Psychological distress and alcohol use among adolescents

2017 ◽  
Vol 41 (S1) ◽  
pp. s882-s882
Author(s):  
N. Charfi ◽  
M. Turki ◽  
N. Smaoui ◽  
M. Maalej Bouali ◽  
L. Zouari ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Physical Abuse ◽  
Emotional Distress ◽  
Close Association ◽  
Depression Scale ◽  
Well Being ◽  
Anxiety And Depression ◽  
Public Health Burden ◽  
Supportive Environment

IntroductionAnxiety and depression, as well as alcohol use are widespread among teenagers, and constitute a huge public health burden worldwide.ObjectiveTo study the link between alcohol consumption and emotional distress (anxiety and depression) among adolescents.MethodsWe conducted a cross-sectional study in May and June 2016. The sample consisted of 314 pupils from 4 colleges and schools in Sfax (Tunisia). Alcohol Use Disorders Test (AUDIT) was used to evaluate alcohol dependence. Anxiety and depression levels were evaluated using the “Hospital Anxiety and Depression Scale” (HADS).ResultsThe mean age was 16 years with a sex ratio of 1.08. Among the participants, 18.9% reported having drunk alcohol at least once and 42.37% of them still consume. The main reasons for alcohol initiation were the search of new experiences (78%) or pleasure and well-being (39%) and the curiosity (49.15%). According to AUDIT, 1.7% of alcohol users presented an alcohol misuse and 20% presented dependence.The prevalence of anxiety and depression were respectively 56.1% and 23.7%. Anxiety was correlated to alcohol experimentation (P = 0.03) and non-supportive environment (P = 0.003). Depression was correlated to alcohol experimentation (P = 0.001), AUDIT score (P = 0.009), somatic histories (P = 0.02), physical abuse (P = 0.02), non-supportive environment (P = 0.016) and graduating class level (P = 0.005).ConclusionOur study highlights the close association between alcohol consumption and emotional distress in adolescence, which seems to be bi-directional. When attempting to reduce the risk of alcohol consumption, we should focus a particular attention on adolescents studying in graduating class, reinforce adolescents’ family support and prevent physical abuse.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Predictors of Emotional Distress and Wellbeing 2–5 Years After Stroke

ISRN Stroke ◽  
2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
H. Bergersen ◽  
A.-K. Schanke ◽  
K. S. Sunnerhagen
Keyword(s):  
Emotional Distress ◽  
General Health Questionnaire ◽  
Depression Scale ◽  
Well Being ◽  
Anxiety And Depression ◽  
Independent Mobility ◽  
Hospital Anxiety ◽  
Gender Education ◽  
Comprehensive Rehabilitation

Objectives. To identify predictors of emotional distress and psychological wellbeing in stroke survivors 2–5 years after discharge from comprehensive rehabilitation. Material and Methods. The Hospital Anxiety and Depression Scale (HADS), the General Health Questionnaire (GHQ-30), and questions regarding life situations were mailed to former patients. Multiple regression analyses were performed. Results. The responses from 68 participants (37% women), of an average age of 58 years old, were used. Emotional distress (HADS > 10) was identified in 41%. Well-being (GHQ-30 < 6) was identified in 46%. Not surprisingly, there was a strongly negative association between well-being (GHQ-30 < 6) and emotional distress (HADS > 10) at follow up. Dependency in toileting during rehabilitation predicted emotional distress 2–5 years later. Finally, well-being at followup was predicted by age > 65 years, independent mobility, perceiving proxies as supportive, and being in employment. Conclusions. Dependence in the activities of daily living 3–6 months after-injury predicted emotional distress 2–5 years after-stroke. Being over 65 years, having an occupation, proxy support and being less dependent all predicted well-being. Emotional distress and well-being were clearly negatively associated. Gender, education, marital status, and type of stroke were not associated with the outcome measures.

scholarly journals Family Physicians’ Standpoint and Mental Health Assessment in the Light of COVID-19 Pandemic—A Nationwide Survey Study

2021 ◽  
Vol 18 (4) ◽  
pp. 2093
Author(s):  
Tina Vilovic ◽  
Josko Bozic ◽  
Marino Vilovic ◽  
Doris Rusic ◽  
Sanja Zuzic Furlan ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Perceived Stress ◽  
Depression Scale ◽  
Family Physicians ◽  
Knowledge Score ◽  
Well Being ◽  
Anxiety And Depression ◽  
Event Scale ◽  
The Impact

During the coronavirus disease 2019 (COVID-19) outbreak, family physicians (FPs) are the backbone of the healthcare system with considerable impact on the general population, and their well-being is of great importance. The aim of this investigation was to assess FPs mental health, as well as knowledge, attitudes and practices (KAPs) regarding the pandemic, and opinions on non-communicable disease (NCD) health care provided to patients. A cross-sectional study was carried out with a sample of 613 FPs. Anxiety and depression levels were estimated with the Hospital Anxiety and Depression Scale, subjective perceived stress with the Perceived Stress Scale, while trauma-related symptoms were assessed using the Impact on Event Scale-COVID19. KAPs toward the pandemic and opinions regarding NCD patients were evaluated with questionnaires accordingly. Results have shown that age (β = −0.02, p = 0.013) and personal risk of COVID‑19 (β = 1.05, p < 0.001) were significant independent correlates of the knowledge score. A total of 87.7% FPs expressed moderate/high perceived stress, 45.2% moderate/severe trauma-related symptoms, 60.4% borderline/abnormal anxiety levels, and 52.4% borderline/abnormal depression levels. Knowledge score was an independent predictor of perceived stress (β = −0.33, p = 0.023) and anxiety (β = −0.31, p = 0.006) levels. Limited accessibility to healthcare services and decreased number of newly-diagnosed NCD cases were mostly agreed on. The pandemic puts a considerable strain on FPs mental health, as well as on public health measures, due to the decreased overall quality of NCD patient health care. Educational programs may bridge the gaps between FPs’ knowledge. Thus lowering anxiety and improving patient care.

scholarly journals AB0177 ANXIETY-DEPRESSIVE SPECTRUM IN PATIENTS WITH RHEUMATOID ARTHRITIS AND ANKYLOSING SPONDILITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1114.2-1114
Author(s):  
M. Letaeva ◽  
M. Koroleva ◽  
J. Averkieva ◽  
O. Malyshenko ◽  
T. Raskina
Keyword(s):  
Rheumatoid Arthritis ◽  
Depressive Disorders ◽  
Depression Scale ◽  
Well Being ◽  
Depressive Syndrome ◽  
Depression Screening ◽  
Anxiety And Depression ◽  
Control Group ◽  
Subjective Well Being ◽  
Anxiety Depression

Objectives:to assess the frequency of occurrence of the anxiety-depressive spectrum in patients with rheumatoid arthritis and ankylosing spondylitis.Methods:A survey was conducted of 44 patients aged from 21 to 57 years (average age - 42.3 ± 6.7 years), who were treated at GAUZ KO OKGVV. All patients had a verified diagnosis of RA and AS according to the ACR criteria and received treatment with basic drugs. The control group consisted of 40 people comparable in age and sex, without concomitant pathology of RA and AS.The depression screening card, the subjective well-being scale, and the hospital anxiety and depression scale (HADS) were used to assess and detect anxiety-depressive syndrome. The assessment of the condition is carried out over the last 2 weeks, which corresponds to the temporary diagnostic criterion for depression.The Depression Screening Scale is a 35-item self-questionnaire that assesses 7 categories of signs: sleep and appetite disorders, anxiety, emotional instability, cognitive impairment, loss of self, guilt, and suicidal tendencies. A total score of 65 and above indicates a high likelihood of depression.The Subjective Well-Being Scale is a psychodiagnostic screening tool for measuring the emotional component of subjective well-being or emotional comfort.Hospital Anxiety and Depression Scale Zigmond A.S., Snaith R.P. was developed for the primary detection of depression and anxiety in a general medical practice. The HADS scale consists of 14 statements with 4 possible answers and includes two parts: anxiety and depression. The sum of points of 8 or more is regarded as “subclinically expressed anxiety / depression”, 11 or more points - “clinically expressed anxiety / depression”.Results:According to the results of the depression screening questionnaire, 34 (77.3%) patients with RA and AS showed signs of depression, while in the control group only 6 (15%) patients tested positive for the presence of depressive disorders. According to the data obtained when assessing the scale of well-being in the main group, 26 (59.1%) patients showed signs of emotional discomfort (the indicator was 80% or more), in the control group - in 6 (15%). Using the hospital scale of anxiety and depression HADS, anxiety-depressive syndrome was detected in 36 (81.8%) patients with RA and AS: 16 (44.4%) patients had anxiety, 20 (55.6%) - depression, of them, subclinically expressed anxiety and depression were observed in 10 (27.7%) and 12 (33.3%) people, respectively. Anxiety-depressive syndrome in the control group, according to the HADS questionnaire, was detected only in 8 (20%) patients, of whom 4 (10%) patients had subclinical anxiety and 4 (10%) had signs of depression. No clinically pronounced anxiety and depression were registered in the control group.Conclusion:In most patients with rheumatoid arthritis and ankylosing spondylitis, anxiety-depressive disorders have been identified, which can directly affect both the course of the disease itself and the development of various complications. Timely diagnosis of mental disorders and close cooperation of rheumatologists, psychiatrists and psychologists in the selection of adequate therapy can improve the course and prognosis of the disease.Disclosure of Interests:None declared

P–478 Quality of life assessment in women undergoing assisted reproduction. A study of FertiQol and HADS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
N Figueras-Puigderrajols ◽  
A Ballesteros ◽  
D Guerra
Keyword(s):  
Quality Of Life ◽  
Depression Scale ◽  
Well Being ◽  
Self Esteem ◽  
Mobile App ◽  
Life Assessment ◽  
Fertility Treatment ◽  
Anxiety And Depression ◽  
Gamete Donation

Abstract Study question The present study aims to explore infertility-related psychosocial outcomes, including fertility quality of life (QoL), as well as anxiety and depression levels, in women diagnosed with infertility. Summary answer Differences on fertility-related QoL appeared when comparing treatment types (gamete donation vs own gamete). Furthermore, statistically significant associations were found between QoL and anxious-depressive symptomatology. What is known already Those who wish to have children and do not achieve their objective just like other peers can see their goals and expectations with pessimism, generating concern and a series of negative emotions. Several psychological implications of infertility have been described, such as increased levels of stress, anxiety, depression, decreased self-esteem, mood and hope, or poor relationship adjustment. The emotional impact of infertility in people’s life cycle can be so strong that reducing it only to biological aspects would lead to a dangerous situation of neglect. For this reason, QoL assessment in ART becomes an important need. Study design, size, duration FertiQol stands as the most widely used tool to assess infertility-related QoL, overcoming the limitations of other instruments that only target specific medical conditions. The present is a multi-site cross-sectional study over patients with infertility (n = 104), aiming to explore their fertility-QoL, as well as their anxiety and depression levels, which are symptoms that have been previously associated.Questionnaire administration, and sociodemographic and medical data gathering took place between January 2019 and December 2020. Participants/materials, setting, methods Participants were 104 female patients (M.age= 39.8) undergoing or expecting a fertility treatment. The FertiQol Spanish version was administered through mobile app, and its paper version distributed at medical/psychological appointments. QoL was self-reported through FertiQol, assessing the influence of infertility problems in various areas (e.g. impact on self-esteem, emotions, general health, family, partners, social relationships, work, life projects...). Additionally, HADS (Hospital Anxiety and Depression Scale) was provided as a measurement of anxiety and depression levels. Main results and the role of chance Regarding treatments, 50.6% of participants were currently undergoing gamete donation while 44.3% were undergoing treatments that involved using their own gametes. After comparing QoL between these treatment types, results showed that patients who underwent egg donation, compared to those who used their own eggs, reported statistically significantly lower scores of QoL in the Social Subscale (p = .03), but not in the other psychological outcomes. Also, statistically significant negative correlations were found between HADS and all core FertiQol subscales (p&lt; .05). Results are consistent with previous studies showing similar associations between fertility QoL and anxiety and depression, as well as with increased psychological negative implications of gamete donation. The majority of participants reported non-pathological scores of anxiety and depression when considering the cut off value of 8 for HADS, thus suggesting the presence of a relatively healthy sample. The number of treatments that patients had previously taken and the years of infertility were not associated with any of the psychological variables. Limitations, reasons for caution Some limitations to consider are presence of co-morbid diagnosis, differences in medication, or patient’s cultural backgrounds.Also, conclusions should be interpreted cautiously since the design doesn’t allow causal inferences. Further investigations should consider a continuous assessment to explore changes in psychological well-being at different points of intervention, specially with gamete donation. Wider implications of the findings: The great advantage we’ve seen so far when using FertiQol is the possibility to identify more accurately the true impact on other aspects of patient’s well-being besides the emotional area.ART professionals, including psychologists and counselors,will have more information within a small amount of time about QoL when using this tool. Trial registration number 1503-BCN–019-DG

scholarly journals ASSESSMENT OF ALCOHOL USE BY POPULATION AND RELATED PROBLEMS

2019 ◽  
Vol 4 (9-10) ◽  
pp. 93-99
Author(s):  
V. B. Zamkevich ◽  
M. D. Diachuk ◽  
T. S. Gruzieva
Keyword(s):  
Public Health ◽  
Information System ◽  
Risk Factor ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Fatal Outcome ◽  
Significant Proportion ◽  
Public Health Problem ◽  
Well Being ◽  
Negative Consequences

Introduction. The development of the public health system provides for the solution of the basic operational functions of public health, including surveillance and assessment of the state of health and well-being of the population, taking into account risks to public health.Given the importance of alcohol as a risk factor for the development of diseases, the study of its prevalence in the population, consumption patterns and health effects is an important public health problem. The aim of the study. To identify current trends in alcohol consumption and the associated risk factor for health damage in Ukraine and countries of the WHO European Region.Materials and methods. Bibliographic, medical, statistical and information-analytical methods were used in the study. The key  scientific base were the European Health for All Database, the Global Information System on Alcohol and Health (GISAH) and the European Information System on Alcohol and Health (EISAH). Results. Significant differences were found in the prevalence of alcohol consumption by population in different regions of the world per capita per year, up to 16 times, with the highest rates in the WHO ER. Ukraine is characterized by high levels of alcohol consumption (8.6 liters) and negative tendencies for their growth during 1991-2016 by 45.8%. At the same time, in Ukraine the consumption of strong alcoholic drinks predominates, while in the countries of the European Union - wine and beer. The increase in alcohol consumption in Ukraine and the prevalence of strong drinks in the structure of consumed products (51.5%) is an unfavorable prognostic indicator and requires the adoption of preventive measures. The negative consequences of alcohol consumption are the prevalence of alcohol dependence (2.2%), alcohol-related disorders (6%), a significant proportion of deaths (20.5%) due to this risk factor in the overall structure of all deaths, etc. Significant is the contribution of alcohol to the formation of indicators of road traffic injuries, including those with a fatal outcome, crime rates, etc. Conclusions. Surveillance of the prevalence of alcohol use, patterns of consumption and assessment of alcohol-related public health problems is an important basis for determining directions, justification and taking countermeasures.

#3123 Assessing international alcohol and internet use patterns during COVID-19 isolation using an online survey: highlighting distinct stressors conferring risk to compulsive behaviours

2021 ◽  
Vol 92 (8) ◽  
pp. A17.3-A18
Author(s):  
Samantha N Sallie ◽  
Valentin JE Ritou ◽  
Henrietta Bowden-Jones ◽  
Valerie Voon
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Use ◽  
Internet Use ◽  
Short Form ◽  
Internet Gaming Disorder ◽  
Depression Scale ◽  
Online Gaming ◽  
The United States ◽  
Stress Factors ◽  
Problematic Alcohol

Objectives and AimsThe Coronavirus (COVID-19) pandemic has required drastic safety measures to contain virus spread, including an extended self-isolation period. Those with greater perceived or actual life stress are vulnerable to develop or reinstate problematic behaviours characterised by addiction and compulsive mechanisms. Thus, we assessed how the COVID-19 pandemic and isolation measures affected alcohol consumption and internet use in the general population.MethodsWe developed an online international survey, entitled Habit Tracker (HabiT), completed by 1,346 adults (≥18 years), which measured changes in amount and severity of alcohol consumption (Alcohol Use Disorders Identification Test; AUDIT),online gaming (Internet Gaming Disorder Scale-Short Form; IGDS9-SF), and pornography viewing (Cyber Pornography Addiction Test; CYPAT) before (post-hoc recall)and during the COVID-19 pandemic and consequent lockdown. These measures were related to ten COVID-19-specific stress factors. Lastly, we assessed psychiatric factors widely recognized to be associated with problematic alcohol and internet use such as anxiety, depression (Hospital Anxiety and Depression Scale; HADS), and impulsivity (Short Impulsive-Behavior Scale; SUPPS-P).ResultsOf the sample, we observed an overall increase in online gaming and a decrease alcohol consumption and pornography viewing. Those who increased their amount and severity of alcohol use (36%) during lockdown reported stress associated with the pandemic itself, such as being an essential worker directly caring for those with or having a loved one become severely ill from COVID-19. Further, those residing in the United Kingdom- as opposed the United States or Canada- increased their weekly amount of alcohol consumption. Alternatively, those who increased online gaming (64%) and pornography viewing (43%)reported low frequency or poor quality social interactions resultant of lockdown measures. All three groups displayed higher levels of depression, anxiety, and urgency impulsivity.ConclusionsOur findings underscore the theoretical mechanism of negative emotionality underlying forms of compulsive behaviour driven by stress, depression, and anxiety; while highlighting distinct avenues by which these behaviours can manifest. Limitations include subjects being within varying phases of lockdown during the time of testing and a large degree of study dropout (n=1,515). We emphasise the relevance of identifying those in need of greater support services to mitigate negative health outcomes associated with problematic alcohol consumption and internet usage in the context of COVID-19 isolation.

Exploring factors associated with quality of life in women undergoing mammography

2020 ◽  
Author(s):  
Chih Jung Wu ◽  
Ya-Jung Wang ◽  
Liang-Chih Liu
Keyword(s):  
Quality Of Life ◽  
Emotional Distress ◽  
Medical Center ◽  
Depression Scale ◽  
Emotional Problems ◽  
Well Being ◽  
Cross Sectional ◽  
Factors Associated ◽  
Central Taiwan

Abstract Purpose: Mammography is broadly used in early detection of breast cancer. However, women undergoing mammography had experienced physical, psychological, and social disturbance; this could affect their Quality of Life (QoL). Only few studies in QoL have been done on cancer screening populations. The purpose of this study was to explore factors associated with QoL among women undergoing mammography. Methods: This research used a cross-sectional questionnaire survey and conducted with 158 women who were undergoing mammography. Data were collected from an outpatient department in a medical center located in central Taiwan from December 2014 to October 2015. The Functional Assessment of Cancer Therapy Scale –General, Chinese version was used to assess the QoL. Emotional distress was measured by using the Hospital Anxiety and Depression Scale and Mishel’s Uncertainty in Illness Scale. Descriptive statistic and multiple liner regression were used to analyze the data. Results: The multiple liner regression results revealed that women with benign breast tumors had better functional well-being (β = 1.276, p = 0.021). Women who had higher uncertainty (β=-0.216, p < 0.01) and emotional distress (β = -1.229, p < 0.01) experienced lower QoL. Conclusion: In this study, the uncertainty, emotional distress significantly predicted the QoL in women undergoing mammography screening. Clinical staff should pay attention to the emotional problems of women undergoing mammography. When women receive the mammography, this is an opportune time to educate them regarding the examination process and inform them of how reductions in uncertainty and emotional problems may help improve their QoL.

Communication About Prognosis With Adolescent and Young Adult Patients With Cancer: Information Needs, Prognostic Awareness, and Outcomes of Disclosure

2018 ◽  
Vol 36 (18) ◽  
pp. 1861-1867 ◽  
Author(s):  
Jennifer W. Mack ◽  
Karen M. Fasciano ◽  
Susan D. Block
Keyword(s):  
Information Needs ◽  
Depression Scale ◽  
Well Being ◽  
Adolescent And Young Adult ◽  
Anxiety And Depression ◽  
Cancer Information ◽  
Prognostic Information ◽  
Communication Preferences ◽  
Peace Of Mind ◽  
Spiritual Well Being

Purpose Communication about prognosis affects decisions patients and family members make about cancer care, and most patients say they want to know about their chances of cure. We sought to evaluate experiences with prognosis communication among adolescents and young adults (AYAs) with cancer. Patients and Methods We surveyed 203 AYAs with cancer age 15 to 29 years (response rate, 74%) treated at Dana-Farber Cancer Institute and their oncologists. Patients were approached within 6 weeks of diagnosis and asked to report on their prognosis communication preferences and experiences, their beliefs about likelihood of cure, and psychosocial outcomes of communication, such as trust (using an item from the Trust in Physician Scale), peace of mind (using select items from the Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale), and anxiety and depression (using the Hospital Anxiety and Depression Scale). Oncologists were asked to report the patient’s likelihood of cure. Results Most patients (83%, 167 of 203 patients) considered prognostic information to be extremely or very important. Patients who reported having received more extensive prognostic disclosure had higher odds of trust in the oncologist (odds ratio [OR], 1.30; 95% CI, 1.01 to 1.67; P = .05), peace of mind (OR, 2.13; 95% CI, 1.29 to 3.51; P = .002), and hope related to physician communication (OR, 1.27; 95% CI, 1.01 to 1.59; P = .04), after adjusting for patient sex, age, race or ethnicity, prognosis, and diagnosis. Disclosure was also associated with lower distress related to knowing about prognosis (OR, 0.65; 95% CI, 0.44 to 0.95; P = .03). However, a majority of patients (62%) reported prognostic estimates that exceeded those reported by physicians (McNemar P < .001). Conclusion Most AYAs with cancer value receiving prognostic information, which is positively associated with aspects of well-being. However, most overestimate chances of cure relative to oncologists, highlighting the importance of efforts to improve communication with this young population.

scholarly journals The COVID-19 Pandemic and Mental Well-Being of Pregnant Women in Japan: Need for Economic and Social Policy Interventions

2020 ◽  
pp. 1-6 ◽  
Author(s):  
Midori Matsushima ◽  
Hanna Horiguchi
Keyword(s):  
Social Support ◽  
Depressive Symptoms ◽  
Pregnant Women ◽  
Perceived Risk ◽  
Depression Scale ◽  
Well Being ◽  
Anxiety And Depression ◽  
Cutoff Score ◽  
Economic Wealth ◽  
Mental Well Being

ABSTRACT Objective: This study explores the mental well-being of pregnant women in Japan during the coronavirus disease (COVID-19) pandemic. Methods: We collected 1777 responses from pregnant women through an online survey. Using the Japanese version of the Edinburgh Postnatal Depression Scale (EPDS), we calculated the percentage of pregnant women above the cutoff (≥ 13), and the factor scores of anhedonia, anxiety, and depression. Regression analyses were performed to identify factors and socioeconomic characteristics correlated with depressive symptoms. Results: The point prevalence of pregnant women with an EPDS score of ≥ 13 was 17%. The mean scores were 0.73, 3.68, and 1.82 for anhedonia, anxiety, and depression, respectively. The probability of becoming above the cutoff score positively correlated with the cancellation of planned informal support, higher perceived risk for infection of COVID-19, difficulties in household finances, and lack of social support. Moreover, being younger, less wealthy, unemployed, and without a partner showed a significantly higher possibility of having a score above the cutoff. Conclusions: The present study found a high percentage of pregnant women with depressive symptoms. Notably, COVID-19-related variables, including perceived risk for the infection, fear of decreasing economic wealth, and social support, were significantly associated with depressive symptoms.

Survival Prediction in Terminally Ill Cancer Patients by Clinical Estimates, Laboratory Tests, and Self-Rated Anxiety and Depression

2007 ◽  
Vol 25 (22) ◽  
pp. 3313-3320 ◽  
Author(s):  
Stephan Gripp ◽  
Sibylle Moeller ◽  
Edwin Bölke ◽  
Gerd Schmitt ◽  
Christiane Matuschek ◽  
...  
Keyword(s):  
Brain Metastases ◽  
Cancer Patients ◽  
Emotional Distress ◽  
Laboratory Tests ◽  
Performance Status ◽  
Univariate Analysis ◽  
Depression Scale ◽  
Tumor Board ◽  
Anxiety And Depression ◽  
Survival Prediction

Purpose To study how survival of palliative cancer patients relates to subjective prediction of survival, objective prognostic factors (PFs), and individual psychological coping. Patients and Methods Survival was estimated according to three categories (< 1 month, 1 to 6 months, and > 6 months) by two physicians (A and B) and the institutional tumor board (C) for 216 patients recently referred for palliative radiotherapy. After 6 months, the accuracy of these estimates was assessed. The prognostic relevance of clinical symptoms, performance status, laboratory tests, and self-reported emotional distress (Hospital Anxiety and Depression Scale) was investigated. Results In 61%, 55%, and 63% of the patients, prognoses were correctly estimated by A, B, and C, respectively. κ statistic showed fair agreement of the estimates, which proved to be overly optimistic. Accuracy of the three estimates did not improve with increasing professional experience. In particular, the survival of 96%, 71%, and 87% of patients who died in less than 1 month was overestimated by A, B, and C, respectively. On univariate analysis, 11 of 27 parameters significantly affected survival, namely performance status, primary cancer, fatigue, dyspnea, use of strong analgesics, brain metastases, leukocytosis, lactate dehydrogenase (LDH), depression, and anxiety. On multivariate analysis, colorectal and breast cancer had a favorable prognosis, whereas brain metastases, Karnofsky performance status less than 50%, strong analgesics, dyspnea, LDH, and leukocytosis were associated with a poor prognosis. Conclusion This study revealed that physicians' survival estimates were unreliable, especially in the case of patients near death. Self-reported emotional distress and objective PFs may improve the accuracy of survival estimates.

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