Latent class analysis differentiation of adjustment disorder and demoralization, more severe depressive and anxiety disorders, and somatic symptoms in patients with cancer

Bobevski, Irene; Kissane, David W.; Vehling, Sigrun; McKenzie, Dean Philip; Glaesmer, Heide; Mehnert, Anja

doi:10.1002/pon.4761

Cited by 39 publications

(51 citation statements)

References 29 publications

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“…This perspective would not understand existential distress‐adjustment disorder as a “subthreshold problem” (hierarchically only diagnosed when criteria for depressive or anxiety disorders are not fully met) but a distinct entity that can be related to intense suffering. It is also coherent with the findings of Bobevski et al, indicating a distinct and significant subgroup (13%) with moderate demoralization, significant functional impairment and increased risk for suicidal ideation. Two dominant symptom clusters of adjustment difficulty could exist: (1) worried preoccupation with what could happen in an excessive attempt to control and (2) the disheartened despair about what cannot happen.…”

Section: What Is the Threshold For Clinically Relevant Existential DIsupporting

confidence: 91%

“…Also, symptom classification studies point towards a differentiation of anhedonia and demoralization . Applying latent class differentiation, Bobevski et al found that demoralization was present in two groups, where one had severe symptoms of anxiety and depression with high levels of demoralization (10%) and the second was characterized by moderate demoralization and low anxiety and depression (13%). These results are coherent with the idea that demoralization can occur independently and also as a result of high levels of depression and anxiety.…”

Section: The Comorbidity Of Existential Distress With Anxiety and Depmentioning

confidence: 99%

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Existential distress in cancer: Alleviating suffering from fundamental loss and change

2018

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A severe life threatening illness can challenge fundamental expectations about security, interrelatedness with others, justness, controllability, certainty, and hope for a long and fruitful life. That distress and suffering but also growth and mastery may arise from confrontation with an existentially threatening stressor is a longstanding idea. But only recently have researchers studied existential distress more rigorously and begun to identify its distinct impact on health care outcomes.Operationalizations of existential distress have included fear of cancer recurrence, death anxiety, demoralization, hopelessness, dignity-related distress, and the desire for hastened death. These focus in varying emphasis on fear of death, concern about autonomy, suffering, or being a burden to others; a sense of profound loneliness, pointlessness or hopelessness; grief, regret, or embitterment about what has been missed in life; and shame if dignity is lost or expectations about coping are not met.We provide an overview of conceptual issues, diagnostic approaches, and treatments to alleviate existential distress. Although the two meta-analyses featured in this special issue indicate the progress that has been made, many questions remain unresolved. We suggest how the field may move forward through defining a threshold for clinically significant existential distress, investigating its comorbidity with other psychiatric conditions, and inquiring into adjustment processes and mechanisms underlying change in existential interventions. We hope that this special issue may inspire progress in this promising area of research to improve recognition and management of a central psychological state in cancer care. KEYWORDScancer, death anxiety, demoralization, existential distress, existential suffering, existential therapy, fear of cancer recurrence, hopelessness, sense of dignity

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Section: What Is the Threshold For Clinically Relevant Existential DIsupporting

confidence: 91%

Section: The Comorbidity Of Existential Distress With Anxiety and Depmentioning

confidence: 99%

Existential distress in cancer: Alleviating suffering from fundamental loss and change

2018

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“…The cited data within literature vary between 40% and 77%. Bobevsky et al (2018) reported a higher proportion of 54.3% for a subgroup characterized by the absence of distress in a German cancer patient sample.…”

Section: Discussionmentioning

confidence: 98%

Distress in cancer patients: Who are the main groups at risk?

et al. 2020

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Objectives: Psychosocial distress is common in cancer patients and survivors and encompasses a broad range of concerns and psychological symptoms. The aim of the current study was to identify subgroups of respondents who experience a specific constellation of distress symptoms.Methods: This study uses data from a large data base (n = 21 680) of cancer patients from diverse settings who provided data in the Questionnaire on Distress in Cancer Patients-Short Form (QSC-R10). Cluster analysis was applied to identify subgroups with a distinct constellation of distress symptoms. Results:The results showed five distinct clusters: minimally distressed patients (46.6% of the sample), highly distressed patients (12.7%), mainly physically distressed patients (15.2%), mainly psychologically distressed patients (15.6%), and mainly socially distressed patients (9.9%). These groups differed with regard to age, sex, cancer site, treatment setting, and disease progression. Conclusion:The results revealed large heterogeneity in the experience of distress.Distress clusters were associated with socio-demographic and clinical variables.These associations might aid a clinician to tailor interventions and to address specific types of distress. K E Y W O R D Scancer, cluster analysis, distress screening, oncology, psycho-oncology, psychosocial distress

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“…Insbesondere in der Phase der Ambivalenz (. 13,9-30,2 % der befragten onkologischen Patienten Suizidgedanken bejahten [2].…”

Section: Präsuizidale Entwicklungunclassified

Suizidalität bei Krebspatienten

2020

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Suizidalität bei Krebspatienten Suizidalität im Kontext des täglichen Kampfes ums Überleben? Das erscheint Ärzten zunächst paradox [23]. Jedoch stellt eine Krebserkrankung und ihre Behandlung für die Patienten eine große Belastungssituation dar, aus der sich ohne entsprechende Bewältigungsfähigkeiten eine anhaltende Krise entwickeln kann [17]. Der selbstbestimmte Tod kann dann als einziger Ausweg erscheinen, um die als unerträglich wahrgenommene Situation zu beenden.

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Latent class analysis differentiation of adjustment disorder and demoralization, more severe depressive and anxiety disorders, and somatic symptoms in patients with cancer

Abstract: In contrast with the severe symptom cluster carrying anhedonia, anxiety, and demoralization, the moderate symptom cluster was formed by patients with demoralization and impaired functioning, a clinical picture consistent with a unidimensional model of adjustment disorder.

Cited by 39 publications

References 29 publications

Existential distress in cancer: Alleviating suffering from fundamental loss and change

Existential distress in cancer: Alleviating suffering from fundamental loss and change

Distress in cancer patients: Who are the main groups at risk?

Suizidalität bei Krebspatienten

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