Differences in depressive and anxiety symptoms between cancer and noncancer patients with psychological distress

Exploring Palliative Care Needs Among Patients With Cancer and Non-Cancer Serious Chronic Diseases: A Comparison Study

BACKGROUND

Palliative care (PC) is integral to improving the quality of life and mitigating suffering for individuals with serious illnesses. This interdisciplinary-led study aims to comprehensively evaluate the prevalence of distressing problems and unmet needs among both cancer and non-cancer chronic disease patients and explore their need for PC.

METHODS

A cross-sectional, comparative, and multicenter design was conducted, involving 458 patients from eight hospitals, utilizing a self-reported Problems and Needs in Palliative Care-sv questionnaire.

RESULTS

The study included 276 (60.3%) patients with cancer and 182 (39.7%) with non-cancer chronic diseases. Most were 45-64 years old (n = 216, 47.2%). Patients with cancer reported a higher prevalence of physical symptoms, notably pain (n = 240, 87%) and anorexia (n = 192, 69.6%), while non-cancer patients faced more social challenges, including issues in companion relationships (n = 77, 42.3%) and discussing their disease with life companion (n = 78, 42.9%). Unmet needs were prevalent in both groups, with cancer patients having an average of 75.6% (n = 120) unmet needs, predominantly in the information (n = 145, 91.75%) and spiritual domains (n = 123, 77.8%). Non-cancer patients emphasized financial (n = 71, 66.6%) and autonomy (n = 59, 55.0%) problems. Moreover, patients in both groups with severe Charlson Comorbidity Index scores demonstrated significantly higher PC needs across all health domains.

CONCLUSION

The study highlights the universal demand for comprehensive PC for patients with both cancer and non-cancer chronic diseases. The findings underscore the need for enhanced PC provision, especially for patients with multiple comorbidities. Further research is needed to comprehensively address psychological, social, and spiritual problems in both patient groups.

Prospective study of predictors for anxiety, depression, and somatization in a sample of 1807 cancer patients

In cancer patients, psychological distress, which encompasses anxiety, depression, and somatization, arises from the complex interplay of emotional and behavioral reactions to the diagnosis and treatment, significantly influencing their functionality and quality of life. The aim was to investigate factors associated with psychological distress in cancer patients. This prospective and multicenter study, conducted by the Spanish Society of Medical Oncology (SEOM), included two cohorts of patients with cancer (localized resected or advanced unresectable). They completed surveys assessing psychological distress (BSI-18) before and after cancer treatment and coping (MINI-MAC) and spirituality (FACIT-sp) prior to therapy. A multivariable logistic regression analysis and a Structural Equation Modeling (SEM) were conducted. Between 2019 and 2022, 1807 patients were evaluated, mostly women (54%), average age 64 years. The most frequent cancers were colorectal (30%), breast (25%) and lung (18%). Men had lower levels of anxiety and depression (OR 0.66, 95% CI 0.52-0.84; OR 0.72, 95% CI 0.56-0.93). Colorectal cancer patients experienced less anxiety (OR 0.63, 95% CI 0.43-0.92), depression (OR 0.55, 95% CI 0.37-0.81), and somatization (OR 0.59, 95% CI 0.42-0.83). Patients with localized cancer and spiritual beliefs had reduced psychological distress, whereas those with anxious preoccupation had higher level. SEM revealed a relationship between psychological distress and coping strategies, emphasizing how baseline anxious preoccupation exacerbates post-treatment distress. This study suggests that age, sex, extension and location of cancer, coping and spirituality influence psychological distress in cancer patients.

Association between Having Cancer and Psychological Distress among Family Caregivers Using Three Years of a Nationwide Survey Data in Japan

We aimed to describe the characteristics of caregivers with cancer compared to those without and analyze the association between having cancer and caregivers' psychological distress in Japan. We used data from the Japanese Comprehensive Survey of Living Conditions in 2010, 2013, and 2016. The participants were 5258 family caregivers aged ≥40 years, caring for only one family member whose information in the dataset was available for all the covariates included in the model. The family caregivers' psychological distress was defined by the Kessler Psychological Distress Scale (K6) score (K6 ≥ 5). We conducted a Poisson regression analysis to examine the association between having cancer and family caregivers' distress. The sample of family caregivers consisted of mostly females (69.3%) and people within the 40-64 years age group (51.8%). As a result, family caregivers with cancer increased across the survey periods; a higher number of participants were unemployed. When adjusted for covariates, including the presence of other diseases, having cancer was significantly associated with distress (risk ratio 1.33, 95% confidence interval 1.05-1.69) among family caregivers. Family caregivers with cancer are expected to increase in the future; it is important to provide them with more support in managing both their treatment and caregiving to cope with their distress.

Effects of Drawing Therapy on Pediatric Oncology Patients: A Systematic Review

BACKGROUND

A small but significant number of children and adolescents with cancer experience severe physical and psychological distress. Previous studies have shown that drawing therapy positively affects relieving psychological problems. However, the effect of drawing therapy on pediatric oncology patients has not been established by systematic review.

OBJECTIVE

The aim of this study was to determine the effect of drawing therapy on the pediatric oncology population.

METHODS

PubMed, EMBASE, MEDLINE, Cochrane, PsycINFO, CINAHL, and Chinese databases including CNKI, Wanfang, VIP, and CBM were searched. Studies published in the English and Chinese languages up to December 2019 were screened, and randomized controlled trials and nonrandomized experimental studies of drawing therapy interventions for pediatric oncology patients were reviewed. Screening was undertaken independently by 2 reviewers. The review protocol was registered with PROSPERO (registration number: CRD42020178365).

RESULTS

Eight studies were included. Three studies were randomized controlled trials, and 5 studies were nonrandomized experimental studies. Seven studies showed that drawing therapy had positive effects on reducing depression and anxiety and improving quality of life. However, 1 study showed a contradictory result, that is, participants had an increased anxiety level after intervention.

CONCLUSIONS

Drawing therapy is effective in improving negative emotions, relieving somatic symptoms, and increasing social communication for pediatric oncology patients.

IMPLICATIONS FOR PRACTICE

Drawing therapy may be considered an adjuvant psychological intervention strategy for pediatric oncology patients. Meanwhile, more rigorous studies are needed to address the deficiencies of small number size and methodological weakness.