Background Depression is one of the major psychiatric morbidities in cancer patients. The purpose of our study was to evaluate the impact of depressive symptoms in the quality of life (QoL) of patients with breast cancer undergoing chemotherapy and monoclonal antibodies treatments. Methods Observational, cross-sectional study conducted between April and November 2016. To evaluate the QoL, the EORTC QLQ-C30 and QLQ-BR23 questionnaire were used. The patients were screened for depressive symptoms using the Hospital Anxiety and Depression Scale (HADS-D) and those with a positive HADS-D positive questionnaire were referenced to the Psychiatry and Mental Health Department for further assessment and follow-up. Results We included 45 female patients. Sixteen (35.6%) patients had a positive HADS-D questionnaire and depressive symptoms confirmed by a psychiatric physician. Of those patients, 7 (15.6%) had a major depressive episode confirmed by psychiatric interview. There was a significant association of depressive symptoms with the future perspectives scale ( p = 0.022), breast symptoms scale ( p = 0.011) and arm symptom scale ( p = 0.005). Significant differences were found in the fatigue ( p = 0.024), pain ( p = 0.037) and dyspnea ( p = 0.009) subscales being worse in patients with depressive symptoms. The association between having depressive symptoms or not was shown to be significant or marginally significant for the variables stage of the tumour ( p = 0.057), presence of distant metastasis ( p = 0.072) and previous diagnosis of depression ( p = 0.011). The patients treated with regimens containing monoclonal antibodies presented better outcomes in various subscales of the EORTC QLQ-C30 and QLQ-B23 questionnaires than those patients treated with chemotherapy regimens without monoclonal antibodies. Conclusions Despite the small sample of our study, this study provided evidence that depressive symptoms in patients with breast cancer undergoing chemotherapy and monoclonal antibodies treatments detrimentally reduced various aspects of QoL.
Perinatal mental health (PMH) has been a growing field of practice for psychiatry in the last decades. It focuses on mental health during pregnancy, childbirth and the postpartum period including the distinctive presentations of mental illness and well‐being challenges associated with parenting experiences. Mental health problems in pregnancy and the postnatal period can have significant differences and challenges to its approach compared to other periods of life. Working in PMH requires specific and updated know ‐ledge regarding carers’ experiences and manifestations of mental illness in this particular life stage and psychotropic management during pregnancy and breastfeeding, as well as regarding the mother/parent and baby relationship and bond, and the baby’s safeguarding along several developmental issues. For all this, PMH specialist services and multidisciplinary teams with specific training have been developing to cater to this need in several countries around the world. To provide a broadened overlook on the matter, some key aspects of PMH will be discussed below in this perspective.
Introduction The perinatal period constitutes a unique individual and family experience, involved in multifaceted transformations and adaptations at the physical, psychological, social, and emotional levels. This is the period in women’s life cycle where there is a higher risk for the development of mental illness. Objectives To introduce the perinatal mental health programme of the Hospital do Espírito Santo de Évora. The main objective is to structure an intervention with the woman and her support network to promote healthy parenting. Methods Implementing secondary and tertiary intervention approaches in a general and public hospital in the Alentejo region of Portugal. The programme is composed of the following components and domains of intervention in the pre-conception, pregnancy, and post-partum periods: individual consultation; brief intervention consultation; mindfulness sessions in the immediate postpartum period; home-based interventions; empowerment interventions for hospital and community healthcare professionals. Results It is expected that the project will result in a multidisciplinary approach to perinatal mental health, with significant impact, improved perinatal mental health of the women integrated in the project, as well as improved level of satisfaction in the provision of care in the woman/family. Conclusions Considering the prevalence and impact of mental health issues in the perinatal period, it is desirable to structure interventions with a holistic and multidisciplinary approach. Perinatal mental health should be prioritized during the entire process of pregnancy and postnatal period. A network of primary and secondary care systems may allow mitigating and/or overcoming vulnerabilities. Disclosure No significant relationships.
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