The hidden burden of anxiety and depression in ovarian cancer: A prospective study from diagnosis.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 155-155
Author(s):  
Penelope M Webb ◽  
Vanessa Beesley ◽  
Anna deFazio ◽  
Andreas Obermair ◽  
Peter T. Grant ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Prospective Study ◽  
Depression Scale ◽  
Cancer Prognosis ◽  
Anxiety And Depression ◽  
Prior History ◽  
Persistent Symptoms ◽  
A Prospective Study ◽  
Time Point

155 Background: Women with ovarian cancer (OC) report high rates of anxiety (A) and depression (D), but most studies have used a cross-sectional design at a single time-point, not considered prior history and not included affected women who are symptom-free due to medication. Our goals were to quantify (i) the total burden of A and D among women with newly diagnosed OC; the proportions who (ii) experience symptoms only after their OC diagnosis and (iii) with persistent symptoms; and (iv) use of appropriate medication/services by those affected. Methods: The OPAL (Ovarian Cancer Prognosis & Lifestyle) Study is a prospective study of Australian women diagnosed with OC from 2012-15 who agreed to complete questionnaires at baseline, 3, 6, 9, 12, 24, 36 & 48 months after diagnosis. At baseline, they were asked if they had ever been diagnosed with A or D and if they took medication for this in the year before their OC diagnosis. At follow-up they completed the Hospital Anxiety and Depression Scale (HADS) and were asked about current medication use. Results: Of 893 women with data for ≥1 time point, 216 (24%) reported clinical levels (HADS > 10) of anxiety (18%) and/or depression (15%) on at least one occasion during the first 3 years after diagnosis, with another 157 (18%) reporting use of anxiolytic or antidepressant medications. A further 167 (19%) reported subclinical (HADS 8-10) A or D. Of those with clinical levels of A/D and/or taking medication, 225 (60%) reported this at ≥3 time-points, 216 (58%) reported no prior history of A or D, and 271 (73%) reported no use of anxiolytic/antidepressant medication in the year before diagnosis. When women reported clinical levels of A or D, only 45% reported taking medication (37%) and/or seeing a psychiatrist or psychologist (19%). Conclusions: More than 40% of women with OC experienced clinical levels of A or D during treatment or the first 3 years of follow-up, for 25% this persisted. For 24% this was their first experience of distress and > 50% of those affected did not receive appropriate medication or psychological support. The hidden burden of anxiety and depression in this population is much greater than previously reported but is amenable to effective intervention if recognized.

The Ovarian cancer Prognosis And Lifestyle (OPAL) study.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 88-88
Author(s):  
Penelope M Webb ◽  
Anna deFazio ◽  
Andreas Obermair ◽  
Peter T. Grant ◽  
Michael Friedlander ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Prospective Study ◽  
Large Population ◽  
Depression Scale ◽  
Cancer Prognosis ◽  
Sitting Time ◽  
Newly Diagnosed ◽  
Questionnaire Response ◽  
Patient Reported

88 Background: Five-year survival after a diagnosis of ovarian cancer (OC) is < 45% and women often ask what they can do, beyond following the recommended treatment, to improve their chance of survival. The OPAL Study addresses the question of whether lifestyle choices during or after treatment could positively impact quality of life (QoL) and, ultimately, survival. Methods: OPAL is a prospective study of Australian women newly diagnosed with primary OC from 2012-15 who agreed to complete questionnaires at baseline, 3, 6, 9, 12, 24, 36 & 48 months after diagnosis. Baseline data include sociodemographic, reproductive & hormonal, medical & family history, and lifestyle (diet, alcohol, smoking, physical activity, sitting time) information. At follow-up, women are asked about their current lifestyle, medication and complementary therapy use, and a range of patient-reported outcomes including the Hospital Anxiety and Depression Scale, Insomnia Severity Index and FACT instruments for ovarian cancer, neurotoxicity and fatigue. 85% also provided a blood sample at recruitment and/or 12 months after diagnosis. Detailed treatment and outcome data are collected annually from medical records. Results: Of 1451 eligible women identified, 219 were excluded and 274 declined leaving a cohort of 958; 72% have high-grade serous and 72% advanced stage disease. Follow-up is now close to 36 months with questionnaire response rates of 85-95% among active participants. At October 2017, we had received 734, 751, 636, 434 and 225 questionnaires at 6, 12, 24, 36 and 48 months, respectively; women have completed a mean of 5 questionnaires (range 1-8). A total of 558 (58%) have experienced disease progression or recurrence, 332 (35%) have died and 300 are still active in the study. The proportion of women reporting clinical levels of anxiety ranges from 6-9% at each time-point, depression from 5-7%, insomnia from 9-14% and fatigue from 30-57%. Conclusions: This is the first prospective study to collect detailed lifestyle, QoL, clinical and outcome information from a large population-based cohort of women newly diagnosed with OC. It provides a valuable resource to identify relationships between potentially modifiable aspects of lifestyle and outcomes (QoL & survival) in women with OC.

scholarly journals Do Anxiety and Depression Predict Persistent Physical Symptoms After a Severe COVID-19 Episode? A Prospective Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Hugo Bottemanne ◽  
Clément Gouraud ◽  
Jean-Sébastien Hulot ◽  
Anne Blanchard ◽  
Brigitte Ranque ◽  
...  
Keyword(s):  
Prospective Study ◽  
Acute Infection ◽  
Depression Scale ◽  
Physical Symptom ◽  
Physical Symptoms ◽  
Anxiety And Depression ◽  
Increased Risk ◽  
A Prospective Study ◽  
Anxiety Depression

Background: Persistent physical symptoms are common after a coronavirus disease 2019 (COVID-19) episode, but their pathophysiological mechanisms remain poorly understood. In this study, we aimed to explore the association between anxiety and depression at 1-month after acute infection and the presence of fatigue, dyspnea, and pain complaints at 3-month follow-up.Methods: We conducted a prospective study in patients previously hospitalized for COVID-19 followed up for 3 months. The Hospital Anxiety and Depression Scale (HAD-S) was administered by physicians at 1-month follow-up, and the presence of fatigue, dyspnea, and pain complaints was assessed at both 1 month and 3 months. Multivariable logistic regressions explored the association between anxiety and depression subscores and the persistence of each of the physical symptom at 3 months.Results: A total of 84 patients were included in this study (Median age: 60 years, interquartile range: 50.5–67.5 years, 23 women). We did not find any significant interaction between anxiety and the presence of fatigue, dyspnea, or pain complaints at 1 month in predicting the persistence of these symptoms at 3 months (all p ≥ 0.36). In contrast, depression significantly interacted with the presence of pain at 1 month in predicting the persistence of pain at 3 months (OR: 1.60, 95% CI: 1.02–2.51, p = 0.039), with a similar trend for dyspnea (OR: 1.51, 95% CI: 0.99–2.28, p = 0.052).Discussion and Conclusion: Contrary to anxiety, depression after an acute COVID-19 episode may be associated with and increased risk of some persistent physical symptoms, including pain and dyspnea.

scholarly journals P778 Longitudinal trajectory of fatigue in inflammatory bowel disease patients: a prospective study

2020 ◽  
Vol 14 (Supplement_1) ◽  
pp. S616-S617
Author(s):  
N Borren ◽  
M Long ◽  
J van der Woude ◽  
R Sandler ◽  
A Ananthakrishnan
Keyword(s):  
Inflammatory Bowel Disease ◽  
Prospective Study ◽  
Sleep Disturbance ◽  
Bowel Disease ◽  
Substantial Impact ◽  
Persistent Fatigue ◽  
Inflammatory Bowel ◽  
A Prospective Study ◽  
Time Point

Abstract Background Fatigue is a commonly reported and sometimes disabling symptom in patients with inflammatory bowel disease (IBD). Its prevalence, mechanism, and impact remain poorly understood. Using a large cohort of patients with IBD, we aimed to prospectively determine the trajectory of fatigue and to identify determinants and impact of incident and prevalent fatigue on patients with IBD. Methods This prospective study was nested within the IBD partners cohort, a validated internet-based cohort of patients with IBD. Participants were invited to prospectively complete questionnaires assessing fatigue status at baseline and subsequently after 6 and 12 months. Fatigue was assessed using the validated Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) score. A FACIT-F score of &lt; 43 was defined as significant fatigue. We examined the trajectory and predictors of different courses of fatigue including incident fatigue (not fatigued as baseline but fatigued at 6 months) and resolved fatigue (fatigue at baseline but resolved on follow-up). Results A total of 2429 patients (1605 CD, 824 UC) completed baseline assessment among whom 1057 completed a second assessment at 6 months. First, we identified three distinct patterns of fatigue. Episodic fatigue defined as fatigue at any one (but not both) time point was the most common, affecting 1182 patients (57.0%). Persistent fatigue (at both baseline and follow-up) affected 33.5% (n = 695) while only 196 patients (9.5%) reported no fatigue at any time point (n = 196) (Figure). Patients that reported persistent or intermittent fatigue were more likely to have active disease (p &lt; 0.001), be younger, (p &lt; 0.001), report anaemia (p = 0.002) and low vitamin B12 levels (p &lt; 0.001) and to have a prior diagnosis of depression, anxiety or sleep disorder (p &lt; 0.001). Among patients who were not fatigued at baseline, 26% developed new fatigue at 6 months defined as incident fatigue). The strongest predictor of this being presence of sleep disturbance at baseline (OR 2.45, 95% CI 0.24–1.55) (Table). In contrast, only 12.3% of those with fatigue at baseline had symptom resolution by month 6. Resolution of fatigue was more common in those with UC (p = 0.03), quiescent disease at baseline (p = 0.006), not receiving biologic therapy at baseline (p = 0.016) and no sleep disturbance (p &lt; 0.001), anxiety (p = 0.002) and depressive (p = 0.005) symptoms at baseline. Conclusion Our findings indicate three distinct trajectories of fatigue in patients with IBD with their distinct predictors. Importantly, 26% of patients developed new onset fatigue at 6 months demonstrating the substantial impact of this on patients with IBD.

Is alexithymia a personality trait increasing the risk of depression? A prospective study evaluating alexithymia before, during and after a depressive episode

2008 ◽  
Vol 38 (12) ◽  
pp. 1717-1722 ◽  
Author(s):  
C. Marchesi ◽  
S. Bertoni ◽  
A. Cantoni ◽  
C. Maggini
Keyword(s):  
Prospective Study ◽  
Pregnant Women ◽  
Personality Trait ◽  
Depressive Episode ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
State Dependent ◽  
A Prospective Study ◽  
Care Evaluation

BackgroundWhether alexithymia is a personality trait that increases the risk of major depression (MD) is still debated. In this prospective study, alexithymic levels were evaluated before, during and after a depressive episode.MethodThe alexithymic levels, the presence of MD and the severity of anxious-depressive symptoms were evaluated at intervals of about 1 month in pregnant women attending the Centers for Prenatal Care, using the Toronto Alexithymia Scale (TAS), the Primary Care Evaluation of Mental Disorders (PRIME-MD) and the Hospital Anxiety and Depression Scale (HADS).ResultsSixteen women affected by MD, 21 affected by subthreshold depression and 112 non-depressed women were included in the study. Women who developed depression, compared to non-depressed women, showed similar TAS and HADS scores during the pre-morbid phase, a significant increase in the scores during depression and a significant decrease after remission, whereas no change was observed in non-depressed women.ConclusionsOur data suggest that in pregnant women alexithymia does not represent a personality trait that increases the risk of developing a depressive episode, and they support the hypothesis that alexithymia is a state-dependent phenomenon in depressed pregnant women.

Comment on: “Anxiety and depression in patients with advanced ovarian cancer: a prospective study”

2016 ◽  
Vol 38 (1) ◽  
pp. 83-84 ◽  
Author(s):  
Salvatore Giovanni Vitale ◽  
Valentina Lucia La Rosa ◽  
Agnese Maria Chiara Rapisarda ◽  
Antonio Simone Laganà
Keyword(s):  
Ovarian Cancer ◽  
Prospective Study ◽  
Advanced Ovarian Cancer ◽  
Anxiety And Depression ◽  
A Prospective Study

The relevant psychological burden of having a benign brain tumor: a prospective study of patients undergoing surgical treatment of cranial meningiomas

2019 ◽  
Vol 131 (6) ◽  
pp. 1840-1847 ◽  
Author(s):  
Arthur Wagner ◽  
Youssef Shiban ◽  
Nicole Lange ◽  
Ann-Kathrin Joerger ◽  
Ute Hoffmann ◽  
...  
Keyword(s):  
Prospective Study ◽  
Trait Anxiety ◽  
Physical Disability ◽  
Preoperative Anxiety ◽  
Anxiety And Depression ◽  
Intracranial Meningioma ◽  
Psychological Burden ◽  
Psychological Comorbidities ◽  
A Prospective Study

OBJECTIVEMeningiomas are the most common intracranial neoplasm. Evidence concerning surgical management and outcome is abundant, while the implications for the quality of life (QOL) of a patient confronted with the diagnosis and undergoing surgery are unclear. The authors conducted a prospective study to evaluate QOL in relation to psychological comorbidities comorbidities.METHODSA prospective study of patients undergoing elective surgery for the removal of an intracranial meningioma was performed. The authors evaluated depression (Allgemeine Depressionsskala K score) and anxiety (Post-Traumatic Stress Scale–10 [PTSS-10]; State Trait Anxiety Inventory–State Anxiety and –Trait Anxiety [STAI-S and STAI-T]; and Anxiety Sensitivity Index–3 [ASI-3]) scores before surgery and at 3 and 12 months after surgery. The correlation between preoperative psychological burden and postoperative QOL as measured by the 36-Item Short Form Health Survey and EQ-5L questionnaires was analyzed. Incidence and influence of these psychiatric comorbidities on clinical outcome were examined.RESULTSA total of 78 patients undergoing resection of a meningioma between January 2013 and September 2017 participated in the preoperative psychological screening and 71 patients fully completed postoperative follow-up examination after 1 year of follow-up. At presentation, 48 patients (67.7%) had abnormal anxiety scores, which decreased to 29.6% (p = 0.003). On follow-up at 12 months, mean EQ-5L visual analog scale scores were significantly lower in patients with pathological scores on the PTSS-10 (0.84 vs 0.69; p = 0.004), STAI-S (0.86 vs 0.68; p = 0.001), and STAI-T (0.85 vs 0.71; p = 0.011). Neurological status (modified Rankin Scale) improved slightly and showed some correlation with psychological comorbidities QOL scores (p = 0.167). There was a nonsignificant increase of EQ-5L scores over the period of follow-up (p = 0.174) in the repeated-measures analysis. In the regression analysis, impaired QOL and physical disability on follow-up correlated with elevated preoperative anxiety and depression levels.CONCLUSIONSThe QOL and physical disability of patients undergoing resection of an intracranial meningioma highly depend on preoperative anxiety and depression levels. Stress and anxiety scores generally decrease after the resection, which leads us to conclude that there is a tremendous emotional burden caused by an upcoming surgery, necessitating close psychooncological support in order to uphold functional outcome and health-related QOL in the postoperative course.

scholarly journals Ovarian Cancer Follow-up: A Preliminary Comparison of 2 Approaches

2016 ◽  
Vol 27 (1) ◽  
pp. 59-68 ◽  
Author(s):  
Anne Lanceley ◽  
Carlo Berzuini ◽  
Matthew Burnell ◽  
Sue Gessler ◽  
Stephen Morris ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Ovarian Cancer ◽  
Patient Satisfaction ◽  
Confidence Interval ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Preliminary Comparison

ObjectiveThe aim of the study was to perform a preliminary comparison of quality of life (QoL) and patient satisfaction in individualized nurse-led follow-up versus conventional medical follow-up in ovarian cancer.MethodsOne hundred twelve women who received a diagnosis of ovarian, fallopian tube, or peritoneal cancer, completed primary treatment by surgery alone or with chemotherapy, irrespective of outcome with regard to remission, and expected survival of more than 3 months. Fifty-seven participants were randomized to individualized follow-up and 55 patients to conventional follow-up. Well-being was measured at baseline and at 3, 6, 12, and 24 months after randomization for QoL (QLQ-C30 [European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire], QLQ-Ov28), the Hospital Anxiety and Depression Scale (HADS), and a Patient Satisfaction Questionnaire (PSQ-III). The primary endpoints were the effects of follow-up on each of the scores (via hierarchical mixed-effects model) and on relapse-free time (via Cox model). The total cost of follow-up was compared between each group.ResultsThere was evidence for a QoL and patient satisfaction benefit for individualized versus standard follow-up (QLQ-C30, P = 0.013; 95% confidence interval, −0.03 to −0.001; PSQ-III P = 0.002; 95% confidence interval, −0.003 to −0.015; QLQ-Ov28, P = 0.14). Hospital Anxiety and Depression Scale data provided no evidence in favor of either treatment (P = 0.42). Delivered to protocol individualized follow-up resulted in a delay in the presentation of symptomatic relapse (P = 0.04), although the effect on survival in this study is unknown. Cost was £700 lower on average for the individualized follow-up group, but the difference was not statistically significant at the 5% level (P = 0.07).ConclusionsIndividualized follow-up was superior to conventional follow-up in 3 of the 4 QoL and patient satisfaction surveys in this preliminary study. Further prospective studies are needed in a larger population.Trial registration number is ISRCTN59149551.

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