with psychological distress.

CONCLUSION

This study shows that there is a high prevalence of psychological distress among cancer patients in Africa. We have also found a significant relationship between psychological distress and rural living, a lack of social support, an advanced stage of the disease, coexisting medical conditions, financial problems, and emotional difficulties. Early detection to lessen psychological discomfort in this susceptible population is essential to reduce the burden of psychological distress among cancer patients.

Moderators of interdependent psychological distress in cancer survivor-caregiver dyads

BACKGROUND

The purpose of this study was to test dyadic interdependence in psychological distress (anxiety and depressive symptoms) and explore moderators of interdependence among cancer survivors in treatment and their informal caregivers.

METHODS

Cancer survivors and their caregivers completed measures of anxiety and depressive symptoms, social support, social isolation, and burden of other symptoms, at three points in time over the course of 17 weeks.

RESULTS

In 315 dyads, depressive symptoms and anxiety were transmitted from caregivers to survivors. Survivors with high symptom burden or low social support were especially influenced by caregivers' depressive symptoms. Caregivers who had high social isolation or low social support were most likely to be influenced by survivors' depressive symptoms.

CONCLUSION

Psychological distress is transmitted within dyads during cancer treatment. Dyadic interdependence was most pronounced from caregivers to survivors. Symptom burden, social isolation, and low social support enhanced this dyadic interdependence.

Psychiatric disorders in patients with benign and malignant sinonasal tumors: a prospective cross-sectional study

Objective

To assess the prevalence of depression, anxiety, insomnia, and somatic symptom disorder (SSD) in patients with benign and malignant sinonasal tumors.

Materials and methods

Pretreatment patients with sinonasal tumors were prospectively recruited on the rhinology ward of a tertiary hospital from July 2021 to March 2022. The electronic questionnaire which contains the rhinological symptom scale, the 22-item Sinonasal Outcome Test (SNOT-22) Scale, the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Insomnia Severity Index (ISI), and the Patient Health Questionnaire-15 (PHQ-15) was filled out by patients at admission. The associations between the scores of symptom/SNOT-22 and psychometric tests were assessed by the Pearson correlation coefficient (r) and simple linear regression. The receiver operating characteristic (ROC) analysis was used to evaluate the performance of the SNOT-22 score in predicting psychiatric disorders.

Results

Thirteen patients with benign sinonasal tumors and 15 patients with malignant sinonasal tumors were recruited. The benign and malignant groups did not differ significantly regarding symptomatology and mental wellbeing. Of the total patients, 9 were at risk of depression (PHQ-9 > 4), 10 were at risk of anxiety (GAD-7 > 4), 11 were at risk of insomnia (ISI > 7), and 11 were at risk of SSD (PHQ-15 > 4). The overall symptom, facial pain/pressure, postnasal drip, and SNOT-22 scores were positively associated with scores of psychometric tests. Patients with a high SNOT-22 score (>18) are likely to be affected by comorbid psychiatric disorders. When interpreting the results of this study, it should be noted that screening tools, not diagnostic tools, were used to identify psychiatric risk.

Conclusion

Depression, anxiety, insomnia, and SSD are prevalent in patients with sinonasal tumors. Otolaryngologists should have a low threshold to ask the patient about psychiatric symptoms, especially for patients with an SNOT-22 score > 18.