Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-22T03:08:36.119Z Has data issue: false hasContentIssue false

Course of distress, anxiety, and depression in hematological cancer patients: Association between gender and grade of neoplasm

Published online by Cambridge University Press:  04 November 2013

Cristiane Decat Bergerot*
Affiliation:
Psycho-Oncology Services, Centro de Câncer de Brasília, Brasília, Brazil
Karen Lynn Clark
Affiliation:
Department of Supportive Care Medicine, City of Hope, Duarte, California
Alexandre Nonino
Affiliation:
Medical Onco-Hematology Services, Centro de Câncer de Brasília, Brasília, Brazil
Sarah Waliany
Affiliation:
Department of Medical Oncology, City of Hope, Duarte, California
Marco Murilo Buso
Affiliation:
Medical Oncology Services, Centro de Câncer de Brasília, Brasília, Brazil
Matthew Loscalzo
Affiliation:
Department of Supportive Care Medicine, City of Hope, Duarte, California
*
Address correspondence and reprint requests to: Cristiane Decat Bergerot, SMH/N Quadra 02 Bloco A – Ed. de Clínicas – 12° andar, 70710-904, Brasília, DF, Brazil. E-mail: [email protected]

Abstract

Objective:

The aim of our study was to explore the impact of gender and hematological cancer grade on distress, anxiety, and depression in patients receiving chemotherapy.

Methods:

A prospective study was done in a cohort of 104 patients with hematological cancer. We employed the (1) Distress Thermometer (DT) and the Problem List (PL) and (2) the Hospital Anxiety and Depression Scale (HADS) for assessments at baseline (T1), the halfway timepoint (T2), and completion of chemotherapy (T3).

Results:

The proportion of patients experiencing significant distress (DT ≥ 4) decreased from the first to the last timepoint; the proportion experiencing anxiety and depression (as assessed by HADS) also decreased. Specifically, 50% of participants reported significant distress levels, 47.1% anxiety, and 26% depression at T1. At T2, the proportion of patients experiencing distress was reduced by 60.8%, by 76% for anxiety, and by 48.5% for depression; at T3, the reduction was close to 80% for all assessments compared with T1. Emotional and physical problems were most commonly reported. Significant reductions were discovered for distress and problem-related distress levels over time, and a significant interaction was found between gender and practical and physical problems (p < 0.05).

Significance of results:

Our findings suggest that female patients reported more distress, anxiety, and depression than male patients. Gender differences were related to problem-related distress but not to grade of neoplasm. We observed that, over the course of chemotherapy, the distress levels of patients with hematological cancer decrease over time.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Albrecht, T.A. & Rosenzweig, M. (2012). Management of cancer-related distress in patients with a hematological malignancy. Journal of Hospital & Palliative Nursing, 14(7), 462468.CrossRefGoogle ScholarPubMed
Allart, P., Soubeyran, P. & Cousson-Gélie, F. (2013). Are psychosocial factors associated with quality of life in patients with haematological cancer? A critical review of the literature. Psycho-Oncology, 22, 241249.CrossRefGoogle Scholar
American Psychosocial Oncology Society (2006). Quick reference for oncology clinicians: The psychiatric and psychological dimensions of cancer symptom management. Charlottesville, VA: APOS Press.Google Scholar
Armitage, J.O. & Weisenburger, D.D. (Non-Hodgkin's Lymphoma Classification Project) (1998). New approach to classifying non-Hodgkin's lymphomas: Clinical features of the major histologic subtypes. Journal of Clinical Oncology, 16(8), 2780.CrossRefGoogle ScholarPubMed
Botega, N.J., Bio, M.R., Zomignani, M.A., et al. (1995). Transtorno do humor de clínica médica e validação de escala de medida (HAD) de ansiedade e depressão. Revista de Saúde Pública, 29(5), 355363.CrossRefGoogle Scholar
Cole, C.E., Haugen, A.R., Mathiason, M.A., et al. (2011). Screening for psychosocial distress in patients with hematological malignancies and identifying specific factors that cause distress throughout stage disease. Abstracts of 53rd ASH Annual Meeting and Exposition, 901.CrossRefGoogle Scholar
Decat, C.S., Laros, J.A. & Araujo, T.C.C.F. (2009). Termômetro de distress: Validação de um instrumento breve para avaliação diagnóstica de pacientes oncológicos. PsicoUSF, 14(3), 253260.Google Scholar
Fife, B.L. & Fausel, C.A. (2010). Hematopoietic dycrasias and stem cell/bone marrow transplantation. In Psycho-Oncology, 2nd ed.Holland, J.C. et al. (eds.), pp. 191195. New York: Oxford.CrossRefGoogle Scholar
Giese-Davis, J., Waller, A., Carlson, L.E., et al. (2012). Screening for distress, the sixth vital sign: Common problems in cancer outpatients over one year in usual care: Associations with marital status, sex, and age. BioMed Central Cancer, 12, 441453.Google Scholar
Keller, M. & Henrich, G. (1999). Illness-related distress: Does it mean the same for men and women? Acta Oncologica, 38(6), 747755.Google ScholarPubMed
Khan, A.G., Irfan, M., Shamsi, T.S., et al. (2007). Psychiatric disorders in bone marrow transplant patients. Journal of the College of Physicians and Surgeons, 17(2), 98100.Google ScholarPubMed
Lamers, J., Hartmann, M., Goldschmidt, H., et al. (2013). Psychosocial support in patients with multiple myeloma at time of diagnosis: Who wants what? Psycho-Oncology. doi: 10.1002/pon.3284. Epub ahead of print.CrossRefGoogle Scholar
Lesko, L.M. (1998). Hemotopoietic discrasias. In Psycho-Oncology, Holland, J.C. et al. (eds.), pp. 406416. New York: Oxford.Google Scholar
Loscalzo, M.J. (2008). Palliative care and psychosocial contributions in the ICU. American Society of Hematology Education Program, 1, 481490.CrossRefGoogle Scholar
Loscalzo, M.J., Kim, Y. & Clark, K.L. (2010). Gender and caregiving. In Psycho-Oncology, 2nd ed.Holland, J.C. et al. (eds.), pp. 522526. New York: Oxford.CrossRefGoogle Scholar
McDowell, M.E., Occhipinti, S., Fersguson, M., et al. (2010). Predictors of change in unmet supportive care needs in cancer. Psycho-Oncology, 19(5), 508516.CrossRefGoogle ScholarPubMed
Mitchell, A.J., Chan, M., Bhatti, H., et al. (2011). Prevalence of depression, anxiety, and adjustment disorder in oncological, hematological, and palliative care settings: A meta-analysis of 94 interview-based studies. The Lancet Oncology, 12, 160174.CrossRefGoogle ScholarPubMed
National Comprehensive Cancer Network (NCCN) (2012) Practice guidelines in oncology: distress management, Version 1. Available from http://www.nccn.org/professionals/physician_gls/PDF/distress.pdf.Google Scholar
Pal, S.K. & Hurria, A. (2010). Impact of age, sex, and comorbidity on cancer therapy and disease progression. Journal of Clinical Oncology, 28(26), 40864093.CrossRefGoogle ScholarPubMed
Pandey, M., Sarita, G.P., Devi, N., et al. (2006). Distress, anxiety, and depression in cancer patients undergoing chemotherapy. World Journal of Surgical Oncology, 4, 6872.CrossRefGoogle ScholarPubMed
Prieto, J.M., Blanch, J., Atala, J., et al. (2002). Psychiatric morbidity and impact on hospital length of stay among hematologic cancer patients receiving stem-cell transplantation. Journal of Clinical Oncology, 20(7), 19071917.CrossRefGoogle ScholarPubMed
Santos, F.R.M., Kozasa, E.H., Chauffaille, M.L.L.F., et al. (2006). Psychosocial adaptation and quality of life among Brazilian patients with different hematological malignancies. Journal of Psychosomatic Research, 60(5), 505511.CrossRefGoogle ScholarPubMed
Schmetzer, O. & Florcken, A. (1998). Sex and gender differences in hematology. In Sex and gender aspects in clinical medicine, Oertelt-Prigione, S. & Regitz-Zagrosek, V. (eds.), pp. 151168. New York: Springer.Google Scholar
Swerdlow, S.H., Campo, E., Harris, N.L., et al. (2008). World Health Organization classification of tumours of haematopoietic and lymphoid tissues. Lyons: IARC Press.Google Scholar
WHO International Agency for Research on Cancer. (2008). Globocan 2008: Cancer incidence, mortality and prevalence worldwide in 2008. Available from http://globocan.iarc.fr.Google Scholar
Winzer, A., Hoppe, A., Altenhoff, J., et al. (2009). Interest in a psycho-educational group intervention among outpatients with malignant melanoma in relation to their need: Which patients are likely to participate? Psycho-Oncology, 18, 11791188.CrossRefGoogle Scholar
Wittmann, M., Vollmer, T., Schweiger, C., et al. (2006). The relation between the experience of time and psychological distress in patients with hematological malignancies. Palliative & Supportive Care, 4, 357363.CrossRefGoogle ScholarPubMed
Zabora, J., Brintzenhofe-Szoc, K., Curbow, B., et al. (2001). The prevalence of psychological distress by cancer site. Psycho-Oncology, 10, 1928.3.0.CO;2-6>CrossRefGoogle ScholarPubMed