Disease stage predicts post-diagnosis anxiety and depression only in some types of cancer

Abstract

Background:We hypothesised that patients with advanced disease or a cancer type that has a poor prognosis may be more likely to report anxiety and depressive symptoms after diagnosis; younger age and female gender may moderate these effects.Methods:Patients (n=3850) were consecutively assessed with PSSCAN, a standardised, validated tool, at two large cancer centres between 2004 and 2009.Results:Female patients reported more anxiety and depressive symptoms (P=0.003 to P<0.001) compared with men and a healthy comparison group. Older age was associated with fewer anxiety (P=0.033 to P<0.001) and fewer depressive symptoms (P<0.001), but this was not true for lung cancer. Presence of metastases was associated with more anxiety symptoms in patients with gastrointestinal (P=0.044; R2Δ=0.001), lung (P=0.011; R2Δ=0.016), and prostate (P=0.032; R2Δ=0.008) cancer, but this was not true for breast cancer. Furthermore, early disease stage was associated with fewer depressive symptoms among older prostate cancer patients (P=0.021; R2Δ=0.008). Men with early lung cancer reported fewer anxiety (P=0.020; R2Δ=0.013) and depressive (P=0.017; R2Δ=0.016) symptoms than men with advanced disease or women.Conclusion:As hypothesised, disease stage was directly associated with emotional distress, except for patients with breast cancer. Furthermore, age and gender moderated some of these effects.

Depression and anxiety symptoms following cancer diagnosis: a cross-sectional study

“…Our study confirms the findings that a more advanced cancer stage was associated with depression (Vodermaier et al, 2011). However, we found an even stronger association with anxiety.…”

“…Linden et al (2012), on the contrary, found a significant decrease in clinical anxiety and depression rates with ageing, suggesting that older people may accept a cancer diagnosis better. Vodermaier et al (2011) found that older age was associated with reduced anxiety and depression in gastrointestinal, breast, and prostate, but not in lung cancer. Our different results could be explained by differences in tumor location.…”

“…It overlaps anxiety and depression, including a continuum from common normal adjustment to depression and anxiety disorders (NCCN, 2012). Psychological distress prevalence rates in patients with cancer range from 22 to 58% (Grassi et al, 2013;Vodermaier, Linden, MacKenzie, Greig, & Marshall, 2011) with increased levels associated with the more advanced stages, poorer prognosis, and invasive treatment (Vodermaier et al, 2011).…”

A systematic review of the supportive care needs of women living with and beyond cervical cancer

“…As a result, the needs of women with recurrent or metastatic cervical cancer remain unexplored. Existing empirical evidence suggests that advanced cancer can be predictive of more physical, psychological, information and practical SCNs and increased psychological distress [67,68]. Widening the scope of research to include women at all stages of the cervical cancer trajectory is thus essential to grasp the spectrum of SCNs experienced in its entirety.…”

Disease stage, but not sex, predicts depression and psychological distress in Huntington's disease: A European population study

“…Consequently, improved understanding of any sex differences regarding the emotional component of the disease, and the interactions with disease stage, may help identify stages of critical risk for men and women in terms of mental health, and inform the design of future disease-modifying clinical trials [18]. Finally, such a consideration would add to research that have examined these as key factors in other medical conditions, where an interaction between sex and disease-stage was found to influence mood symptoms among those in certain diseases [28,29], but not others [30].…”