Psychological distress after cancer cure: a survey of 459 Hodgkin's disease survivors

Loge, Jon Håvard; Abrahamsen, Arne Foss; Ekeberg, Øivind; Hannisdal, Einar; Kaasa, Stein

doi:10.1038/bjc.1997.464

Cited by 87 publications

(117 citation statements)

References 23 publications

(34 reference statements)

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“…20,21,23,25,18 The course of psychological distress in the CT group was more in line with our expectations, peaking shortly after diagnosis. The time of assessments during the course of disease is important in this respect, in line with studies indicating that psychological distress reaches the highest levels in the time between diagnoses and start of treatment.…”

Section: Discussionsupporting

confidence: 78%

“…42 Thus, we found a higher level of psychological distress in all patient groups after 1 year compared with the general Norwegian population, particularly regarding anxiety, regardless of whether the lower or higher cut-off was used for case definition. This is in line with reports from other cancer survivors 13,18 and consistent with studies in SCT or ASCT patients employing questionnaires which provide population data. 3,4,7,10 The lack of assessment of prior psychological health and the great differences between the SCT and ASCT patients regarding previous treatment experiences as discussed previously 27 might be regarded as a limitation of this study.…”

Section: Discussionsupporting

confidence: 77%

“…4,10 The Hospital and Anxiety Depression scale (HADS) 11 has been developed for evaluation of anxiety and depression in physically ill patients and has been frequently used in various cancer populations, both with in patients and outpatients. [12][13][14][15][16][17][18][19] We identified six studies which have employed the HADS in SCT and ASCT patients; two crosssectional, 20,21 one retrospective 22 and three prospective. [23][24][25] No significant differences in anxiety or depression were found between 53 SCT and 38 ASCT patients at a mean of 40 months post transplant, but they were significantly less depressed when compared to 73 patients receiving maintenance chemotherapy.…”

mentioning

confidence: 99%

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The course of anxiety and depression during the first year after allogeneic or autologous stem cell transplantation

Hjermstad

Loge

Evensen³

et al. 1999

Bone Marrow Transplant

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Summary:Psychological distress is frequently reported in transplant survivors. We prospectively assessed anxiety and depression before transplant, in the isolation period and during a follow-up period of 1 year. The Hospital Anxiety and Depression Scale (HADS) was administered to 131 cancer patients treated with high-dose chemotherapy followed by allogeneic (SCT) or autologous (ASCT) stem cell transplantation, and a concurrent group of 123 lymphoma patients receiving standard chemotherapy (CT) who served as a reference group. Relatively low levels of anxiety and depression were found. The level of anxiety slightly declined from baseline during follow-up (mean scores SCT: from 5.3 to 3.6, CT: from 6.0 to 4.2) or remained fairly stable (ASCT: from 5.4 to 4.8). The level of depression peaked when the transplant patients were in protective isolation or shortly thereafter (SCT: 6.1, ASCT: 6.4), but stabilized at baseline levels after 4 months. The highest level of depression in the CT group was reported 4 months after start of chemotherapy (3.4). Elevated levels of anxiety and depression at baseline predicted more anxiety and depression at the later assessments (P values Ͻ0.0001). The ASCT group had higher levels of anxiety after 1 year (mean 4.8) than those found in the other two groups (SCT: 3.6, CT: 4.2), although they were not statistically significant. This study revealed lower than expected levels of anxiety and depression after intensive chemotherapy followed by SCT or ASCT. There was a decline in psychological distress during the 1-year follow-up period. Keywords: anxiety; depression; HADS; high-dose chemotherapy; prospective study Allogeneic (SCT) and autologous (ASCT) stem cell transplantation subsequent to high-dose chemotherapy (HDC) produces significant physical morbidity. 1,2 Most patients who undergo high-dose chemotherapy are young, and with increasing numbers of long-term survivors, prospective Correspondence: MJ Hjermstad, Department of Oncology, The Norwegian Radium Hospital, Montebello, N-0310 Oslo, Norway Received 18 December 1998; accepted 15 July 1999 data on the prevalence and severity of psychological morbidity are important. In order to identify patients with symptoms of anxiety and depression in the early stages of disease and treatment, who might be at risk of psychological maladjustment after such intensive treatment, it is important to raise the awareness of signs of psychological distress in clinical oncology. A routine-based incorporation of assessment of anxiety and depression might be helpful.Previous studies which have used questionnaires such as the Profile of Moods State (POMS) or the Brief Symptom Inventory (BSI) for the evaluation of anxiety and depression, have shown that psychological distress is frequently reported by SCT and ASCT patients. The percentages of patients with these problems vary from 14% to 41%, depending on the study design, types of measures, and time of assessment relative to diagnoses and treatment. [3][4][5][6][7][8][9] When data from transplant patients ha...

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Section: Discussionsupporting

confidence: 78%

Section: Discussionsupporting

confidence: 77%

mentioning

confidence: 99%

See 1 more Smart Citation

The course of anxiety and depression during the first year after allogeneic or autologous stem cell transplantation

Hjermstad

Loge

Evensen³

et al. 1999

Bone Marrow Transplant

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“…This is a 14-item questionnaire which has been well validated as a tool for identifying abnormal mood states. The HADS has been used in studies of distress in cancer patients in general (Carroll et al, 1993;Ibbotson et al, 1994;Aass et al, 1997) and specifically in Hodgkin's disease (Loge et al, 1997). It has been shown to perform well in cancer patients free of disease (Ibbotson et al, 1994).…”

Section: Patientsmentioning

confidence: 99%

“…Forty-four of these individuals were males under the age of 60 years, and this cohort was used for comparison with the cancer patients (normals). Information regarding education level was also collected for all the subjects as this has been found to correlate with the incidence of anxiety and depression (Loge et al, 1997). Mann-Whitney U and Student's t-tests were used to compare non-parametric and parametric data between groups.…”

Section: Patientsmentioning

confidence: 99%

Fatigue, sexual function and mood following treatment for haematological malignancy: the impact of mild Leydig cell dysfunction

et al. 2000

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Summary Fatigue, sexual dysfunction, anxiety and depression are all more common in patients who have previously been treated with cytotoxic chemotherapy and radiotherapy (XRT) for haematological malignancies. Following therapy, a significant proportion of men have biochemical evidence of Leydig cell dysfunction, defined by a raised luteinizing hormone level in the presence of a low/normal testosterone level. We postulated that mild testosterone deficiency may account for some of the long-term side-effects of treatment, and we have therefore assessed fatigue, mood and sexual function by questionnaire in 36 patients with Leydig cell dysfunction (group 1), and also in a group of 30 patients (group 2) with normal hormone levels who underwent the same treatment for cancer. There was no significant difference in anxiety and depression scores between the two groups although anxiety scores were higher than those previously reported for normal men. Eightyseven per cent of group 2 were sexually active compared with only 69% of group 1 (P = 0.1), and patients in group 1 engaged less in sexual activity than those in group 2 (mean of 1.8 times per week compared with 3.2 times per week; P = 0.02) Fatigue scores were significantly higher in both groups compared with normal men, but there were no significant differences in any of the fatigue subscales between the two groups. We conclude that mild Leydig cell insufficiency following treatment with cytotoxic chemotherapy ± XRT is not associated with higher levels of fatigue and anxiety but may result in reduced sexual function. These results do not provide a convincing argument that androgen replacement therapy is mandatory to improve quality of life in the majority of these patients, although it may be beneficial in a minority. To establish criteria for selection of patients for a trial of androgen therapy a randomized placebo-controlled study will be necessary.

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Psychological Distress in Long-term Survivors of Adult-Onset Cancer

Hoffman¹,

McCarthy²,

Recklitis³

et al. 2009

Arch Intern Med

189

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Psychological distress after cancer cure: a survey of 459 Hodgkin's disease survivors

Cited by 87 publications

References 23 publications

The course of anxiety and depression during the first year after allogeneic or autologous stem cell transplantation

The course of anxiety and depression during the first year after allogeneic or autologous stem cell transplantation

Fatigue, sexual function and mood following treatment for haematological malignancy: the impact of mild Leydig cell dysfunction

Psychological Distress in Long-term Survivors of Adult-Onset Cancer

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