Oncologists' recognition of depression in their patients with cancer.

1998 ◽  
Vol 16 (4) ◽  
pp. 1594-1600 ◽  
Author(s):  
S D Passik ◽  
W Dugan ◽  
M V McDonald ◽  
B Rosenfeld ◽  
D E Theobald ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Cancer Patients ◽  
Rating Scales ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Patient Characteristics ◽  
Disease Stage ◽  
Tumor Type ◽  
Ambulatory Oncology ◽  
Highly Correlated

PURPOSE This study was performed as part of a large depression screening project in cancer patients to determine the degree of physician recognition of levels of depressive symptoms in cancer patients and to describe patient characteristics that influence the accuracy of physician perception of depressive symptoms. METHODS Twenty-five ambulatory oncology clinics affiliated with Community Cancer Care, Inc of Indiana enrolled and surveyed 1,109 subjects treated by 12 oncologists. Subjects completed the Zung Self-Rating Depression Scale (ZSDS) and physicians were asked to rate their patients' level of depressive symptoms, anxiety, and pain using numerical rating scales. Subjects' sex, age, primary tumor type, medications, primary caregiver, and disease stage at diagnosis were also recorded. RESULTS Physician ratings of depression were significantly associated with their patients' levels of endorsement of depressive symptoms on the ZSDS. However, agreement between physicians and patients is most frequently clustered when patients report little or no depressive symptoms. While physician ratings are concordant with patient endorsement of no significant depressive symptomatology 79% of the time, they are only concordant 33% and 13% of the time in the mild-to-moderate/severe ranges, respectively. Physician ratings were most influenced by patient endorsement of frequent and obvious mood symptoms, ie, sadness, crying, and irritability. Physician ratings also appeared to be influenced by medical correlates of patients' level of depressive symptoms (functional status, stage of disease, and site of tumor). Additionally, patients whose depression was inaccurately classified reported significantly higher levels of pain and had higher levels of disability. Physicians' ratings of depression were most highly correlated with physicians' ratings of patients' anxiety and pain. CONCLUSION Physicians' perceptions of depressive symptoms in their patients are correlated with patient's ratings, but there is a marked tendency to underestimate the level of depressive symptoms in patients who are more depressed. They are most influenced by symptoms such as crying and depressed mood, and medical factors that are useful, but not the most reliable, indicators of depression in this population. Physicians' ratings of their patients' distress symptoms seem to be global in nature--they are highly correlated with anxiety, pain, and global dysfunction. Physician assessment might be improved if they were instructed to assess and probe for the more reliable cognitive symptoms such as anhedonia, guilt, suicidal thinking, and hopelessness. Screening instruments and the use of brief follow-up interviews would help to identify patients who are depressed.

Distress experienced by lung cancer patients and their family caregivers in the first year of their cancer journey

2021 ◽  
pp. 1-7
Author(s):  
Michèle Aubin ◽  
Lucie Vézina ◽  
René Verreault ◽  
Sébastien Simard ◽  
Éveline Hudon ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Family Caregivers ◽  
Screening Program ◽  
Depression Scale ◽  
Participation Rate ◽  
Quebec City ◽  
Lung Cancer Patients ◽  
Distress Score ◽  
Ambulatory Oncology

Abstract Objectives Diagnosis of cancer is emotionally threatening not only for patients but also for their family caregivers (FC) who witness and share much of the illness experience. This study compares distress experienced by lung cancer patients and their FC during the year following the diagnosis. Methods A prospective cohort study of 206 patients recently diagnosed with inoperable lung cancer (participation rate 79.5%) and 131 FC (participation rate 63.6%) was conducted in an ambulatory oncology clinic in Quebec City (Canada). They completed validated questionnaires regarding their personal and psychological characteristics (Hospital and Anxiety Depression Scale—HADS), in the first months after the diagnosis of lung cancer and after 6 and 12 months. Univariate, bivariate, and linear mixed models were conducted to compare patient and FC distress. Results At baseline, 7.8% of patients reported distress (HADS total score >15) and their mean distress score was 7.0 ± 4.9 (range 0–42). In contrast, 33.6% of FC presented significant distress and their mean distress score was 12.0 ± 7.2 (P < 0.0001). Proportions of patients and FC with distress remained relatively stable at 6 and 12 months, and at every time point, FC reported higher levels of distress compared to their relative with cancer (P < 0.0001). Comparable trends were found when looking at the mean scores of distress, anxiety, and depression throughout the study. Significance of results Being diagnosed with lung cancer and going through its different phases seems to affect more FC than patients. The psychological impact of such diagnosis appears early after the diagnosis and does not significantly change over time. These findings reinforce the importance for oncology teams, to include FC in their systematic distress screening program, in order to help them cope with their own feelings and be able to play their role in patient support and care throughout the cancer journey.

A neuropsychological group rehabilitation program with institutionalized elderly

2016 ◽  
Vol 33 (S1) ◽  
pp. s235-s235
Author(s):  
L. Lemos ◽  
H. Espírito-Santo ◽  
S. Simões ◽  
F. Silva ◽  
J. Galhardo ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Depressive Symptomatology ◽  
Randomized Study ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Rehabilitation Program ◽  
Post Intervention ◽  
Institutionalized Elderly ◽  
Group Rehabilitation ◽  
The Impact

IntroductionElderly institutionalization involves an emotional adaptation and the research shows that the risk of depression increases.ObjectivesEvaluate the impact of a neuropsychological group rehabilitation program (NGRP) on depressive symptomatology of institutionalized elderly.AimsNGRP influences the decrease of depressive symptoms.MethodsElderly were assessed pre- and post-intervention with the Geriatric Depression Scale (GDS) and divided into a Rehabilitated Group (RG), a Waiting List Group (WLG), and a Neutral Task Group (NTG).ResultsIn this randomized study, before rehabilitation, 60 elderly people (RG; 80.31 ± 8.98 years of age; 74.2% women) had a mean GDS score of 13.33 (SD = 9.21). Five elderly included in the NTG (80.13 ± 10.84 years; 75.0% women) had a mean GDS score of 10.60 (SD = 4.72). Finally, 29 elderly in the WLG (81.32 ± 6.68 years; 69.0% women) had a mean GDS score of 14.93 (SD = 6.02). The groups were not different in GDS baseline scores (F = 0.74; P = 0.478). ANCOVA has shown significant differences (P < 0.05) in GDS scores between the three groups after 10 weeks. Sidak adjustment for multiple comparisons revealed that elderly in the WLG got worse scores in GDS, comparing with elderly in RG (P < 0.01), and with elderly in NTG (P < 0.05).ConclusionsElderly that are not involved in a task get worse in depressive symptomatology. Being involved in a structured group task means lower depressive symptoms and being in a NGRP means even greater results.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Emotional Distress in Cancer Patients During the First Wave of the COVID-19 Pandemic

2021 ◽  
Vol 12 ◽  
Author(s):  
Patricia Toquero ◽  
Carmen Blanco Fernández ◽  
María Pilar López Martí ◽  
Berta Hernández Marín ◽  
E. Beatriz Vera Cea ◽  
...  
Keyword(s):  
Mental Health ◽  
Cancer Patients ◽  
Emotional Distress ◽  
Mental Health Problems ◽  
Psychological Symptoms ◽  
Univariate Analysis ◽  
Depression Scale ◽  
Tumor Type ◽  
Prevention Measures ◽  
Psychological Symptomatology

Background: The COVID-19 pandemic has caused mental health problems worldwide. The psychopathological implications of COVID-19 in cancer patients have rarely been addressed. Considering the increased vulnerability of oncology patients, this issue needs to be addressed to improve the long-term mental health status of these patients.Methods: We conducted a prospective study in outpatients under active cancer treatment during the first wave of the COVID-19 pandemic. A semi-structured 24-question survey was designed to measure baseline sociodemographic, psychosocial and COVID-19 exposure characteristics. The Hospital Anxiety and Depression Scale was used to measure psychological symptoms. A descriptive and analytical univariate analysis of the variables studied was performed. We used the Z-score to compare different populations (experimental and historical control cohort).Results: 104 patients were included, the majority of which were women (64.4%), were above 65 years of age (57.7%), had either lung and breast cancer (56.7%), had advanced disease (64%) and were undergoing chemotherapy (63.5%). 51% of them expressed greater fear of cancer than of COVID-19 infection or both.In relation to HADS, 52.8% of emotional distress, 42.3% of anxiety and 58.6% of depression rates were detected. The main factors related with higher rates of psychological symptomatology were history of previous psychotropic drug consumption and the adoption of additional infection prevention measures because they considered themselves at risk of severe COVID-19 infection (p = 0.008; p = 0.003 for emotional distress, p = 0.026; p = 0.004 for anxiety, and p = 0.013; p = 0.008 for depression). Tumor type, stage, oncologic treatment or rescheduling of cancer treatments were not related to higher levels of psychological symptomatology.Comparison of our results with another population of similar characteristics was not significant (Z score = −1.88; p = 0.060).Conclusions: We detected high rates of emotional distress during the first wave of the COVID-19 pandemic among cancer patients in active treatment (52.8%). This was higher and clinically relevant than observed in a comparable population (42.5%), although not significant. Cancer itself is the main factor of concern for cancer patients, above and beyond the emotional distress generated by COVID-19 pandemic.

A chart review, pilot study of two single-item screens to detect cancer patients at risk for cachexia

2003 ◽  
Vol 1 (4) ◽  
pp. 331-335 ◽  
Author(s):  
KENNETH L. KIRSH, ◽  
CHRISTINE DUGAN ◽  
DALE E. THEOBALD ◽  
STEVEN D. PASSIK
Keyword(s):  
At Risk ◽  
Cancer Patients ◽  
Chart Review ◽  
Depression Scale ◽  
Early Death ◽  
Nutritional Risk ◽  
Single Item ◽  
Wasting Syndrome ◽  
Ambulatory Oncology ◽  
Patients At Risk

Objective: Cachexia is a problematic wasting syndrome experienced by some cancer patients that can lead to early death in these patients. The purpose of the present study was to examine the criterion validity and sensitivity and specificity of two single items from a depression scale to rapidly screen patients in ambulatory oncology clinics for cancer-related nutritional risk and cachexia.Methods: A chart review was conducted of 50 randomly selected patient profiles. Patients' responses to item 5 (“I eat as much as I used to”) and item 7 (“I notice I am losing weight”) of the Zung Self Rating Depression Scale (ZSDS) were compared against the Scored Patient-Generated Subjective Global Assessment (PG-SGA) as well as to Body Mass Index (BMI) scores and weight at two time periods.Results: Item 5 of the ZSDS was significantly related to initial weight (F3,45 = 6.06, p < 0.001), weight at 6-month follow-up (F3,27 = 4.16, p < 0.05), BMI score (F3,46 = 2.89, p < 0.05), and nutritional risk on the PG-SGA (F3,45 = 5.80, p < 0.01). Item 7 of the ZSDS was only a significant predictor of nutritional risk as measured by the PG-SGA (F3,46 = 6.01, p < 0.01). When the two items were combined to form a two-item scale, it maintained the individual items' significant relationship to the PG-SGA (F1,48 = 13.99, p < 0.001). Using this as the criterion for identifying nutritionally at-risk patients, the two-item screen yields a sensitivity of 50% and specificity of 88%.Significance of the research: It is concluded that a single item or a combination of two items can yield a reliable initial screen for identifying patients who might be at nutritional risk for the development of cachexia. Further study is needed in prospective trials to further explore the utility of these items.

scholarly journals Prevalence and Associated Factors for Depressive Symptomatology in Chinese Adults During COVID-19 Epidemic

2020 ◽  
Vol 11 ◽  
Author(s):  
Songxu Peng ◽  
Xin Lai ◽  
Yukai Du ◽  
Yuting Li ◽  
Kunming Tian ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
General Population ◽  
Associated Factors ◽  
Depressive Symptomatology ◽  
Multivariate Logistic Regression Analysis ◽  
Depression Scale ◽  
Considerable Proportion ◽  
Chinese Adults ◽  
Cross Sectional ◽  
Targeted Interventions

Background: The coronavirus disease 2019 (COVID-19) has been rapidly transmitted worldwide, which contributed to various psychological problems (such as fear, depression, and anxiety) among the general population in China. The purpose of this study is to investigate the prevalence and associated factors of depressive symptoms among Chinese adults.Methods: A cross-sectional study of Chinese adults was conducted during 17–29 February 2020. Symptoms of depression were assessed using the Center for Epidemiologic Studies Depression scale (CES-D).Results: A total of 3,399 respondents were included in the analysis. It was observed that 14.2% (481/3,399) of the participants were screened positive for depressive symptoms. In a multivariate logistic regression analysis, older age (OR = 0.98; 95% CI, 0.97–0.99), smoking (OR = 1.57; 95% CI, 1.10–2.26), self-rated health (good: OR = 0.49; 95% CI, 0.37–0.66; fairly: OR = 0.60; 95% CI, 0.45–0.80), having greater support scores (OR = 0.95; 95% CI, 0.94–0.96), knowledge about the main symptom of COVID-19 (very clearly: OR = 0.58; 95% CI, 0.42–0.79; relatively clearly: OR = 0.59; 95% CI, 0.44–0.79), and staying in Wuhan within 3 months before the outbreak of epidemic (OR = 1.78; 95% CI, 1.34–2.38) were associated with depressive symptoms.Conclusion: A considerable proportion of the general population in China had depressive symptoms during the COVID-19 epidemic. Routine screening and targeted interventions for depression are needed among high-risk depressed individuals during the COVID-19 epidemic.

Absence of major depressive disorder in female cancer patients.

1985 ◽  
Vol 3 (11) ◽  
pp. 1553-1560 ◽  
Author(s):  
S B Lansky ◽  
M A List ◽  
C A Herrmann ◽  
E G Ets-Hokin ◽  
T K DasGupta ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Rating Scale ◽  
Performance Status ◽  
Depression Scale ◽  
Current Treatment ◽  
Karnofsky Performance Scale ◽  
Prevalence Of Depression ◽  
History Of ◽  
Highly Correlated ◽  
History Of Depression

This investigation evaluated the prevalence of depression in female patients who had cancer in any of five predesignated sites. Five hundred five women aged 17 to 80 (190 with breast cancer, 143 with gynecologic malignancies, 111 with melanoma, 37 with bowel cancer, and 24 with lymphoma) were randomly screened. Assessment included the Hamilton rating scale for depression, the Zung self-rating depression scale, the Karnofsky performance scale, and a 10-cm visual pain analogue line. The results revealed a mean Hamilton of 10.2 (range, 0 to 41; SD, 7.5), a mean Zung score of 35.3 (range, 11 to 68; SD, 9.6), a Karnofsky median score of 80, and a median pain score of 0. Scores on the Zung scale were highly correlated with those of the Hamilton scale (r = .75). Based on cutoff scores accepted as indicating depression (Hamilton greater than or equal to 20 and Zung greater than or equal to 50), patients were depressed. The depressed subgroup was in significantly more pain, experienced greater physical disability, and was more likely to have had prior episodes of depression as compared to the non-depressed women. The two best predictors of current depression were performance status (Karnofsky) and history of depression. No relationship was found between depression and other demographic variables or disease parameters (diagnosis, time since diagnosis, stage or phase of illness, and current treatment). Our findings indicate that the prevalence of major depression in cancer patients is lower than many previous studies have indicated and falls within the range seen in the general population.

scholarly journals Depressive symptoms and cognitive decline in elderly people

2002 ◽  
Vol 181 (5) ◽  
pp. 406-410 ◽  
Author(s):  
Sabrina Paterniti ◽  
Marie-Hélène Verdier-Taillefer ◽  
Carole Dufouil ◽  
Annick Alpérovitch
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Decline ◽  
Elderly People ◽  
Depressive Symptomatology ◽  
Mmse Score ◽  
Epidemiologic Study ◽  
Depression Scale ◽  
Depressive Episodes ◽  
State Examination

BackgroundDepressive symptoms are associated with cognitive decline in elderly people, but the nature of their temporal relationship remains equivocal.AimsTo test whether depressive symptoms predict cognitive decline in elderly people with normal cognition.MethodThe Center for Epidemiologic Study depression scale (CES – D) and the Mini-Mental State Examination (MMSE) were used to evaluate depressive symptomatology and cognitive functioning, respectively. A sample of 1003 persons aged 59–71 years and with a MMSE score of 26 or over was selected. Cognitive decline was defined as a drop of at least 3 points on the MMSE at 4-year follow-up.ResultsBaseline high levels of depressive symptoms predicted a higher risk of cognitive decline at 4-year follow-up. The MMSE score of participants with depression was more likely to fall below 26 at 2-year follow-up and to remain below at 4-year follow-up than the MMSE score of those without depressive symptoms. Persistent but not episodic depressive episodes were associated with cognitive decline.ConclusionsHigh levels of depressive symptoms, when persistent, are associated with cognitive decline in a sample of elderly people.

DEPRESSIVE SYMPTOMATOLOGY AMONG IN-SCHOOL ADOLESCENTS WITH IMPAIRED HEARING

2020 ◽  
Vol 8 (2) ◽  
pp. 931-940
Author(s):  
Olufemi Timothy Adigun
Keyword(s):  
Depressive Symptoms ◽  
Psychosocial Development ◽  
Depressive Symptomatology ◽  
Survey Design ◽  
Depression Scale ◽  
Study Data ◽  
Family Type ◽  
Low Grade ◽  
Impaired Hearing ◽  
Significant Difference

Purpose of the study: This study determined incidences of depressive symptoms and associated causative contextual factors among in-school adolescents with impaired hearing in South West, Nigeria. The study determined symptoms of depression exhibited by in-school adolescents with impaired hearing vis-à-vis some associated intrapersonal causative (age, religion, gender, the onset of hearing loss, satisfaction with the home environment, and family type) variables. Methodology: Descriptive survey design was adopted for the study. Data were collected from 236 adolescents who are either prelingually (39.1%) and postlingually (60.9%) hearing impaired with the Depressive Symptomatology Questionnaire (α = .89). Data collected over a period of 10 weeks were analysed with both descriptive and inferential statistics via SPSS version 23. Main Findings: 58.8% of the participants scored higher on the depression scale, which is mostly characterized by loss of appetite and fearfulness. There is a significant difference (F = 7.61; p < 0.05) in the expression of depressive symptoms between gender and across variants in the onset of deafness (F = 3.59; p < 0.05) and family type (F = 23.14; p < 0.05). Academic stressor and lack of access to information were found to be the major source of their depression. Applications of this study: This study is of importance to counselling psychologist and mental health practitioners for the development of strategic therapeutic approach geared towards positive psychosocial development of individuals with impaired hearing Novelty/Originality of this study: The study confirms the manifestation of moderate to a high level of depressive symptoms among those in-school adolescents with impaired hearing. Academic anxiety/low grade, communication difficulties, and negative societal attitude were the major source of depression for adolescents with impaired hearing in high schools.

Direct costs associated with depressive symptoms in late life: a 4.5-year prospective study

2012 ◽  
Vol 25 (2) ◽  
pp. 292-302 ◽  
Author(s):  
Melanie Luppa ◽  
Hans-Helmut König ◽  
Dirk Heider ◽  
Hanna Leicht ◽  
Tom Motzek ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Home Care ◽  
Old Age ◽  
Service Use ◽  
Depressive Symptomatology ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
The Elderly ◽  
Direct Costs ◽  
Cross Sectional

ABSTRACTBackground: Depression in old age is common. Only few studies examined the association of depressive symptoms and direct costs in the elderly in a cross-sectional way. This study aims to investigate prospectively health service use and direct costs over a course of 4.5 years considering also different courses of depressive symptomatology.Methods: 305 primary care patients aged 75+ were assessed face-to-face regarding depressive symptoms (Geriatric Depression Scale), and service use and costs at baseline and 4.5 years later. Resource utilization was monetarily valued using 2004/2005 prices. The association of baseline factors and direct costs after 4.5 years was analyzed by multivariate linear regression.Results: Mean annual direct costs of depressed individuals at baseline and follow-up were almost one-third higher than of non-depressed, and highest for individuals with chronic depressive symptoms. Most relevant cost drivers were costs for inpatient care, pharmaceuticals, and home care. Costs for home care increased at most in individuals with chronic depressive symptoms. Baseline variables that were associated with direct costs after 4.5 years were number of medications as a measure of comorbidity, age, gender, and depressive symptoms.Conclusions: Presence and persistence of depressive symptoms in old age seems to be associated with future direct costs even after adjustment for comorbidity. The findings deign a look to the potential economic consequences of depressive symptoms in the elderly for the healthcare system in the future.

What are the best terms in Portuguese to explain the concepts of “fatigue” and “depression” in cancer patients?

2014 ◽  
Vol 13 (4) ◽  
pp. 991-996
Author(s):  
Carlos Eduardo Paiva ◽  
Luciana Lopes Manfredini ◽  
Bianca Sakamoto Ribeiro Paiva ◽  
Estela Cristina Carneseca ◽  
Sriram Yennurajalingam ◽  
...  
Keyword(s):  
Cancer Patients ◽  
English Language ◽  
Rating Scales ◽  
Pearson Correlation ◽  
Depression Scale ◽  
Cancer Related Fatigue ◽  
Clinical Vignettes ◽  
Pearson Correlation Analysis ◽  
Positive Correlations ◽  
Numeric Rating

AbstractObjective:Although “fatigue” and “depression” are well-accepted clinical terms in the English language, they are ill defined in many other languages, including Portuguese. We aimed to investigate the most appropriate words to describe cancer-related fatigue (CRF) and depression in Brazilian cancer patients.Method:The interviewers read to patients two clinical vignettes describing fatigued patients and two others describing depressed patients. Participants were asked to choose from among “fatigue,” “tiredness,” “weakness,” “depression,” and “sadness” the best and worst terms to explain the vignettes. In addition, they were administered an instrument containing numeric rating scales (NRSs), addressing common symptoms, including the aforementioned terms. Pearson correlation analysis and accuracy diagnostic tests were conducted using the Hospital Anxiety and Depression Scale (HADS) and the Functional Assessment of Cancer Treatment–Fatigue (FACIT–F) as references.Results:Among the 80 participants, 40% reported that the best term to explain the concept of CRF was “tiredness,” and 59% chose “sadness” as the best descriptor of depression. Regarding diagnostic accuracy, the areas under the curve (AUCs) for “fatigue,” “weakness,” and “tiredness” were 0.71, 0.81, and 0.76, respectively; the AUCs for “depression” and “sadness” ranged from 0.81 to 0.91 and 0.73 to 0.83, respectively. Negative correlations were found among FACIT–F fatigue subscale scores and NRS scores for “fatigue” (r = –0.58), “tiredness” (r = –0.67), and “weakness” (r = –0.62). Regarding depression, there were positive correlations between HADS–D scores and both NRS for “depression” (r = 0.61) and “sadness” (r = 0.54).Significance of results:“Tiredness” was considered the best descriptor of CRF. Taking into consideration the clinical correlation with depression scores, the term “depression” was accepted as the best term to explain the concept of depression.

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