Prevalence of Anxiety and Depression and Their Impact on the Quality of Life of Cancer Patients Treated with Palliative Antineoplasic Therapy – Results of the PALINT Trial
Authors:
L. Světláková 1; O. Sláma 1; M. Světlák 2; L. Pochop 1; J. Šedo 1; R. Alexandrová 1; O. Bílek 1; R. Vyzula 1
Authors place of work:
Klinika komplexní onkologické péče, Masarykův onkologický ústav, Brno
1; Ústav psychologie a psychosomatiky, LF MU, Brno
2
Published in the journal:
Klin Onkol 2019; 32(3): 201-207
Category:
Původní práce
doi:
https://doi.org/10.14735/amko2019201
Summary
Background: Anxiety, depression, and psychological distress are common syndromes of advanced cancer; all have a negative impact on overall quality of life. However, these symptoms are not monitored explicitly and they are managed only by pharmacotherapy. Given the complex etiology of these symptoms, this biomedical approach is inadequate and inefficient.
Materials and methods: Here, we present the results of a longitudinal assessment of distress, anxiety, and depression in a sample of 126 patients treated with palliative systemic therapy for advanced cancer in the PALINT trial. Symptoms and quality of life were assessed regularly using the Hospital Anxiety and Depression Scale (HADS) and The European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), respectively.
Results: The baseline prevalence of significant distress, anxiety, and depression was 32,6; 35,9; and 56,5%, respectively. A decreasing trend in the prevalence of distress and anxiety occurred after 2 and months – distress (19.4 and 16.3%), anxiety (20.9 and 16.3%), and depression (46.3 and 46.9%). However, these changes did not reach statistical significance. The presence of anxiety and depression correlated negatively with overall quality of life.
Conclusion: High rates of distress, anxiety, and depression are a strong argument for implementation of systematic screening for psychological distress, and for comprehensive psychosocial support for all patients with advanced cancer throughout the disease trajectory. The HADS questionnaire is a suitable tool for this type of screening.
This work was supported by the grant of Ministry of Health AZV 15-33590A.
The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.
Submitted: 3. 12. 2018
Accepted: 24. 3. 2019
Keywords:
palliative therapy – anxiety – depression
Zdroje
. Vodermaier A, Linden W, Siu C. Response: Screening for emotional distress in cancer patients: A systematic review of assessment instruments. J Natl Cancer Inst 2010; 102 (7): 508. doi: 10.1093/jnci/djq047.
2. Carlson LE, Angen M, Cullum J et al. High levels of untreated distress and fatigue in cancer patients. Br J Cancer 2004; 90 (12): 2297–2304. doi: 10.1038/sj.bjc.6601 887.
3. Grassi L, Sabato S, Rossi E et al. Use of the diagnostic criteria for psychosomatic research in oncology. Psychother Psychosom 2005; 74 (2): 100–107. doi: 10.1159/000083 168.
4. Anderkova L, Elfmarkova N, Sverak T et al. Change in quality of life measured over time in Czech women with breast cancer. Klin Onkol 2016; 29 (2): 113–121. doi: 10.14735/amko2016113.
5. Sochor M, Sláma O. Management of chronic and acute pain in patients with cancer diseases. Klin Onkol 2015; 28 (2): 94–98. doi: 10.14735/amko201594.
6. Reiche EMV, Nunes SOV, Morimoto HK. Stress, depression, the immune system, and cancer. Lancet Oncol 2004; 5 (10): 617–625. doi: 10.1016/S1470-2045 (04) 01 597-9.
7. Gaertner J, Wolf J, Voltz R. Early palliative care for patients with metastatic cancer. Curr Opin Oncol 2012; 24 (4): 357–362. doi: 10.1097/CCO.0b013e328352ea20.
8. Sochor M, Slama O, Loucka M. Early integration of palliative care into standard oncology care – benefits, limitations, barriers and types of palliative care. Klin Oncol 2015; 28 (3): 171–176. doi: 10.14735/amko2015171.
9. Parikh RB, Kirch RA, Smith TJ et al. Early specialty palliative care – translating data in oncology practice. N Engl J Med 2013; 369 (24): 2347–2351. doi: 10.1056/ NEJMsb1305469.
10. Šmíd D, Skalický T, Fichtl J et al. The influence of palliative chemotherapy on the quality of life of patients with gastric cancer. Klin Onkol 2016; 29 (4): 279–286. doi: 10.14735/amko2016279.
11. Von Roenn JH, Cleeland CS, Gonin R et al. Physician attitudes and practice in cancer pain management. A survey from the Eastern Cooperative Oncology Group. Ann Intern Med 1993; 119 (2): 121–126.
12. Breuer B, Fleishman SB, Cruciani SA et al. Medical oncologists’attitudes and practice in cancer pain management: a national survey. J Clin Oncol 2011; 29 (36): 4769–4775. doi: 13.1200/ JCO.2011.35.0561.
14. Mack JW, Wolfe J, Cook EF et al. Hope and prognostic disclosure. J Clin Oncol 2007; 25 (35): 5636–5642. doi: 10.1200/JCO.2007.12.6110.
15. Wright AA, Zhang B, Ray A et al. Associations between end-of-life discussions: patient mental health, medical care near death, and caregiver bereavement adjustments. JAMA 2008; 300 (14): 1665–1673. doi: 10.1001/ jama.300.14.1665.
16. Weeks JC, Catalano PJ, Cronin A et al. Patients’ expectations about eff ects of chemotherapy for advanced cancer. N Engl J Med 2012; 367 (17): 1616–1625. doi: 10.1056/ NEJMoa1204410.
17. Mack JW, Weeks JC, Wright AA et al. End-of-life discussions, goal attainment, and distress at the end of life: predictors and outcomes of receipt of care constistent with preferences. J Clin Oncol 2010; 28 (7): 1203–1208. doi: 10.1200/ JCO.2009.25.4672.
18. Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 67 (6): 361–370. doi: 10.1111/j.1600-0447.1983.tb09716.x.
19. Mitchell AJ, Meader N, Symonds P. Diagnostic validity of the hospital anxiety and depression scale (HADS) in cancer and palliative settings: A meta-analysis. J Affect Disord 201; 126 (3): 335–348. doi: 10.1016/j.jad.2010.01. 067.
20. Aaronson NK, Ahmedzai S, Bergman B et al. The european organization for research and treatment of cancer QLQ-C30: A quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst 1993; 85 (5): 365–376. doi: 10.1093/jnci/85.5. 365.
21. Yi JC, Syrjala KL. Anxiety and depression in cancer survivors. Med Clin North Am 2017; 101 (6): 1099–1113. doi: 10.1016/j.mcna.2017.06.005.
22. Söllner W, DeVries A, Steixner E et al. How successful are oncologists in identifying patient distress, perceived social support, and need for psychosocial counselling? Br J Cancer 2001; 84 (2): 179–185. doi: 10.1054/ bjoc.2000.1545.
Štítky
Detská onkológia Chirurgia všeobecná OnkológiaČlánok vyšiel v časopise
Klinická onkologie
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