Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-24T10:54:05.288Z Has data issue: false hasContentIssue false
  • English
  • Français

Depressive, anxiety, and distress symptoms among cancer patients who endorse appearance problems

Published online by Cambridge University Press:  15 August 2018

Deepti Chopra Open the ORCID record for Deepti Chopra [Opens in a new window]  and
Richard De La Garza II
Deepti Chopra*
Affiliation:
University of Texas M.D. Anderson Cancer Center, Department of Psychiatry, Houston, TX
Richard De La Garza II
Affiliation:
University of Texas M.D. Anderson Cancer Center, Department of Psychiatry, Houston, TX
*
Author for correspondence: Deepti Chopra, M.B.B.S., M.P.H., 1400 Pressler Street, Houston, TX 77030-3722. E-mail: [email protected] ORCID ID# 0000-0001-5678-1318
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

Body image is a vital and complex issue in cancer patients, but not well recognized. In the ambulatory psychiatric-oncology clinic, we assessed what portion of cancer patients endorsed appearance problems and if they differed in terms of depression, anxiety, or distress scores when compared with those who did not endorse appearance problems.

Method

All adult patients with active cancer diagnosis seen in the outpatient psychiatry oncology clinic (June 2014–January 2016) who provided informed consent were included (N = 1,939) in the cross-sectional study design. “Appearance problems” were assessed as a categorical, binomial variable (yes/no) using the National Comprehensive Cancer Network Distress Thermometer checklist. Other assessments included the Patient Health Questionnaire-9, Patient Health Questionnaire-2, Generalized Anxiety Disorder-7, Distress Thermometer, and Edmonton Symptom Assessment Scale.

Result

The overall prevalence rate of individuals who endorsed appearance problems was approximately 36%; they were more likely to be younger, female, Black or Hispanic, and not in a committed relationship (all results for demographic variables were statistically significant; all p < .001). Importantly, those patients who endorsed appearance problems exhibited higher scores for depression (p < .0001), anxiety (p < .0001), and distress (p < .0001), and these differences were of medium effect size (Cohen's d = 0.5−0.6).

Significance of results

The current results underscore the need to identify patients with body image problems early given that they are likely to exhibit higher magnitude of anxiety, depression and distress symptoms while undergoing cancer care. The results highlight the importance of body image issues and the need to evaluate them in cancer patients.

Keywords

AnxietyBody imageDepressionEmotional distressPhysical appearanceCancer
Type
Original Article
Information
Palliative & Supportive Care , Volume 17 , Issue 3 , June 2019 , pp. 328 - 332
Copyright
Copyright © Cambridge University Press 2018 

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

Annunziata, MA, Giovannini, L, & Muzzatti, B (2012) Assessing the body image: Relevance, application and instruments for oncological settings. Supportive Care in Cancer 20(5), 901–907.10.1007/s00520-011-1339-xGoogle Scholar
Arroll, B, Goodyear-Smith, F, Crengle, S, et al. (2010) Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population. Annals of Family Medicine 8(4), 348–353.10.1370/afm.1139Google Scholar
Bruera, E, Kuehn, N, Miller, MJ, et al. (1991). The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care, 7(2), 6–9.10.1177/082585979100700202Google Scholar
Bullen, T L, Sharpe, L, Lawsin, C, et al. (2012) Body image as a predictor of psychopathology in surgical patients with colorectal disease. Journal of Psychosomatic Research 73(6), 459–463.10.1016/j.jpsychores.2012.08.010Google Scholar
Cohen, J (1988) Statistical power analysis for the behavioral sciences. Hillsdale, NJ.: Lawrence Earlbaum Associates.Google Scholar
Fingeret, MC (2016) Body image and disfigurement. In MD Anderson manual of psychosocial oncology. Duffy, JD & Valentine, AD (eds.), New York, NY: McGraw-Hill Education, pp. 271–286.Google Scholar
Fingeret, MC, Teo, I, & Epner, DE (2014) Managing body image difficulties of adult cancer patients: Lessons from available research. Cancer 120(5), 633–641.10.1002/cncr.28469Google Scholar
Flexen, J, Ghazali, N, Lowe, D, et al. (2012) Identifying appearance-related concerns in routine follow-up clinics following treatment for oral and oropharyngeal cancer. British Journal of Oral and Maxillofacial Surgery 50(4), 314–320.10.1016/j.bjoms.2011.05.005Google Scholar
Fobair, P, Stewart, SL, Chang, S, et al. (2006). Body image and sexual problems in young women with breast cancer. Psychooncology 15(7), 579–594. doi:10.1002/pon.991Google Scholar
Hawley, ST, Griggs, JJ, Hamilton, AS, et al. (2009) Decision involvement and receipt of mastectomy among racially and ethnically diverse breast cancer patients. Journal of the National Cancer Institute 101(19), 1337–1347.10.1093/jnci/djp271Google Scholar
Holland, JC and Bultz, BD (2007) The NCCN guideline for distress management: A case for making distress the sixth vital sign. JNCCN Journal of the National Comprehensive Cancer Network 5(1), 3–7.10.6004/jnccn.2007.0003Google Scholar
Kroenke, K, Spitzer, RL, & Williams, JB (2003) The Patient Health Questionnaire-2: Validity of a two-item depression screener. Medical Care 41(11), 1284–1292.10.1097/01.MLR.0000093487.78664.3CGoogle Scholar
Kroenke, K, Spitzer, RL, & Williams, JBW (2001) The PHQ-9: Validity of a Brief Depression Severity Measure. Journal of General Internal Medicine 16(9), 606–613.10.1046/j.1525-1497.2001.016009606.xGoogle Scholar
Krok, JL, Baker, TA, & McMillan, SC (2013) Sexual activity and body image: Examining gender variability and the influence of psychological distress in cancer patients. Journal of Gender Studies 22(4), 409–422.10.1080/09589236.2012.708828Google Scholar
Manea, L, Gilbody, S, & McMillan, D (2012) Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire (PHQ-9): A meta-analysis. CMAJ : Canadian Medical Association Journal 184(3), E191–E196.10.1503/cmaj.110829Google Scholar
Nozawa, K, Shimizu, C, Kakimoto, M, et al. (2013) Quantitative assessment of appearance changes and related distress in cancer patients. Psycho-Oncology 22(9), 2140–2147.10.1002/pon.3268Google Scholar
Rhondali, W, Chisholm, GB, Filbet, M, et al. (2015) Screening for body image dissatisfaction in patients with advanced cancer: A pilot study. Journal of Palliative Medicine 18(2), 151–156.10.1089/jpm.2013.0588Google Scholar
Rhoten, BA, Murphy, B, & Ridner, SH (2013) Body image in patients with head and neck cancer: A review of the literature. Oral Oncology 49(8), 753–760.10.1016/j.oraloncology.2013.04.005Google Scholar
Spitzer, RL, Kroenke, K, Williams, JB, et al. (2006) A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine 166(10), 1092–1097.10.1001/archinte.166.10.1092Google Scholar
Tanco, K, Vidal, M, Arthur, J, et al. (2017) Testing the feasibility of using the Edmonton Symptom Assessment System (ESAS) to assess caregiver symptom burden. Palliative and Supportive Care 16(1), 1–9.Google Scholar
Cash, TF and Pruzinsky, T (2002) Body image. A handbook of theory, research, and clinical practice. The Guilford Press.Google Scholar