A prospective study of changes in anxiety, depression, and problems in living during chemotherapy treatments: effects of age and gender

Abstract

Purpose Monitoring distress assessment in cancer patients during the treatment phase is a component of good quality care practice. Yet, there is a dearth of prospective studies examining distress. In an attempt to begin filling this gap and inform clinical practice, we conducted a prospective, longitudinal study examining changes in distress (anxiety, depression, and problems in living) by age and gender and the roles of age and gender in predicting distress. Methods Newly diagnosed Brazilian cancer patients (N = 548) were assessed at three time points during chemotherapy. Age and gender were identified on the first day of chemotherapy (T1); anxiety, depression, and problems in living were self-reported at T1, the planned midway point (T2), and the last day of chemotherapy (T3). Results At T1, 37 and 17% of patients reported clinically significant levels of anxiety and depression, respectively. At T3, the prevalence was reduced to 4.6% for anxiety and 5.1% for depression (p < .001). Patients 40-55 years, across all time points, reported greater anxiety and practical problems than patients >70 years (p < .03). Female patients reported greater emotional, physical, and family problems than their male counterparts (p < .04).Conclusions For most patients, elevated levels of distress noted in the beginning of treatment subsided by the time of treatment completion. However, middle-aged and female patients continued to report heightened distress. Evidence-based psychosocial intervention offered to at risk patients during early phases of the treatment may provide distress relief and improve outcomes over the illness trajectory while preventing psychosocial and physical morbidity due to untreated chronic distress.

Distress in patients with renal cell carcinoma: a curious gap in knowledge

“…This could be due to feelings of isolation and/or lack of information related to understanding of their diagnosis and treatments related to their histological subtype. Younger age and female gender were also associated with higher levels of distress, although this is a common finding across multiple studies in other cancer types […”

Emotional functioning to screen for psychological distress in breast and colorectal cancer patients prior to adjuvant treatment initiation

“…Psychological evaluation during and after cancer treatment, as recommended by ASCO (Andersen et al, 2014), would allow for different profiles of patients with psychological distress to be established, based on age, gender and other characteristics. During adjuvant treatment, younger individuals (aged 40-55 years) reported more anxiety and depression than patients over 70 years of age (Bergerot, Mitchell, Ashing, & Kim, 2017;Stanton et al, 2015); likewise, women reveal these symptoms more than men (Bergerot et al, 2017). In an attempt to search for depression profiles, we found that the study conducted by Stanton et al.…”

“…Psychological evaluation during and after cancer treatment, as recommended by ASCO (Andersen et al, ), would allow for different profiles of patients with psychological distress to be established, based on age, gender and other characteristics. During adjuvant treatment, younger individuals (aged 40–55 years) reported more anxiety and depression than patients over 70 years of age (Bergerot, Mitchell, Ashing, & Kim, ; Stanton et al, ); likewise, women reveal these symptoms more than men (Bergerot et al, ). In an attempt to search for depression profiles, we found that the study conducted by Stanton et al identified three subgroups in BC patients: (a) those who did not present depression at any time (43%); (b) those who displayed depressive symptoms before, during and after treatment (38%); and (c) patients who exhibited depressive symptoms at baseline, but who subsequently recovered (20%) (Stanton et al, ).…”

Association between chemotherapy toxicity risk scores and physical symptoms among older Brazilian adults with cancer

“…Our results also showed that men were at higher risk of having high CARG chemotherapy toxicity risk scores according to the CARG tool, which may be related to the fact that genitourinary tumors, which are more common in men, increase the CARG score. Despite the fact that, historically, gender has played an important role in adjustment to cancer, past studies mostly highlight the frailty associated with female gender, described by worse physical and emotional well-being, and lower global physical functioning [21][22][23][24][25][26].…”