Perspectives on psychological distress in cancer patients: Comparison between expected, perceived and actual disturbances in a clinic from Argentina

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 18515-18515
Author(s):  
F. Torrente ◽  
D. Gercovich ◽  
H. Hirsch ◽  
P. Margiolakis ◽  
E. Gil Deza ◽  
...  
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Cancer Patients ◽  
Mental Health Treatment ◽  
Depression Scale ◽  
High Rate ◽  
Anxiety And Depression ◽  
Cutoff Score ◽  
Waiting Room ◽  
Psychological Assistance

18515 Background: Psychological distress is a widespread phenomenon in cancer patients (pts.) Notwithstanding, its recognition and the threshold criteria for referral to a specialized unit are still problematic in clinical practice. Correspondingly, the aim of this study was to explore how much psychological distress (PD) is expected by the oncologists, how much distress is actually present in these pts., and finally how many of them are detected as having significant problems and referred to the mental health unit (MHU). Methods: Three sources of data were compared for the purpose of this study. Firstly, a survey to the practicing oncologists (n =18) was carried out in order to establish the rate of PD expected by them. Secondly, a consecutive sample of 259 pts. was evaluated in the waiting room with the Hospital Anxiety and Depression Scale (HADS) for establishing an estimation of the actual rate of PD in this population. Finally, 115 pts. from the MHU were studied for determining the rate and the accuracy of the referral made by the oncologists. Results: Sixty one percent of the surveyed oncologists considered that 75% or more of their pts would need psychological assistance. The waiting room sample evaluated with the HADS showed that 74.9% of patients surpassed the cutoff score (11 points) for either anxiety or depression, or both. Despite this, less than 5% of the total population of the clinic was referred to the MHU. From this sample, 38.3% of the pts. scored below the cutoff line. The proportion of pts. who exceeded the cutoff score for depression was significantly higher in the MHU sample. Conclusions: Most of the oncologists expect a high rate of PD in their patients, and even overestimate it. Actual rates of anxiety and depression were also high. On the contrary, the rate of referral to specialized mental health treatment was extremely low and the pts. referred were not necessarily highly disturbed. Depression is probably better recognized than anxiety by oncologists. In conclusion, both quantitative and qualitative problems were detected in the referral to the MHU, regardless the awareness of the oncologists about PD. No significant financial relationships to disclose.

scholarly journals Prevalence and course of anxiety and depression among patients selected for bariatric surgery

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S25-S25
Author(s):  
Jonathan Gibb ◽  
Chris Rogers ◽  
Eleanor Gidman ◽  
Graziella Mazza ◽  
Jane Blazeby ◽  
...  
Keyword(s):  
Mental Health ◽  
Bariatric Surgery ◽  
Controlled Trial ◽  
Depression Scale ◽  
High Rate ◽  
Anxiety And Depression ◽  
Rank Test ◽  
Signed Rank Test ◽  
Randomised Controlled ◽  
Post Randomisation

AimsTo determine the prevalence of anxiety and depression amongst participants with severe or complex obesity randomised and selected for bariatric surgery in a large multi-centre trial.To describe the change in prevalence of anxiety and depression amongst participants who had undergone bariatric surgery, within 6 months of randomisation and at 12 months post-randomisation.MethodThe By-Band-Sleeve (BBS) study is a multi-site randomised controlled trial evaluating the surgical management of severe or complex obesity and is the largest trial of its kind. Participants completed the Hospital Anxiety and Depression Scale (HADS) on study enrolment (pre-randomisation) and at 12 months post-randomisation. In this sub-study, we describe provisional data concerning the baseline prevalence of anxiety and depression along with change in median HADS symptom score amongst those who actually underwent bariatric surgery.Result758 participants met the criteria for study inclusion with 716 (94.46%) and 712 (93.93%) individuals fully completing questionnaires for HADS-A and HADS-D. At pre-randomisation, the prevalence of possible (HADS A/D = 8-10) and probable (HADS A/D >11) anxiety or depression was 46.19% (n 330/716) and 48.17% (n 48.17%) respectively. Paired and complete HADS-A and HADS-D questionnaires were available for 70.25% (n 503/716) and 69.94% (n 498/712) participants. There was a highly statistically significant decrease in median HADS-A and HADS-D scores at 12 months post-randomisation (Wilcoxon signed-rank test p < 0.001). This was coupled with a statistically significant reduction in the proportion of cases with possible and probable anxiety (–9.54%, p < 0.001) and also depression (–22.21%, p < 0.001) at 12 months post-randomisation.ConclusionOur results characterise the high rate of psychological comorbidity amongst patients with severe or complex obesity selected for bariatric surgery. Whilst bariatric surgery remains the most clinically effective treatment for severe obesity, its effects on long-term post-operative mental health outcomes are less clear. These findings contribute to the growing body of evidence calling for increased pre/post-operative mental health surveillance and integrated care for this cohort of patients.

Would women with breast cancer prefer to receive an antidepressant for anxiety or depression from their oncologist?

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 219-219
Author(s):  
Daniel Curtis McFarland ◽  
Megan Johnson Shen ◽  
Kirk Harris ◽  
Amy Tiersten ◽  
John Mandeli ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Mental Health ◽  
Health Professional ◽  
Cancer Patients ◽  
Mental Health Professional ◽  
Depression Scale ◽  
Patient Treatment ◽  
Anxiety And Depression ◽  
Breast Cancer Patients ◽  
To Receive

219 Background: Patient treatment preferences for the management of anxiety and depression influence adherence and treatment outcomes, yet breast cancer patient preferences for provider-specific pharmacologic management of anxiety and depression is unknown. This study examined breast cancer patients’ antidepressant prescriber preferences and their preferences for treatment by a mental health professional. Methods: Breast cancer patients (Stage 0-IV) were asked two questions: 1) “Would you be willing to have your oncologist treat your depression or anxiety with an antidepressant medication if you were to become depressed or anxious at any point during your treatment?”; and 2) “Would you prefer to be treated by a psychiatrist or mental health professional for problems with either anxiety or depression?” Additionally, the Distress Thermometer and Problem List, Hospital Anxiety and Depression Scale, Risky Families Questionnaire, and demographic information were assessed. Results: One hundred twenty-five participants completed the study. 60.4% were willing to accept an antidepressant from an oncologist and 26.3% preferred treatment by a mental health professional. 77.3% who were willing to receive an antidepressant from their oncologist reported either no preference or that treatment by a mental health professional didn’t matter (p = 0.01). Participants taking antidepressants (p = 0.02) or reporting high chronic stress (p = 0.03) preferred a mental health professional. Conclusions: The majority of patients accepted antidepressant prescribing by their oncologist; only a minority preferred treatment by a mental health professional. These findings suggest the benefit for promoting education of oncologists to assess psychological symptoms and manage anxiety and depression as a routine part of an outpatient visit.

Meaning of life, representation of death, and their association with psychological distress

2017 ◽  
Vol 16 (5) ◽  
pp. 511-519 ◽  
Author(s):  
Ines Testoni ◽  
Giulia Sansonetto ◽  
Lucia Ronconi ◽  
Maddalena Rodelli ◽  
Gloria Baracco ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Path Analysis ◽  
Cancer Patients ◽  
Meaning In Life ◽  
Religious Orientation ◽  
Depression Scale ◽  
Meaning Of Life ◽  
Anxiety And Depression ◽  
Cross Sectional ◽  
Healthy Participants

AbstractObjective:This paper presents a two-phase cross-sectional study aimed at examining the possible mitigating role of perceived meaning of life and representation of death on psychological distress, anxiety, and depression.Method:The first phase involved 219 healthy participants, while the second encompassed 30 cancer patients. Each participant completed the Personal Meaning Profile (PMP), the Testoni Death Representation Scale (TDRS), the Hospital Anxiety and Depression Scale (HADS), and the Distress Thermometer (DT). The primary analyses comprised (1) correlation analyses between the overall scores of each of the instruments and (2) path analysis to assess the indirect effect of the PMP on DT score through anxiety and depression as determined by the HADS.Results:The path analysis showed that the PMP was inversely correlated with depression and anxiety, which, in turn, mediated the effect on distress. Inverse correlations were found between several dimensions of the PMP, the DT, and the HADS–Anxiety and HADS–Depression subscales, in both healthy participants and cancer patients. Religious orientation (faith in God) was related to a stronger sense of meaning in life and the ontological representation of death as a passage, rather than annihilation.Significance of Results:Our findings support the hypothesis that participants who represent death as a passage and have a strong perception of the meaning of life tend to report lower levels of distress, anxiety, and depression. We recommend that perceived meaning of life and representation of death be more specifically examined in the cancer and palliative care settings.

scholarly journals The Impact of Cancer Treatment “Out-of-Pocket” Costs on the Mental Health of Chemotherapy Patients: A Comparative Study

2021 ◽  
Author(s):  
Thiago Artioli ◽  
Karine Corcione Turke ◽  
Aline Hernandez Marquez Sarafyan ◽  
Beatriz Boos Ortolani ◽  
Ingrid Victoria Maria Biondo Edle von Schmadel ◽  
...  
Keyword(s):  
Mental Health ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Depression Scale ◽  
Tertiary Hospital ◽  
Anxiety And Depression ◽  
Cross Sectional ◽  
Unified Health System ◽  
The Impact ◽  
Out Of Pocket Costs

Abstract Introduction: Anxiety and depression are prevalent comorbidities in cancer patients. Although cancer treatment is funded by the Brazilian Unified Health System (SUS), economic burden is also borne by patients through out-of-pocket costs. Our study sought to evaluate the impact of out-of-pocket costs of cancer treatment on depression, anxiety and stress levels in cancer patients.Methods: Observational, cross-sectional and analytical study conducted in 2021. Patients undergoing chemotherapy were being treated at tertiary hospital affiliated with the SUS and enrolled in research protocols at research center. To evaluate out-of-pocket costs, we used a socioeconomic questionnaire to identify costs and time spent by patients. Primary outcomes were prevalence of depression and anxiety, as determined by the Hospital Anxiety and Depression Scale (HADS), and prevalence of stress, as determined using a stress thermometer.Results: 195 patients were included. Among included patients, 61% were female, and mean age was 57 years. Patients' median overall out-of-pocket costs was R$ 453.80 (US$ 78.92). Based on the HADS, 62.1% of patients had possible or probable depression/anxiety. There was no correlation between overall out-of-pocket spending and levels of depression/anxiety. However, when stratified by cost-time variables, there was a negative correlation between spending on telephones and HADS (rho = -0.140; P = 0.049) and positive correlations between spending on medications (rho = 0.140; P = 0.05) and time spent purchasing medications (rho = 0.157; P = 0.029) with HADS.Conclusion: Although overall spending was not directly correlated with mental health, specific costs impacted levels of anxiety, depression and stress.

scholarly journals Effect of Anxiety and Depression on Survival of Cancer Patients, a 13 Year Follow-up

2021 ◽  
Vol 6 (1) ◽  
pp. 9-13
Author(s):  
Suriati Mohamed Saini ◽  
Susan Tan Mooi Koon ◽  
Mohamad Adam Bujang ◽  
Gerard Lim Chin Chye ◽  
Shalisah Sharip ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Cancer Patients ◽  
Depression Scale ◽  
Cox Proportional Hazards ◽  
Anxiety Symptoms ◽  
High Rate ◽  
Anxiety And Depression ◽  
Risk Of Death ◽  
Increased Risk

Introduction: Anxiety and depression occur at a high rate in cancer patients. However, debate remains regarding the effect of anxiety and depression on cancer survival. Objective: This study aimed to determine the effect of anxiety and depressive symptoms on the survival of cancer patients. Methods: The subjects consisted of 112 cancer patients who attended the Oncology and Radiotherapy outpatient clinic Hospital Kuala Lumpur, Malaysia, in 1999. Anxiety and depressive symptoms were measured using the Hospital Anxiety and Depression Scale (HADS) questionnaire at inception. Information on patients’ mortality status for extended 13 years follow-up (in 2011) was obtained from the National Registration Department death records. Overall survival for each anxiety and depressive symptoms scores in HADS at 13 years was calculated using Cox proportional hazards regression analysis. Results: Cancer patients experienced more anxiety (83%) compared to depressive symptoms (40.2%). The mean (S.D.) HADS scores for depressive symptoms were 9.9 (2.5), and the anxiety symptoms score was 12.6 (2.1). At 13 years, half of the patients (50.9%) had died. No significant effect of anxiety (p=0.399, 95% C.I.= 6.2-8.4) or depressive symptoms at inception (p=0.749, 95% C.I.= 5.9-8.4) towards cancer patients’ survival was found at 13 years follow-up. Conclusion: The occurrence of anxiety symptoms among cancer patients in this study was 2-folds higher than depressive symptoms. However, no significant increased risk of death was found in cancer patients with anxiety or depressive symptoms at 13 years follow-up. It may imply that as time extended, survival in cancer patients may be related to various interacting elements, and intervening health factors are of importance.

Detecting psychological distress in cancer patients: validity of the Italian version of the Hospital Anxiety and Depression Scale

1999 ◽  
Vol 7 (3) ◽  
pp. 121-127 ◽  
Author(s):  
M. Costantini ◽  
Marco Musso ◽  
Paola Viterbori ◽  
Francesca Bonci ◽  
Lucia Del Mastro ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Cancer Patients ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Italian Version

Disparities in quality-of-life outcomes in immigrant cancer patients.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e16507-e16507
Author(s):  
David Goldstein ◽  
Ming Sze ◽  
Melanie Bell ◽  
Madeleine King ◽  
Michael Jefford ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Unmet Need ◽  
Depression Scale ◽  
High Rate ◽  
Anxiety And Depression ◽  
Cancer Type ◽  
Life Outcomes ◽  
Quality Of Life Outcomes

e16507 Background: Immigration is increasing world-wide. We explored disparities in quality of life outcomes for immigrant (IM) versus Anglo-Australian (AA) cancer patients having anti-cancer treatment. Methods: In a cross-sectional design, cancer patients were recruited through outpatient Oncology clinics in New South Wales, Victoria, and the Northern Territory in Australia. IM participants, their parents and grand parents were born in a country where Chinese, Greek, or Arabic is spoken and spoke one of those languages. AAs were born in Australia and spoke English. All were diagnosed with cancer < 1 year previously. Questionnaires (completed in preferred language) included the Hospital Anxiety and Depression Scale (anxiety/depression), FACT-G (quality of life) and the Supportive Care Needs Survey (unmet needs). Adjusted regression models comparing AA and IM groups included age, gender, socio-economic status, education, marital status, religion, time since diagnosis, and cancer type (colorectal, breast, lung, other). Results: There were 910 participants (response rate 57%). IM were similar to AA, except that IM were more likely to be married (76 vs 67 %, p = 0.01) and in the low and the highly educated groups (p < 0.0001). In adjusted analyses, IMs had clinically significant higher anxiety, greater unmet information and physical needs and lower quality of life than AAs (see table). The possible ranges are 0-21 for anxiety and depression, and 0-100 otherwise. Conclusions: In this hospital-based study with a high rate of advanced disease, immigrants with cancer experienced poorer quality of life outcomes, even after adjusting for socio-economic, demographic, and disease variables. Interventions are required to improve their experience of cancer care. Results highlight areas of unmet need that might be better addressed by the health system (particularly with regards to provision of information and meeting support and physical needs). [Table: see text]

scholarly journals Performance of Distress Thermometer and Associated Factors of Psychological Distress among Chinese Cancer Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Sudip Thapa ◽  
Huihui Sun ◽  
Gaurab Pokhrel ◽  
Bangyan Wang ◽  
Sanuja Dahal ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Cancer Patients ◽  
Predictive Value ◽  
Clinical Utility ◽  
Depression Scale ◽  
Distress Thermometer ◽  
Cutoff Score ◽  
Characteristic Analysis ◽  
Cross Sectional ◽  
Factors Associated

Objective. We aimed to examine the performance of the distress thermometer (DT) and identify the prevalence and risk factors associated with psychological distress (PD) in heterogeneous cancer patients. Methods. This cross-sectional study enrolled 1496 heterogeneous cancer patients from the inpatient and outpatient departments. Receiver operating characteristic analysis (ROC) of DT was evaluated against the Hospital Anxiety and Depression Scale-Total (HADS-T ≥15). An area under the curve (AUC), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and clinical utility index were calculated. Multiple binary logistic regression was used to identify the factors associated with PD. Results. Referring to ROC analysis, DT showed good discriminating accuracy (AUC = 0.88). A cutoff score of 4 was established, and it yielded sensitivity (0.81), specificity (0.88), PPV (0.87), NPV (0.82), and clinical utility indexes (screening utility = 0.71 and case-finding utility = 0.73). 46.5% of our participants was distressed. Lower education levels (odd ratio (OR) = 1.39), advanced stage (OR = 1.85), active disease status (OR = 1.82), lack of exercise (OR = 3.03), diagnosis known (OR = 0.64), emotional problems (OR = 3.54), and physical problems (OR = 8.62) were the predictive factors for PD. Conclusion. DT with a cutoff score (≥4) is a comprehensive, appropriate, and practical initial screener for PD in cancer patients. Predicting factors should be considered together for effective management of PD in such population.

The impact of a multidimensional exercise program on self-reported anxiety and depression in cancer patients undergoing chemotherapy: A phase II study

2005 ◽  
Vol 3 (3) ◽  
pp. 197-208 ◽  
Author(s):  
JULIE MIDTGAARD ◽  
MIKAEL RØRTH ◽  
REINHARD STELTER ◽  
ANDERS TVETERÅS ◽  
CHRISTINA ANDERSEN ◽  
...  
Keyword(s):  
Psychological Distress ◽  
Cancer Patients ◽  
Phase Ii ◽  
Exercise Intervention ◽  
Phase Ii Study ◽  
Depression Scale ◽  
Exercise Program ◽  
Anxiety And Depression ◽  
Adherence Rate ◽  
The Impact

Little is known about the role of exercise in improving cancer patients' mood while undergoing chemotherapy. In this phase II study changes in self-reported anxiety and depression and fitness (VO2max) are reported in relation to a 6-week, 9 h weekly, multidimensional exercise program. A total of 91 patients receiving chemotherapy, between 18 and 65 years old, completed a Hospital Anxiety and Depression Scale Questionnaire (HADS; response rate 91%, adherence rate 78%). Anxiety (p< 0.001) and depression (p= 0.042) was significantly reduced. The mean ±SDof the change was −1.14 ± 2.91 for anxiety and −0.44 ± 2.77 for depression. Improvements in fitness were correlated with improvements in depression, χ2(1) = 3.966,p= 0.046, but not with improvements in anxiety, χ2(1) = 0.540,p= 0.462. The research suggests that exercise intervention may have a beneficial impact on psychological distress for cancer patients receiving chemotherapy with low to moderate levels of baseline psychomorbidity. The study furthermore indicates that changes in distress may be associated with disease status and levels of physical activity undertaken during disease. The study is followed up by an ongoing randomized clinical controlled trial to evaluate potential causal effects of exercise intervention on psychological distress and fitness in cancer patients undergoing chemotherapy.

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