Psychological burden and resilience factors in patients with Alveolar Echinococcosis – A cross-sectional study

Abstract

BackgroundAlveolar echinococcosis (AE) is a parasitic zoonosis resembling malignancy due to its clinically silent infiltrative growth, predominately in the liver. The comorbid psychological burden and fear of disease progression in AE patients have hardly been examined to date. The aim of this study was to evaluate depression, anxiety, quality of life, and fear of disease progression in AE patients.Methodology/Principal findingsIn a cross-sectional study, n = 57 AE patients were invited to report on depression (PHQ-9), anxiety (GAD-7), somatic symptom load (SSS 8), trauma symptoms (PTSS-10), quality of life (SF-12) and on fear of disease progression (FoP-Q-SF) using validated psychometric instruments. Furthermore, attachment style was assessed (RQ-2). N = 47 patients completed the questionnaires (response rate 82.5%). Depression, anxiety, and somatic symptom load were above norm sample means, while physical quality of life was below norm sample means. Existing traumatic symptoms were comparable to those in cancer patients, while fear of disease progression even exceeded cancer patient scores. Patients with a secure attachment style showed less pronounced psychological burden than patients with other attachment styles. Adequate, guideline-based depression and anxiety treatment was very rarely installed.Conclusion/SignificanceThe present study revealed remarkable levels of psychological burden in AE patients. In our study sample, we discovered high depression and anxiety levels, a significant reduction of physical quality of life, and fear of disease progression. These results show how important it is for AE patients to be thoroughly assessed with regard to psychological symptoms and mental disorders so that those in need can receive sufficient psychosocial support and treatment according to official guidelines.

A Key Factor for Psychosomatic Burden of Frontline Medical Staff: Occupational Pressure During the COVID-19 Pandemic in China

“…Medical workers needed to answer additional questions including medical work experience, professional title, military personnel or not, department, antiepidemic experience, and hospital category. In the second part, we assessed psychosomatic problems during the peak period of COVID-19 in China using measurements of depression (Patient Health Questionnaire-9; PHQ-9 ≥5) ( 13 ), anxiety (Generalized Anxiety Disorder-7; GAD-7 ≥5) ( 13 ), quality of life (QOL; EuroQol visual analog scale; EQ-VAS) ( 14 ), somatic symptom load (Somatic Symptom Scale-8; SSS-8 ≥4) ( 15 ), stress (stress part of Depression Anxiety Stress Scales-21; DASS-stress ≥15) ( 16 ), sleep quality problems (Pittsburgh Sleep Quality Index; PSQI ≥5) ( 17 ), and posttraumatic stress symptoms (Posttraumatic Stress Symptoms Checklist-10; PTSS-10 ≥5) ( 18 ), while observing medical staff's occupational pressure (adapted from Nurse Job Stressor Questionnaire; NJSQ) ( 19 ). These are all proven psychometric instruments, and the scoring standards and grades were also consistent with the routine.…”

Drug repurposing applied: Activity of the anti-malarial mefloquine against Echinococcus multilocularis

“…In the progressive stage of human AE, non-specific symptoms such as abdominal pain, jaundice, cholestasis, hepatomegaly, fever, anaemia, weight loss, and pleural pain appear ( Kern et al, 2017 ). Additionally, an AE diagnosis poses a continuously high psychological burden to patients ( Schmidberger et al, 2018 ; Nikendei et al, 2019 ). Finally, at an advanced stage, and if not treated properly or if treatment fails, AE will lead to the death ( Lundström-Stadelmann et al, 2019 ).…”

Diagnoseverzögernde Faktoren bei hepatischer alveolärer Echinokokkose

“…Aufgrund der schwierigen und verzögerten Diagnosestellung einer AE können Patienten von Krankheitsprogression, inoperablen Erkrankungsstadien, verzögerter Therapieeinleitung, sowie Auftreten von Komplikationen und vermehrter Strahlenbelastung betroffen sein [8]. Neben den somatischen Befunden stellen die Diagnose AE und der diagnostische Abklärungsprozess für die Patienten eine erhebliche psychische Belastung dar [8,14,15] Ziel dieser Querschnittsstudie war die Analyse des diagnostischen Workflows von Patienten mit Verdacht auf eine alveoläre Echinokokkose bzw. Patienten mit bestätigter alveolärer Echinokokkose sowie die Identifikation möglicher diagnoseverzögernder Faktoren.…”

“…Aufgrund der schwierigen und verzögerten Diagnosestellung einer AE können Patienten von Krankheitsprogression, inoperablen Erkrankungsstadien, verzögerter Therapieeinleitung, sowie Auftreten von Komplikationen und vermehrter Strahlenbelastung betroffen sein 8 . Neben den somatischen Befunden stellen die Diagnose AE und der diagnostische Abklärungsprozess für die Patienten eine erhebliche psychische Belastung dar 8 14 15 …”