Prevalence of psychiatric disorder in asymptomatic or minimally symptomatic cancer patients on treatment

PURPOSE Clinical reports suggest that many breast cancer patients experience persistent fatigue as a long-term side effect of adjuvant chemotherapy treatment. To investigate this issue further, we examined the characteristics and correlates of fatigue in women who had completed adjuvant chemotherapy for breast cancer and in a comparison group of women with no history of cancer. PATIENTS AND METHODS Participants were 61 women with breast cancer who had completed chemotherapy an average of 471 days previously and 59 women with no history of cancer. All participants completed standardized self-report measures of fatigue, sleep quality, menopausal symptoms, and coping and were administered a structured clinical interview to identify current and past psychiatric disorder. RESULTS Compared with women with no history of cancer, former adjuvant chemotherapy patients reported more severe fatigue (P < .01) and worse quality of life because of fatigue (P < .05). More severe fatigue among patients was significantly (P < .05) related to poorer sleep quality, more menopausal symptoms, greater use of catastrophizing as a coping strategy, and current presence of a psychiatric disorder. CONCLUSION These findings support the view that many breast cancer patients experienced heightened fatigue after completion of adjuvant chemotherapy treatment. Results yield a profile of women who are at increased risk for heightened fatigue after chemotherapy and suggest ways to intervene clinically to prevent or reduce fatigue in this patient population.

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Adjustment Disorders in Cancer

Psycho-Oncology ◽

10.1093/med/9780190097653.003.0041 ◽

2021 ◽

pp. 313-319

Author(s):

Froukje de Vries ◽

Sarah Hales ◽

Gary Rodin ◽

Madeline Li

Keyword(s):

Psychiatric Disorder ◽

Cancer Patients ◽

Diagnostic Criteria ◽

Adjustment Disorder ◽

Evidence Base ◽

Adjustment Disorders ◽

Related Disorder ◽

Dsm 5 ◽

And Behaviors

Adjustment disorder (AD) refers to a condition in which an individual reacts to an identifiable stressor with disproportionate symptoms and behaviors. It is now considered as a stress-related disorder in both the DSM-5 and ICD-11 and is the most commonly diagnosed psychiatric disorder in cancer patients. Nevertheless, this diagnosis remains problematic in terms of its conceptualization and evidence base. The specificity of the diagnostic criteria has been questioned and concern has been expressed that it medicalizes distress and increases the likelihood of unnecessary psychopharmacological interventions. However, evidence suggests that categorizing distress as AD may actually lead to appropriate interventions aimed at prevention or treatment. This chapter focuses on the validity and utility of the concept of and diagnostic criteria for AD and reviews the available evidence base regarding treatment of this disorder in cancer patients.

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Prognostic consequences of implementing cancer patient pathways in Denmark: a comparative cohort study of symptomatic cancer patients in primary care

BMC Cancer ◽

10.1186/s12885-017-3623-8 ◽

2017 ◽

Vol 17 (1) ◽

Cited By ~ 12

Author(s):

Henry Jensen ◽

Marie Louise Tørring ◽

Peter Vedsted

Keyword(s):

Primary Care ◽

Cohort Study ◽

Cancer Patient ◽

Cancer Patients ◽

Patient Pathways ◽

Comparative Cohort Study ◽

Symptomatic Cancer

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Exploring Fear of Cancer Recurrence in a Sample of Heterogeneous Distressed Cancer Patients with and Without a Psychiatric Disorder

Journal of Clinical Psychology in Medical Settings ◽

10.1007/s10880-021-09776-2 ◽

2021 ◽

Author(s):

Else M. Bisseling ◽

Félix R. Compen ◽

Melanie P. J. Schellekens ◽

Belinda Thewes ◽

Anne E. M. Speckens ◽

...

Keyword(s):

Psychiatric Disorder ◽

Cancer Patients ◽

Short Form ◽

Psychiatric Morbidity ◽

Specific Treatment ◽

Cancer Recurrence ◽

Fear Of Cancer Recurrence ◽

Axis I ◽

Dsm Iv ◽

Fear Of Cancer

AbstractFear of Cancer Recurrence (FCR) is a concern among cancer patients. Recent insights suggest that FCR should be viewed as a distinct syndrome. However, few studies have explored its overlap with psychiatric morbidity. We examined this overlap in a sample of distressed cancer patients. Self-referred patients (n = 245) were assessed with the Structured Clinical Interview for DSM-IV-TR Axis-I disorders and the Fear of Cancer Recurrence Inventory-Short Form. Proportions of patients with and without a psychiatric disorder meeting validated cut-offs for screening and clinically relevant FCR were compared. The prevalence of psychiatric disorders was 36%. Clinically relevant FCR was found in 198 patients (81%). Patients with a current psychiatric disorder reported clinically relevant FCR more frequently (89%) compared to those with no disorder (77%). Of patients reporting clinically relevant FCR, the majority (61%) did not additionally meet the criteria for a psychiatric disorder. These findings suggest that there should be particular attention for patients with elevated levels of FCR, warranting FCR-specific treatment.Trial registry number Clinicaltrials.gov NCT02138513

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SARS-CoV-2 Testing for Asymptomatic Patients with Cancer Prior and during Treatment: A Single Centre Experience

Current Oncology ◽

10.3390/curroncol28010032 ◽

2021 ◽

Vol 28 (1) ◽

pp. 278-282

Author(s):

Nicholas Meti ◽

Houman Tahmasebi ◽

Angela Leahey ◽

Angela Boudreau ◽

Alia Thawer ◽

...

Keyword(s):

Cancer Patients ◽

Dynamic Testing ◽

Limited Evidence ◽

Single Centre ◽

Routine Testing ◽

Testing Model ◽

Patients With Cancer ◽

Asymptomatic Patients ◽

Single Centre Experience ◽

Symptomatic Cancer

Patients with cancer are more vulnerable to severe COVID-19. As a result, routine SARS-CoV-2 testing of asymptomatic patients with cancer is recommended prior to treatment. However, there is limited evidence of its clinical usefulness. The objective of this study is to evaluate the value of routine testing of asymptomatic patients with cancer. Asymptomatic patients with cancer attending Odette Cancer Centre (Toronto, ON, Canada) were tested for SARS-CoV-2 prior to and during treatment cycles. Results were compared to positivity rates of SARS-CoV-2 locally and provincially. All 890 asymptomatic patients tested negative. Positivity rates in the province were 1.5%, in hospital were 1.0%, and among OCC’s symptomatic cancer patients were 0% over the study period. Given our findings and the low SARS-CoV-2 community positivity rates, we recommend a dynamic testing model of asymptomatic patients that triggers testing during increasing community positivity rates of SARS-CoV-2.

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