Predictors and trajectories of fatigue in ovarian and uterine cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11603-11603
Author(s):  
Hanneke Poort ◽  
Belle Hadewijch de Rooij ◽  
Shicheng Weng ◽  
Nicole Ezendam ◽  
Lonneke V van de Poll-Franse ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Uterine Cancer ◽  
Depression Scale ◽  
Psychological Interventions ◽  
Gynecologic Cancers ◽  
Early Stage Disease ◽  
Persistent Fatigue ◽  
Clinically Significant ◽  
One Year ◽  
Over Time

11603 Background: Fatigue is one of the most common and distressing symptoms reported by patients with gynecological cancers, but few studies have empirically examined whether it resolves without intervention. The aims of this study were to identify: 1) clinically-distinct subgroups of patients with fatigue over time and 2) medical and psychological predictors of clinically-significant fatigue one-year post-diagnosis. Methods: Secondary analysis of a prospective cohort study. Symptoms of fatigue, depression, and anxiety were assessed at diagnosis, 6-months, and 12-months with the 10-item Fatigue Assessment Scale (FAS), and the Hospital Anxiety and Depression Scale (HADS), respectively. Group-based trajectory modeling was used to classify patients by their fatigue scores over time, and logistic regression models were fit to examine associations between clinically-significant fatigue and demographic, clinical, and psychosocial characteristics. Patients with recurrent or primary progressive cancers were excluded from the primary analysis. Results: Among 312 participants with newly diagnosed ovarian (n = 112) or endometrial (n = 200) cancers, the median age was 66 years (IQR = 60-72 years), 36% had ovarian cancer, and 79% had early stage disease. At baseline, 49% reported clinically significant fatigue and one year later, 42% had persistent fatigue. During the year after diagnosis, there were three distinct trajectories of fatigue that persisted: (1) severe fatigue (15%), (2) moderate fatigue (45%), and (3) no fatigue (41%). Patients with ≥2 comorbid conditions (odds ratio [OR] 2.52, 95% confidence interval [CI] = 1.21-5.27, P = 0.01), clinically significant fatigue at baseline (OR 5.47, 95% CI = 2.71-11.03, P < .0001), and those reporting depressive symptoms at baseline (OR 3.45, 95% CI = 1.13-10.55, P = 0.03) were more likely to report clinically-significant fatigue at 12 months. Conclusions: Half of women with gynecologic cancers have clinically-significant fatigue at diagnosis and 42% of survivors have persistent fatigue one year later, suggesting spontaneous regression of symptoms is rare. Importantly, depressive symptoms contribute to persistent fatigue and are modifiable with psychological interventions. Future studies should test scalable psychological interventions to address depressive symptoms, reduce fatigue, and improve quality of life in women with gynecologic cancers.

Depressive Symptoms before and One Year after Heart Surgery

1987 ◽  
Vol 61 (1) ◽  
pp. 173-174 ◽  
Author(s):  
Guido Magni
Keyword(s):  
Depressive Symptoms ◽  
Heart Surgery ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Self Rating ◽  
Clinically Significant ◽  
One Year

For 57 patients undergoing major heart surgery depressive symptoms were assessed before the operation and one year afterwards. The Zung Self-rating Depression Scale was used. Mean depressive scores significantly decreased at the follow-up. However, looking at frequencies instead of mean scores indicated about one-fourth of the sample showed clinically significant depressive symptomatology one year after surgery.

Six-month trajectories of self-reported depressive symptoms in long-term care

2015 ◽  
Vol 28 (1) ◽  
pp. 71-81 ◽  
Author(s):  
Jane McCusker ◽  
Martin G. Cole ◽  
Philippe Voyer ◽  
Johanne Monette ◽  
Nathalie Champoux ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Long Term Care ◽  
Secondary Analysis ◽  
Depression Scale ◽  
Depression Symptom ◽  
Term Care ◽  
Symptom Trajectory ◽  
Over Time

ABSTRACTBackground:Depression is a common problem in long-term care (LTC) settings. We sought to characterize depression symptom trajectories over six months among older residents, and to identify resident characteristics at baseline that predict symptom trajectory.Methods:This study was a secondary analysis of data from a six-month prospective, observational, and multi-site study. Severity of depressive symptoms was assessed with the 15-item Geriatric Depression Scale (GDS) at baseline and with up to six monthly follow-up assessments. Participants were 130 residents with a Mini-Mental State Examination score of 15 or more at baseline and of at least two of the six monthly follow-up assessments. Individual resident GDS trajectories were grouped using hierarchical clustering. The baseline predictors of a more severe trajectory were identified using the Proportional Odds Model.Results:Three clusters of depression symptom trajectory were found that described “lower,” “intermediate,” and “higher” levels of depressive symptoms over time (mean GDS scores for three clusters at baseline were 2.2, 4.9, and 9.0 respectively). The GDS scores in all groups were generally stable over time. Baseline predictors of a more severe trajectory were as follows: Initial GDS score of 7 or more, female sex, LTC residence for less than 12 months, and corrected visual impairment.Conclusions:The six-month course of depressive symptoms in LTC is generally stable. Most residents who experience a more severe symptom trajectory can be identified at baseline.

Depression as a Comorbid Condition: A Descriptive Comparative Study

2020 ◽  
Vol 42 (12) ◽  
pp. 1097-1103
Author(s):  
Judy Frain ◽  
Horng-Shiuann Wu ◽  
Ling Chen
Keyword(s):  
Breast Cancer ◽  
Depressive Symptoms ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Depression Score ◽  
Comorbid Condition ◽  
Persons Living With Hiv ◽  
Immunodeficiency Virus ◽  
Clinically Significant ◽  
Living With Hiv

Studies analyzing depressive symptoms across chronic disease populations are limited. Our descriptive comparison investigation included two studies on life-limiting conditions: Human Immunodeficiency Virus (HIV) and breast cancer. In both, depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale (CES-D). We found a mean depression score of 18.1 (± 11.8) overall ( N = 243). Over half (54%) reported clinically significant depressive symptoms (CES-D ≥ 16); 26% reported severe depressive symptoms (CES-D > 24). Disease and years of education were predictors of depressive symptoms. Persons living with breast cancer showed significantly worse depressive symptoms than persons living with HIV (p < 0.0001). After adjusting for disease, fewer years of education predicted worse depressive symptoms (p < 0.0001). This study demonstrated common determinants of depressive symptoms in both disease populations, suggesting that underlying conditions known to be predictors of depression could be assessed to identify those at higher risk for depression.

The Pain Catastrophizing Scale—short form: psychometric properties and threshold for identifying high-risk individuals

2019 ◽  
Vol 31 (11) ◽  
pp. 1665-1674 ◽  
Author(s):  
Sheung-Tak Cheng ◽  
Phoon Ping Chen ◽  
Yu Fat Chow ◽  
Joanne W. Y. Chung ◽  
Alexander C. B. Law ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Pain Catastrophizing ◽  
Short Form ◽  
Depression Scale ◽  
Full Scale ◽  
Three Dimensions ◽  
Short Version ◽  
Pain Catastrophizing Scale ◽  
Pain Disability ◽  
Clinically Significant

ABSTRACTObjective:The Pain Catastrophizing Scale (PCS) measures three aspects of catastrophic cognitions about pain—rumination, magnification, and helplessness. To facilitate assessment and clinical application, we aimed to (a) develop a short version on the basis of its factorial structure and the items’ correlations with key pain-related outcomes, and (b) identify the threshold on the short form indicative of risk for depression.Design:Cross-sectional survey.Setting:Social centers for older people.Participants:664 Chinese older adults with chronic pain.Measurements:Besides the PCS, pain intensity, pain disability, and depressive symptoms were assessed.Results:For the full scale, confirmatory factor analysis showed that the hypothesized 3-factor model fit the data moderately well. On the basis of the factor loadings, two items were selected from each of the three dimensions. An additional item significantly associated with pain disability and depressive symptoms, over and above these six items, was identified through regression analyses. A short-PCS composed of seven items was formed, which correlated at r=0.97 with the full scale. Subsequently, receiver operating characteristic (ROC) curves were plotted against clinically significant depressive symptoms, defined as a score of ≥12 on a 10-item version of the Center for Epidemiologic Studies-Depression Scale. This analysis showed a score of ≥7 to be the optimal cutoff for the short-PCS, with sensitivity = 81.6% and specificity = 78.3% when predicting clinically significant depressive symptoms.Conclusions:The short-PCS may be used in lieu of the full scale and as a brief screen to identify individuals with serious catastrophizing.

Geriatric Depression Scale: Consistency of Depressive Symptoms over Time

1991 ◽  
Vol 73 (3) ◽  
pp. 1032-1032 ◽  
Author(s):  
Jerome A. Yesavage
Keyword(s):  
Depressive Symptoms ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Geriatric Depression ◽  
Over Time

The following is a comment on the importance of the 1991 finding by I. L. Abraham of the unchanging nature of depressive symptoms over time: one concludes that such patients will not change unless major interventions, both pharmacologic or psychosocial, can be made.

Systematic review and meta-analysis of randomized placebo-controlled trials of folate and vitamin B12 for depression

2015 ◽  
Vol 27 (5) ◽  
pp. 727-737 ◽  
Author(s):  
Osvaldo P. Almeida ◽  
Andrew H. Ford ◽  
Leon Flicker
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Depressive Symptoms ◽  
Vitamin B12 ◽  
Depression Scale ◽  
Manual Search ◽  
Increased Risk ◽  
Short Period ◽  
Clinically Significant ◽  
Folate And Vitamin B12

ABSTRACTBackground:Folate and vitamin B12 insufficiencies have been associated with increased risk of depression. This systematic review aimed to clarify if, compared with placebo, treatment with folate and/or vitamin B12 reduces depression scale scores, increases remission, and prevents the onset of clinically significant symptoms of depression in people at risk.Methods:This systematic review searched the PubMed, PsychInfo, Embase, and Cochrane databases from inception to 6 June 2014, using the following terms and strategy: (vitamin B12 or vitamin B9 or folate or folic acid or cobalamin or cyanocobalamin) and (depression or depressive disorder or depressive symptoms) and (randomized controlled trial or RCT). The electronic search was supplemented by manual search. Two independent reviewers assessed all papers retrieved for eligibility and bias, and extracted crude data. Review Manager 5 was used to manage and analyze the data.Results:Two hundred and sixty-nine manuscripts were identified, of which 52 were RCTs and 11 fulfilled criteria for review. We found that the short-term use of vitamins (days to a few weeks) does not contribute to improve depressive symptoms in adults with major depression treated with antidepressants (5 studies, standardized mean difference = −0.12, 95% confidence interval – 95% CI = −0.45, 0.22), but more prolonged consumption (several weeks to years) may decrease the risk of relapse (1 study, odds ratio (OR) = 0.33, 95% CI = 0.12, 0.94) and the onset of clinically significant symptoms in people at risk (2 studies, risk ratio = 0.65, 95% CI = 0.43, 0.98).Conclusions:The number of available trials remains small and heterogeneity between studies high. The results of these meta-analyses suggest that treatment with folate and vitamin B12 does not decrease the severity of depressive symptoms over a short period of time, but may be helpful in the long-term management of special populations.

scholarly journals Joint Trajectories of Spousal Social Support and Depressive Symptoms in Older Age

2017 ◽  
Vol 31 (5) ◽  
pp. 760-782 ◽  
Author(s):  
Mai Stafford ◽  
Toni C. Antonucci ◽  
Paola Zaninotto
Keyword(s):  
Social Support ◽  
Depressive Symptoms ◽  
Growth Models ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
And Gender ◽  
Bidirectional Associations ◽  
Negative Support ◽  
Positive Support ◽  
Over Time

Objective: We describe changes in depressive symptoms and positive and negative social support from the spouse/partner in a representative sample of older people in England. Method: Men and women aged 50+ ( N = 7,171) from the English Longitudinal Study of Ageing reported social support and depressive symptoms (Center for Epidemiologic Studies Depression Scale) on up to five occasions between 2002-2003 and 2010-2011. Parallel process latent growth models estimated their bidirectional associations, adjusted for gender, wealth, education, and limiting illness. Results: In age- and gender-adjusted models, positive spousal support decreased and negative support increased over time, especially among women. Greater increases over time in depressive symptoms were seen in those with lower positive support or higher negative support at baseline. More baseline depressive symptoms predicted greater declines in positive support and greater increases in negative support from the spouse. Discussion: Improving older couple’s relationship quality may help reduce depressive symptoms.

scholarly journals Depressive symptoms and marital adjustment among primary care patients with erectile dysfunction in Umuahia, Nigeria

2016 ◽  
Vol 22 (1) ◽  
pp. 6
Author(s):  
Nwaonu C. Nwakanma ◽  
John N. Ofoedu
Keyword(s):  
Primary Care ◽  
Erectile Dysfunction ◽  
Depressive Symptoms ◽  
Marital Adjustment ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Dyadic Adjustment ◽  
Primary Care Patients ◽  
Clinically Significant ◽  
Partner Involvement

<p><strong>Objectives:</strong> The aim of this study was to investigate the relationship between erectile dysfunction (ED), marital adjustment and depression. <br /><strong>Methods:</strong> The survey was conducted among primary care patients at Federal Medical Centre, Umuahia. Subjects were 678 married, male primary care patients; aged 20–70 years (mean age = 45 years). ED was assessed by International Index of Erectile Function 5 (IIEF-5) score, the presence of clinically significant depressive symptoms was assessed with the 5-item <br />version of the Center for Epidemiological Studies Depression Scale (CES-D), and marital adjustment was assessed with the Revised Dyadic Adjustment Scale (RDAS).<br /><strong>Results:</strong> The prevalence of probable depression by CES-D and ED by IIEF-5 score was 20.9% and 26.0%, respectively. Marital distress was rampant (62.0%) among subjects with ED (<em>p</em> &lt; 0.05, <em>χ</em>2 = 196.58). Erectile dysfunction was associated with marital adjustment (<em>p</em> &lt; 0.05). Partial correlation revealed that depression affects both ED and marital adjustment, and is closely related to both variables.<br /><strong>Conclusion:</strong> Partner involvement and screening for depression should be emphasised in the care of patients with ED.</p>

Gynecologic cancer outcomes of Medicare's elderly poor: A population-based study of North Carolina.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 290-290
Author(s):  
Kemi Morenikeji Doll ◽  
Ke Meng ◽  
Ethan M Basch ◽  
Paola A. Gehrig ◽  
Wendy R. Brewster ◽  
...  
Keyword(s):  
North Carolina ◽  
Early Stage ◽  
Uterine Cancer ◽  
Gynecologic Cancer ◽  
Population Based ◽  
Cancer Site ◽  
Advanced Stage ◽  
Survival Curves ◽  
Gynecologic Cancers ◽  
Early Stage Disease

290 Background: Women ≥ 65 years dually enrolled in Medicare and Medicaid (‘Duals’) represent an at-risk group in cancer care, yet their outcomes across the spectrum of gynecologic cancers have not been studied. Our goal was to compare the association of insurance type to stage at diagnosis and mortality of older women after a gynecologic cancer diagnosis. Methods: Population-based, retrospective cohort study of women ≥ 65 years, diagnosed with gynecologic cancers from 2003 – 2009 in North Carolina Central Cancer Registry files. Medicare, Medicaid, and claims from privately insured health plans were linked with census data. Multiple logistic regression, Cox proportional hazard models, and Kaplan Meier survival curves were constructed comparing Medicare, Medicare HMO, and Medicare/Medicaid populations. Results: Among 4,554 patients in the cohort, 3,403 (74%) Medicare+/- supplemental private, 531(11%) Medicare HMO, and 620 (14%) Medicare + Medicaid (Dual). There were 2,215(49%) cases of early stage disease and 1,447(32%) deaths. Dual enrollees had increased mortality rates vs. Medicare overall (HR 1.61, 95%CI:1.4–1.8), and within each cancer site: uterine HR 1.50 (95%CI:1.2-1.9); ovarian HR 1.46 (95%CI:1.1-1.9); cervical HR 1.54 (95%CI:1.0–2.3); and vulvar/vaginal HR 2.84 (95%CI:1.9–4.2). Duals also had increased odds of advanced stage diagnosis in uterine cancer (OR 1.48, 95%CI:1.1–2.0). Stratified survival curves demonstrate the largest disparities amongst women with early stage uterine, advanced stage ovarian, and early stage vulvar/vaginal cancers. Conclusions: Dually enrolled gynecologic cancer patients have a 60% increased mortality rate compared to non-duals despite equivalent stage distribution at the time of diagnosis. Specific site/stage subgroups drive these results and should be the focus of future studies elucidating mediators of these disparate outcomes, including barriers in access to specialty surgical care.

scholarly journals Methylation Related to Perceived Parenting in Adolescents and its Association to Depressive Symptoms Two Years Later

2017 ◽  
Vol 41 (S1) ◽  
pp. S307-S307
Author(s):  
E. Van Assche ◽  
E. Vangeel ◽  
K. Freson ◽  
K. Van Leeuwen ◽  
K. Verschueren ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Linear Regression Analysis ◽  
Depression Scale ◽  
Well Being ◽  
Epidemiologic Studies ◽  
Depression Score ◽  
Perceived Parenting ◽  
Competing Interest ◽  
Over Time

IntroductionAdolescents’ well being is affected by their parenting situation and can influence their well being over time. We present an exploratory study with an Illumina 450 k array, comparing methylation in adolescents, based on perceived parenting at T0, and how methylation can interact with parenting in explaining depressive symptoms two years later (T2).ObjectivesIdentify differentially methylated regions (DMRs) associated with perceived parenting at T0 and investigate their association with depressive symptoms two years later.AimsAn exploratory analysis evaluating the association between methylation and depressive symptoms longitudinally.MethodsFrom two extreme parenting clusters: perceived supportive, and punishing neglecting, we randomly selected 44 adolescents (MAge = 14 at T0; 48%boys). The CES-D scale (Center for Epidemiologic Studies Depression Scale) assessed depressive symptoms. DMRs were identified based on the parenting clusters (DMRcate and comb-p) using llumina Infinium HumanMethylation 450 BeadChip data. Associations between the most significant CpG for each DMR and the depression score at T2, were calculated using linear regression analysis.ResultsWe identified 17 DMRs, but only cg13306335 in PEX10 was associated with depressive symptoms at T2 (P = 0.0014, Bonferroni (17 tests): P < 0.0029). Additionally, an interaction between parenting at T0 and PEX10 methylation (T0) in explaining depressive symptoms (T2) can be suggested (P = 0.014).ConclusionsWe show that methylation at PEX10's most significant CpG is correlated with depressive symptoms at T2, these exploratory results also suggest a possible interaction between parenting and PEX10 methylation at T0 in association with depressive symptoms at T2. Validation in a larger sample is needed to support the role of methylation and its interactions in depression over time.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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