Psychological Distress after a Diagnosis of Malignant Mesothelioma in a Group of Patients and Caregivers at the National Priority Contaminated Site of Casale Monferrato

Abstract

Background: Patients of malignant mesothelioma (MM) and their caregivers face significant physical and psychological challenges. The purpose of the present study is to examine the emotional impact after the diagnosis of MM in a group of patients and familial caregivers in a National Priority Contaminated Site (NPCS). Methods: A sample of 108 patients and 94 caregivers received a sociodemographic/clinical questionnaire, the Beck Depression Inventory II, the Davidson Trauma Scale, the Coping Orientation to the Problems Experienced—New Italian Version, and the Defense style questionnaire. The risk of depressive and post-traumatic stress disorder (PTSD) symptoms in relation to the strategies of coping and defense mechanisms was estimated in patients and caregivers separately by logistic regression models. Results: For patients, a high risk of depression was associated with high usage of Defense Style Questionnaire (DSQ) Isolation (OR: 53.33; 95% CI: 3.22–882.30; p = 0.01) and DSQ Somatization (OR: 16.97; 95% CI: 1.04–275.90; p = 0.05). Other significant risks emerged for some coping strategies and some defenses regarding both depression and trauma in patients and caregivers. Conclusions: This research suggests that for both patients and caregivers unconscious adaptive processes have a central role in dealing with overwhelming feelings related to the disease.

The psychosocial impact of living with mesothelioma: Experiences and needs of patients and their carers regarding supportive care

“…While it is justified that almost all care relates to the patient, carers recognise their own need for psychosocial support but experience a lack of attention for the situation they are in. Yet, it has been reported that caregivers' depression and perceived burden increase as patients' functional status declines (Bonafede et al, 2020;Grunfeld et al, 2004). Schmid-Büchi et al (2011) showed that relatives of breast cancer patients have a significant wish for access to, and personal contact with, healthcare professionals during the treatment process.…”

Preliminary validation of a questionnaire assessing psychological distress in caregivers of patients with malignant mesothelioma: Mesothelioma Psychological Distress Tool—Caregivers

“…5 Some authors have found clinically higher levels of somatic and cognitive complaints, anxiety-depressive symptoms, and posttraumatic conditions in the caregivers of MM patients, suggesting that the psychological sequelae of MM could be even more traumatic for caregivers than patients. 9 Caregivers are confronted with a traumatic reality in which their own need to be supported often remains unseen. 10 The literature has repeatedly highlighted the importance of assessing the psychological needs of the caregivers of MM patients.…”

SARS-CoV-2 and Asbestos Exposure: Can Our Experience With Mesothelioma Patients Help Us Understand the Psychological Consequences of COVID-19 and Develop Interventions?

“…Caregivers of MM patients are prone to experiencing depression, anxiety, hopelessness, somatic symptoms, social isolation, and financial stress ( Adelman et al, 2014 ; Kleine et al, 2019 ). It was recently shown that caregivers of MM patients were more severely traumatized than the patients themselves, reporting higher frequencies of intrusive thoughts about death and exhibiting physiologic hyperactivation ( Bonafede et al, 2020 ). The risk of depression is associated with use of avoidance strategies in caregivers, with a higher risk in females as compared to males ( Bonafede et al, 2020 ).…”

“…Common responses to traumatization—which depend on the mind’s degree of integration and quality of functioning—range from a frozen affective internal state based on dissociation and denial, to resilient behaviors developed following exposure to the traumatizing event ( Granieri et al, 2018 ; Bonafede et al, 2020 ). Defense mechanisms in inhabitants of asbestos NPCSs are mainly aimed at maintaining, protecting, modifying, or repairing the shared group identity.…”