Psychiatric morbidity and physical toxicity associated with adjuvant chemotherapy after mastectomy.

Maguire, G. P.; Tait, A; Brooke, Mike; Thomas, Chris; Howat, J M; Sellwood, R A; Bush, Helen A.

doi:10.1136/bmj.281.6249.1179

Cited by 95 publications

(24 citation statements)

References 2 publications

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“…This is of value since early detection and treatment of psychiatric illness has been found to improve outcome (Maguire et al, 1980), as has targeted intervention for patients at high risk (Moorey et al, 1994).…”

Section: Discussionmentioning

confidence: 99%

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A prospective multicentre study in Sweden and Norway of mental distress and psychiatric morbidity in head and neck cancer patients

et al. 1999

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Summary A Swedish/Norwegian head and neck cancer study was designed to assess prospectively the levels of mental distress and psychiatric morbidity in a heterogeneous sample of newly diagnosed head and neck cancer patients. A total of 357 patients were included. The mean age was 63 years, and 72% were males. The patients were asked to answer the HAD scale (the Hospital Anxiety and Depression scale) six times during 1 year. The number of possible or probable cases of anxiety or depression disorder was calculated according to standardized cut-offs. Approximately one-third of the patients scored as a possible or probable case of a major mood disorder at each measurement point during the study year. There were new cases of anxiety or depression at each time point. The anxiety level was highest at diagnosis, while depression was most common during treatment. Females were more anxious than males at diagnosis, and patients under 65 years of age scored higher than those over 65. Patients with lower performance status and more advanced disease reported higher levels of mental distress and more often scored as a probable or possible cases of psychiatric disorder. Our psychometric analyses supported the two-dimensional structure and stability of the HAD scale. The HAD scale seems to be the method of choice for getting valid information about the probability of mood disorder in head and neck cancer populations. The prevalence of psychiatric morbidity found in this study emphasizes the importance of improved diagnosis and treatment.

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Section: Discussionmentioning

confidence: 99%

“…The psychiatric morbidity among cancer patients has been estimated previously and it has been found that approximately 25-30% of all cancer patients develop clinically significant anxiety or depression within 2 years of diagnosis (Maguire, 1992;Greer, 1994). Several risk factors for development of psychiatric disorder have been identified and examined.…”

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confidence: 99%

A prospective multicentre study in Sweden and Norway of mental distress and psychiatric morbidity in head and neck cancer patients

et al. 1999

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“…Numerous instruments have been described to quantify physical or psychological problems in patients. Most are lengthy and require specially trained personnel to use them but they may be valuable in oncological research for detailed study of particular aspects of patients' lives (Maguire et al, 1980;McArdle et al, 1981). Fewer attempts have been made to produce instruments specifically for use in oncological research or practice (Priestman & Baum, 1976;Eisenberg & Goldenburg, 1966;Izsak & Medelie, 1971;Worden & Weisman, 1977;Padilla et al, 1981;Craig et al, 1974), and most of these have not been formally evaluated or widely used.…”

Section: Correlations Between Scores For Items Within Thementioning

confidence: 99%

The development of a method for assessing the quality of life of cancer patients

Selby¹,

Chapman²,

Etazadi-Amoli³

et al. 1984

Br J Cancer

253

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Summary Although the need for a method of measuring the quality of life of patients undergoing therapy for cancer has been widely recognised, no adequately evaluated or feasible method has been established. We describe a method in which 31 items were assessed by patient self report using linear analogue scales. Eighteen items inquiring about general health problems were derived from the Sickness Impact Profile, an established method of assessing the effect of health upon behaviour and function. Thirteen items inquiring about major problems associated with breast cancer were derived from clinical experience and the opinions of patients with this disease.Each item of the measurement method (instrument) has been evaluated for content, feasability, reliability and validity by methods that are widely used in psychometry but less familiar in medicine. It appeared easy to use, acceptable and reliable in these assessment. Validity was evaluated indirectly since no standard measurements of quality of life exist for comparison. Most items appeared valid when compared to alternative measurement methods including the Sickness Impact Profile and evaluation by a physician in a structured interview. The correlations between items in the instrument were analysed by factor analysis and seemed to fit with the clinical features of breast cancer. The method distinguished between clinically distinct groups of patients and detected changes with time.The study illustrates the possible approaches to the scientific evaluation of methods for measuring subjective features of patients lives. This method appears suitable for some purposes to measure quality of life in breast cancer and is intended to be flexible enough to be modified for other diseases. However, further evaluation, development and refinement will be needed before routine clinical application can be recommended.

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confidence: 99%

Psychiatric morbidity in patients with advanced cancer of the breast: prevalence measured by two self-rating questionnaires

Hopwood

Howell²,

Maguire³

1991

Br J Cancer

176

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Summary Two hundred and twenty-two women with advanced cancer of the breast were asked to complete two previously validated self-assessment questionnaires (Hospital Anxiety and Depression Scale (HADS) There has been extensive investigation into the psychological sequelae of early breast cancer and its treatment (Maguire et al., 1978;Maguire et al., 1980;Morris et al., 1977;Robert et al., 1972) but there are few data concerning the prevalence of depression and anxiety in patients with advanced disease. There is a need to determine the extent and severity of affective disorder in patients receiving palliative treatment for breast cancer and to find out whether such disorder is transient or warrants intervention. Plumb and Holland (1981) reported that 20-30% of patients admitted to hospital for the treatment of a variety of advanced cancers developed clinically significant depression and 15% had severe anxiety. In a study of 215 cancer inpatients and outpatients Derogatis and co workers (1983) found 47% met criteria for psychiatric disorder, and of these 13% had a major affective disorder, mainly depression. The majority were described as suffering 'adjustment disorder' that is a less severe form of mood disorder. In a number of other studies (Bukberg et al., 1980;Craig & Abeloff, 1974;Farber et al., 1982;Plumb & Holland, 1977) self report questionnaires have been used to assess psychological morbidity in heterogeneous cancer patient groups. Two such questionnaires were deemed suitable for use for the present study. The Hospital Anxiety and Depression Scale (HADS) (Zigmond & Snaith, 1983) was designed to measure depression and anxiety in medical outpatients and avoids the use of somatic symptoms, which may also be attributed to disease and treatment. It has been shown to be a valid measure of the severity of disorders of mood. The Rotterdam Symptom Checklist (de Haes et al., 1990) was designed as a multidimensional scale for use in quality of life assessment: it contains a subscale of eight items relating to psychological symptoms.The authors validated these two questionnaires in a series of 81 patients with advanced breast cancer (Hopwood et al., 1991), to establish appropriate cut-off values for the identification of 'cases' of affective disorder. Both questionnaires identified 75% of patients diagnosed as cases by a psychiatric interview. The scales were able to correctly identify one in evey two high scorers as a case and, although this predictive power was high in relation to 'screening' for affective disorder, it will inevitably mean that prevalence rates using self-rating scales are an estimate of morbidity rather than an accurate measure of disorder. Nevertheless, scales such as the HADS and RSCL are being used increasingly to evaluate 'quality of life' in cancer patients and their Correspondence: P. Hopwood.Received 16 February 1990; and in revised form 2 April 1991.performance in the measurement of psychological disorder in a homogeneous population of patients warrants evaluation.The aim of the study ...

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Psychiatric morbidity and physical toxicity associated with adjuvant chemotherapy after mastectomy.

Abstract: Blood oxygen and carbon dioxide pressures during three admissions. Results are given under days after admission in each month Month of admission Pressure (kPa) March

Cited by 95 publications

References 2 publications

A prospective multicentre study in Sweden and Norway of mental distress and psychiatric morbidity in head and neck cancer patients

A prospective multicentre study in Sweden and Norway of mental distress and psychiatric morbidity in head and neck cancer patients

The development of a method for assessing the quality of life of cancer patients

Psychiatric morbidity in patients with advanced cancer of the breast: prevalence measured by two self-rating questionnaires

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