Reducing distress and depression in cancer patients during survivorship

Abstract

Objective Distress and depression are prevalent in cancer patients throughout survivorship and are associated with adverse outcomes. This study examines the association between outpatient psycho‐oncology treatment and distress and depression in cancer patients. Methods This is a prospective observational study of adult patients with a primary diagnosis of cancer referred for psycho‐oncology services. Patients were seen for two psycho‐oncology visits in a single clinical setting with various qualified providers. Patients completed the distress thermometer and problem checklist (DT + PL) and the Patient Health Questionnaire (PHQ‐9) at the beginning of their first and second visits and repeated the DT at the end of these visits. Results The analysis included 174 patients seen once and 69 patients seen twice. Patients were seen on average 2.5 years after diagnosis. Both visits were associated with significant reductions in distress (5.56 before and 3.85 after for visit 1, p < 0.001; 4.92 before and 3.43 after for visit 2, p < 0.001). There was a significant reduction in distress from baseline to after visit 2 (p < 0.001). Depression scores significantly decreased from the first to second visits (8.79–7.57; p = 0.002). Conclusions Psycho‐oncology services were associated with significant reductions in distress and depression, with scores after services no longer meeting criteria for clinically significant distress (DT scores ≥ 4) and depression (PHQ‐9 scores ≥ 8) as they did at baseline. Reductions in distress and depression were not significantly associated with provider type, intervention or timing of diagnosis. These findings support the use of psycho‐oncology services in cancer patients throughout survivorship.

Disclosure and nondisclosure of physical health issues in psychodynamic psychotherapy.

“…Cancer is one example of a disease that is often accompanied by distress. Yet studies have shown that, for instance, few patients experiencing mental health issues such as depression or anxiety occurring while undergoing cancer treatment reported these concerns to physicians nor were physicians likely to recognize and then refer these patients for psychological treatment, and most of those identified by nurses as needing psychological treatment were referred for, but did not receive, treatment (Maguire, 1985; Ryan et al, 2005), perhaps because depression and anxiety can mimic physical symptoms of cancer as well as other diseases (Molinaro et al, 2021; Ryan et al, 2005). Other studies have looked across medical conditions to learn more about whether medical patients disclose, or want to disclose, psychological concerns and whether medical providers recognize cues of psychological distress in their patients.…”

Perception of Survivorship Needs Among Breast Cancer Patients in Trinidad and Tobago

“…Following a cancer diagnosis, just nine participants (15%) expected to receive counselling (psychosocial support) from their care providers, while one-third of the participants were resigned and had no further expectations. It is well recognized in the literature on psycho-oncology that psychological interventions, not only at the time of a cancer diagnosis but throughout survivorship, can improve outcomes [ 27 ]. It is well known that several gaps exist in primary health care and health systems in the Latin American and Caribbean region, adversely affecting the quality of care [ 28 ].…”

“…Advice on strategies to manage stress was informally given by physicians in an unstructured manner, dependent on the treating physician and patient relationship. Molinaro et al purport the impact of psycho-oncology in reducing distress and depression in cancer patients [ 27 ]. Techniques such as relaxation and meditation, as well as, physical and recreational activities were discovered by participants for stress management.…”

Anais Do 2° Congresso Internacional Multiprofissional Em Atenção Primária À Saúde

“…A assistência de saúde mental a pacientes diagnosticados com câncer deve ser prioridade no tratamento multiprofissional, pois o recebimento do diagnóstico pelo paciente pode desencadear a presença do transtorno depressivo tanto por uma reação de ajustamento quanto por uma resposta biopsicossocial e a detecção do sofrimento psicológico é importante para o tratamento da saúde mental centrado no paciente. (MOLINARO, J. et al, 2021). Dessa maneira, esta revisão integrativa da literatura buscou analisar e compreender de que maneira o cotidiano de pacientes oncológicos é impactado pela depressão.…”