Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-25T15:44:37.183Z Has data issue: false hasContentIssue false

Does chemotherapy reduce stress?

Published online by Cambridge University Press:  28 September 2010

Francisco Gil*
Affiliation:
Psychooncology Unit, Hospital Duran I Reynals, Institut Català d′Oncologia, L′Hospitalet de Llobregat, Barcelona, Spain
G. Costa
Affiliation:
Psychiatry Service, Hospital de Mataró, Mataró. Barcelona, Spain
F.J. Pérez
Affiliation:
Clinical Research Unit, Medical Oncology Service, Hospital Duran I Reynals, Institut Català d′Oncologia. L′Hospitalet de Llobregat, Barcelona, Spain
*
Address correspondence and reprint requests to: Francisco Gil, Psychooncology Unit, Hospital Duran I Reynals. Institut Català d′Oncologia, 08907- L′Hospitalet de Llobregat, Barcelona, Spain. E-mail: [email protected]

Abstract

Objective:

The purpose of this study was to assess the psychological care needs of cancer patients throughout the healthcare process: after diagnosis, after medical treatment (surgery, chemotherapy, radiotherapy) and during follow-up.

Method:

A total of 703 ambulatory cancer patients were assessed in this study. The inclusion period was from April 1, 2005 to April 30, 2007. The first psychological scales used were the 14-item Hospital Anxiety and Depression Scales (HADS), which has two sub-scales for anxiety (7 items) and for depression (7 items). All patients with a score ≥14 were assessed through the Structured Clinical Interview for Psychiatric Disorder (SCID-I) of the DSM-IV. All data were compared with sociodemographic and medical characteristics.

Results:

Of the 703 cancer patients in the study, 349 were men and 354 women, with a mean age of 53 years. The median time between the cancer diagnosis and our clinical interview was 6 months (range, 12 days to 190 months). Overall, the screening tools indicated that one in four patients needed psychological care. The most common psychiatric diagnosis was adjustment disorder (129 cases), whereas 10 patients were diagnosed with major depression. Using a HADS cut-off score of >7 for anxiety and depression, 28% and 17% of patients, respectively, were classified as “possible clinical cases.” Risk factors for distress included age <65 years, asthenia, constipation, and a low performance status. However, chemotherapy treatment was found to be a protector against distress in cancer patients.

Significance of Results:

Chemotherapy treatment is interpreted by the patients as a protector against cancer, thereby reducing distress levels.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Akechi, T., Nakano, T., Akizuki, N., et al. (2002). Clinical factors associated with suicidality in cancer patients. Japanese Journal of Clinical Oncology, 32, 506511.CrossRefGoogle ScholarPubMed
Bell, K. (2009). “If it almost kills you that means is working.” Cultural models of chemotherapy expressed in a cancer support group. Social Science and Medicine, 68, 169176.CrossRefGoogle Scholar
Charles, C., Redko, C., Whelan, T., et al. (1998). Doing nothing is no choice: Lay constructions of treatment decision-making among women with early-stage breast cancer. Sociology of Health and Illness, 20, 7195.CrossRefGoogle Scholar
Derogatis, L.R., Morrow, G.R., Fetting, J. et al. (1983). The prevalence of psychiatric disorders among cancer patients. Journal of the American Medical Association, 249, 751757.CrossRefGoogle ScholarPubMed
Gil, F., Costa, G., Pérez, F.J., et al. (2008). Adaptación psicológica y prevalencia de trastornos mentales en pacientes con cáncer (Psychological adaptation and prevalence of mental disorders in cancer patients). Medicina Clínica, 130, 9092.Google Scholar
Grassi, L., Travado, L., Gil, F., et al. (2004). Psychosocial morbidity and its correlates in cancer patients of the Mediterranean area: Findings from the Southern European Psycho-Oncology Study. Journal of Affective Disorders, 83, 243248.CrossRefGoogle ScholarPubMed
Hack, T.F., Degner, L.F. & Dyck, D.G. (1994). Relationship between preferences for decisional control and illness information among women with breast cancer: A quantitative and qualitative analysis. Social Science Medicine, 39, 279289.CrossRefGoogle ScholarPubMed
Ibbotson, T., Maguire, P., Selby, P., et al. (1994). Screening for anxiety and depression in cancer patients: The effects of disease and treatment. European Journal of Cancer, 30, 3740.CrossRefGoogle Scholar
Jansen, S.J.T., Otten, W. & Stiggelbout, A.M. (2006). Factors affecting patientś perceptions of choice regarding adjuvant chemotherapy for breast cancer. Breast Cancer Research and Treatment, 99, 3545.CrossRefGoogle ScholarPubMed
Kadan-Lottick, N.S., Vanderwerker, L.C., Block, S.D., et al. (2005). Psychiatric disorders and mental health service use in patients with advanced cancer. Cancer, 104, 28722881.CrossRefGoogle Scholar
Karnofsky, D.A. & Burchenal, J.H. (1949). The clinical evaluation of chemotherapeutic agents in cancer. In Evaluation of Chemotherapeutic Agents, MacLeod, C.M. (ed.). pp 191205. New York: Columbia University Press.Google Scholar
Kim, J.W., Kim, S.-J., Kwon, J.-H., et al. (2008). Cancer patientś awareness of clinical trials, perceptions on the benefit and willingness to participate: Korean perspectives. British Journal of Cancer, 99, 15931599.CrossRefGoogle ScholarPubMed
Martinez de la Iglesia, J., Dueñas, R., Onis, M.C., et al. (2001). Adaptación y validación al castellano del cuestionario de Pfeiffer (SPMSQ) para detectar la existencia de deterioro cognitivo en personas mayores de 65 años (Adaptation and validation to Spanish of the Pfeiffer questionnaire (SPMSQ) for detecting cognitive deficit in adults older than 65 years). Medicina Clínica 1, 17, 129134.CrossRefGoogle Scholar
Razavi, D. & Delvaux, N. (1995). The psychiatrist's perspective on quality of life and quality of care in oncology: Concepts, symptom management, and communication issues. European Journal of Cancer, 31A (Supp. 6), S25S29.CrossRefGoogle Scholar
Sahm, S., Will, R. & Hommel, G. (2005). What are cancer patientś preferences about treatment at the end of life and who should start talking about it?. A comparison with healthy people and medical staff. Support Care Cancer, 13, 206214.CrossRefGoogle ScholarPubMed
SCID I y II. (1999). Guía de Entrevista Clínica Estructurada para los Trastornos del eje I y II del DSM-IV [Structured Clinical Interview for the Psychiatric Disorders Axis I and II of the DSM-IV]. Editorial Masson.Google Scholar
Slevin, M.L., Stubbs, L., Plant, H.J., et al. (1990). Attitudes to chemotherapy: Comparing views of patients with cancer with those of doctors, nurses, and general public. British Medical Journal, 300, 14581460.CrossRefGoogle ScholarPubMed
Tejero, A., Guimerá, E.M., Farré, J.M., et al. (1986). Uso clínico del HAD (Hospital Anxiety and Depression Scale) en población psiquiátrica: un estudio de su sensibilidad, fiabilidad y validez (Clinical use of HAD (Hospital Anxiety and Depresión Scale) in psychiatric population: an study of sensitivity, reliability and validation). Revista del Departamento de Psiquiatría de la Facultad de Medicine de Barcelona, 13, 233238.Google Scholar