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Haywood D, Kotov R, Krueger RF, Wright AGC, Forbes MK, Dauer E, Baughman FD, Rossell SL, Hart NH. Is it time to discard the Diagnostic and Statistical Manual of Mental Disorders (DSM) in psycho-oncology? Cancer Lett 2024; 589:216818. [PMID: 38554804 DOI: 10.1016/j.canlet.2024.216818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/12/2024] [Accepted: 03/12/2024] [Indexed: 04/02/2024]
Abstract
The conceptual basis of psychopathology within cancer survivorship is critical, as the chosen conceptualisation informs assessment and explanatory models, as well as interventions and supportive care approaches. The validity of a chosen conceptualisation of psychopathology is therefore paramount for ensuring cancer survivors receive high-quality and efficacious care and support that can be iteratively improved via coordinated research efforts. In this paper, we discuss the traditional diagnostic approach to conceptualising psychopathology within cancer care, including the diagnostic system the 'Diagnostic and Statistical Manual of Mental Disorders' (DSM) [1], and the significant issues it presents within cancer survivorship. We detail and discuss how an alternate conceptualisation of psychopathology may enhance both research and practice within psycho-oncology. We ultimately pose, and provide our perspective, on the question "Is it Time to Discard the DSM in Psycho-Oncology?"
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Affiliation(s)
- Darren Haywood
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Department of Psychiatry, Melbourne Medical School, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC, Australia; School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia.
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY, USA
| | - Robert F Krueger
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Aidan G C Wright
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA; Eisenberg Family Depression Center, University of Michigan, Ann Arbor, MI, USA
| | - Miriam K Forbes
- School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia
| | - Evan Dauer
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Frank D Baughman
- School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| | - Susan L Rossell
- Department of Mental Health, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia; Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Nicolas H Hart
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Sydney, NSW, Australia; Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia; Exercise Medicine Research Institute, School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia; Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane, QLD, Australia; Institute for Health Research, University of Notre Dame Australia, Perth, WA, Australia
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Haywood D, Dauer E, Baughman FD, Lawrence BJ, Rossell SL, Hart NH, O’Connor M. "Is My Brain Ever Going to Work Fully Again?": Challenges and Needs of Cancer Survivors with Persistent Cancer-Related Cognitive Impairment. Cancers (Basel) 2023; 15:5331. [PMID: 38001592 PMCID: PMC10669848 DOI: 10.3390/cancers15225331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/01/2023] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
Many cancer survivors experience cognitive impairments that impact memory, concentration, speed of information processing, and decision making. These impairments, collectively known as cancer-related cognitive impairments (CRCIs), are a key domain of unmet needs and can significantly impact a cancer survivor's identity and quality of life. However, there are no purpose-built, multi-domain, needs assessment tools specifically for CRCI. The development of such tools requires an in-depth understanding of cancer survivors' CRCI-specific challenges and associated needs. This study explored the challenges and associated needs of cancer survivors with persistent CRCI. An in-depth qualitative design using semi-structured interviews with (a) cancer survivors with perceived CRCI (n = 32) and (b) oncology health professionals (n = 19) was utilised. A reflexive thematic analysis of the interviews resulted in five overarching themes: (1) executing regular activities, (2) relational difficulties, (3) occupational functioning, (4) psychological distress, and (5) social functioning, as well as an additional informational needs domain. Ultimately, CRCI was found to directly produce a range of challenges that negatively, and persistently, impact cancer survivors' quality of life. Cancer survivors were also found to have a range of needs associated with these challenges. This research should be used to inform future challenges and needs assessment tools as well as treatment and supportive care priority areas directly relating to CRCI.
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Affiliation(s)
- Darren Haywood
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, NSW 2021, Australia;
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia
- Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (E.D.); (S.L.R.)
- Department of Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, VIC 3052, Australia
| | - Evan Dauer
- Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (E.D.); (S.L.R.)
| | - Frank D. Baughman
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (F.D.B.); (B.J.L.); (M.O.)
| | - Blake J. Lawrence
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (F.D.B.); (B.J.L.); (M.O.)
| | - Susan L. Rossell
- Department of Mental Health, St. Vincent’s Hospital Melbourne, Fitzroy, VIC 3065, Australia; (E.D.); (S.L.R.)
- Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, VIC 3122, Australia
| | - Nicolas H. Hart
- Human Performance Research Centre, INSIGHT Research Institute, Faculty of Health, University of Technology Sydney (UTS), Moore Park, NSW 2021, Australia;
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Park, SA 5042, Australia
- Cancer and Palliative Care Outcomes Centre, Faculty of Health, Queensland University of Technology (QUT), Brisbane City, QLD 4000, Australia
- Exercise Medicine Research Institute, School of Medical and Health Science, Edith Cowan University, Joondalup, WA 6027, Australia
- Institute for Health Research, University of Notre Dame Australia, Fremantle, WA 6160, Australia
| | - Moira O’Connor
- School of Population Health, Curtin University, Bentley, WA 6102, Australia; (F.D.B.); (B.J.L.); (M.O.)
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Haywood D, Wallace IN, Lawrence B, Baughman FD, Dauer E, O'Connor M. Oncology healthcare professionals' perceptions and experiences of 'chemobrain' in cancer survivors and persons undergoing cancer treatment. Gen Hosp Psychiatry 2023; 84:271-272. [PMID: 37407422 DOI: 10.1016/j.genhosppsych.2023.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 07/07/2023]
Affiliation(s)
- Darren Haywood
- Department of Mental Health, St Vincent's Hospital Melbourne, Melbourne, Australia; Turner Institute for Brain and Mental Health, School of Psychological Science, Melbourne, Australia.
| | - India N Wallace
- School of Population Health, Curtin University, Perth, Australia
| | - Blake Lawrence
- School of Population Health, Curtin University, Perth, Australia
| | - Frank D Baughman
- School of Population Health, Curtin University, Perth, Australia
| | - Evan Dauer
- Department of Mental Health, St Vincent's Hospital Melbourne, Melbourne, Australia
| | - Moira O'Connor
- School of Population Health, Curtin University, Perth, Australia
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Dauer E, Thompson D, Zinsmeister AR, Dierkhising R, Harris A, Zais T, Alexander J, Murray JA, Wise JL, Lim K, Locke GR, Romero Y. Supraesophageal Reflux: Validation of a Symptom Questionnaire. Otolaryngol Head Neck Surg 2016; 134:73-80. [PMID: 16399184 DOI: 10.1016/j.otohns.2005.08.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVES: To develop and validate a questionnaire for supraesophageal manifestations of reflux (SER) that will facilitate its study in clinical and research settings. STUDY DESIGN: The Supraesophageal Reflux Questionnaire (SERQ) and previously validated Reflux Symptom Index (RSI) were subjected to multiple types of validity testing, including content validity, concurrent validity, reproducibility, and predictive validity. RESULTS: The concurrent validity and reproducibility of both instruments was good to excellent for most items tested. The predictive validity of the SERQ was superior to the RSI when it included the covariates of history of sinusitis, use of over-the-counter antacid medications, age, gender, and body mass index. CONCLUSIONS: The SERQ will serve as both a useful clinical and research tool by offering not only SER symptom information, like the RSI, but also information about the patient's medical history and medication usage that will facilitate use of the SERQ in research protocols. EBM rating: B-2b
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Affiliation(s)
- E Dauer
- Department of Otolaryngology, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
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Abstract
OBJECTIVES To determine the appropriate use of the scapula osteocutaneous free flap (SOFF) and to document donor site morbidity. STUDY DESIGN Retrospective review and prospective physical therapy evaluation. METHODS A computer database of all free flap procedures performed at a single institution was created. Specific clinical and operative details from cases involving a bone flap were extracted from the database. Rates of usage of the various osteocutaneous flaps were compared over four successive 2-year intervals (1992-1999). A single physical therapist performed a structured evaluation of the donor site. RESULTS Overall, 64 bone flap procedures were performed, of which 24 (37.5%) were SOFF procedures. The SOFF utilization has increased from 6.6% to 63.6%, while fibula and iliac crest utilization has fallen significantly. This is in part because of the greater versatility of the SOFF, with the possibility of separate skin paddles and adequate bone length. The mean cutaneous area harvested with the SOFF was 110 cm2 (range, 48-200 cm2) compared with 55.4 cm2 (range, 25-102 cm2) and 77.6 cm2 (range, 50-120 cm2) for the fibula and iliac crest, respectively. Mean bone flap lengths were 8.37, 7.65, and 10.1 cm, respectively, for the SOFF, fibula, and iliac crest. Dual skin paddles were used in 50% of the SOFF procedures versus 2.8% for the fibula flap procedures. There were no significant complications of the donor site in any patient, and there was only one flap failure (4.1%). Related to the SOFF, donor site morbidity was subjectively judged as "mild," for pain, mobility, and strength. There were no complaints of poor appearance of the donor site. Activities of daily living were judged as "not limited" or 'limited a little" in the majority of patients. Objective measurements of range of motion revealed an average reduction of 1 degree to 12 degrees in five different shoulder functions. Elbow and arm ranges of motion were not limited. Strength was minimally reduced in the shoulder, while the arm and forearm showed no reduction in strength. CONCLUSIONS The SOFF is a versatile osteocutaneous free flap that can be used for a multitude of reconstructive problems. This and its relative lack of significant donor site morbidity have caused its use to increase significantly.
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Affiliation(s)
- S C Coleman
- Department of Otolaryngology, The Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences, Nashville, Tennessee, USA
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Luttmann W, Dauer E, Schmidt S, Marx O, Hossfeld M, Matthys H, Virchow JC. Effects of interferon-gamma and tumour necrosis factor-alpha on CD95/Fas ligand-mediated apoptosis in human blood eosinophils. Scand J Immunol 2000; 51:54-9. [PMID: 10632976 DOI: 10.1046/j.1365-3083.2000.00645.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Many cells, including eosinophils, express CD95 (Fas), a surface receptor that mediates apoptosis when ligated by specific antibodies or its natural ligand, Fas ligand (FasL). As apoptosis may play an important role in the regulation of tissue eosinophilia, factors that modulate eosinophil sensitivity to apoptosis are of great interest. It has previously been shown that interferon-gamma (IFN-gamma) and tumour necrosis factor-alpha (TNF-alpha) together increase CD95 surface expression on eosinophils. However, the functional consequences of this increase in CD95 expression have not been demonstrated in detail. We therefore investigated whether the increase in CD95 expression mediated by IFN-gamma/TNF-alpha indeed translates into increased, FasL-mediated apoptosis of eosinophils. For this purpose, purified eosinophils from normal donors were incubated with different concentrations of FasL and induction of apoptosis was assessed by annexin-V/propidium iodide assay. Unlike Jurkat cells, which became apoptotic within 2 h after incubation with FasL, an increase in eosinophil apoptosis could first be dedicated after 6 h incubation with FasL. Prestimulation with IFN-gamma/TNF-alpha for 24 h significantly enhanced FasL-induced apoptosis in eosinophils. This increase in CD95/FasL-mediated apoptosis was correlated with an IFN-gamma/TNF-alpha-mediated increase in CD95 expression. From these findings we conclude that the combination of IFN-gamma and TNF-alpha enhances CD95 expression, which results in an increase in FasL-mediated apoptosis of eosinophils in vitro.
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Affiliation(s)
- W Luttmann
- Department of Pneumology, Medical University Clinics, Freiburg, Germany
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Abstract
CD95 (Fas, APO-1) is a cell surface receptor expressed on many cells including eosinophils which mediates apoptosis when ligated by agonistic antibodies or its natural ligand FasL. Since inhibition of apoptosis may play an important role in controlling tissue eosinophilia, we investigated the expression of CD95 on purified peripheral blood eosinophils from normal donors. Freshly isolated eosinophils expressed CD95 on the cell surface as well as CD95-specific mRNA at low levels which did not change during 24-h culture. Incubation of eosinophils with IL-3, IL-5 and granulocyte-macrophage colony-stimulating factor (GM-CSF) did not modulate the basal expression of CD95. IFN-gamma as well as TNF-alpha, however, induced a significant, dose- and time-dependent increase in CD95 mRNA and cell surface expression as measured by reverse transcription-PCR and flow cytometry. Co-stimulation with IFN-gamma and TNF-alpha had synergistic effects on the CD95 surface expression on eosinophils. Addition of IL-3, IL-5 or GM-CSF to IFN-gamma- and TNF-alpha-stimulated eosinophils caused in a reduction of CD95 expression. Functional activity for CD95 following incubation with IFN-gamma and TNF-alpha was demonstrated by increased apoptosis in response to cross-linking with FasL. From these data, we conclude that IFN-gamma and TNF-alpha can up-regulate cell surface expression of CD95 on eosinophils, which leads to an increased susceptibility of eosinophils to Fas-mediated apoptosis. Thus, our results suggest that receptors involved in eosinophil apoptosis can be regulated by antagonistic cytokines.
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Affiliation(s)
- W Luttmann
- Department of Pneumology, Medical University Clinics, Freiburg, Germany.
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