A longitudinal investigation of psychological morbidity in patients with ovarian cancer

Abstract

Ovarian cancer patients may experience psychological disorders due to the aggressive nature of the illness and treatment. We investigated the presence of psychological disorders longitudinally in women with a new diagnosis of ovarian cancer and the factors that predicted development and maintenance of these disorders. Patients were assessed in a prospective longitudinal study at the beginning of chemotherapy treatment, mid-treatment, end of treatment and 3 months follow-up for depression, anxiety, perceived social support, neuroticism and cognitive strategies to control unwanted thoughts. A total of 121 patients were recruited and 85 patients were assessed at all four time points. Three different longitudinal profiles of anxiety and depression caseness were found: non-cases (never cases), occasional cases (cases on at least one but not all four occasions) and stable cases (cases on all four occasions). Most of the women were occasional cases of anxiety (52%, 44), whereas for depression, the majority of women were non-cases (55%, 47). A subset of patients were stable cases of anxiety (22%, 19). Neuroticism and marital status were significant independent predictors of anxiety caseness profile. Neuroticism and use of anti-depressants were independent predictors of depression caseness profile. Social support was not related to psychological morbidity.

Helplessness/hopelessness, minimization and optimism predict survival in women with invasive ovarian cancer: a role for targeted support during initial treatment decision-making?

“…A strength of our study was the inclusion of repeated assessments and the inclusion of timevarying variables in the analyses, since the assumption that people's mood and coping style remain constant over the cancer trajectory is unsupported by the literature [38][39] Thus, use of baseline or cross-sectional assessment of psychosocial variables only, can represent a flaw in the study design. Our analyses using baseline variables only produced quite different findings to those including time varying variables, with optimism and minimization no longer significant in these models, reinforcing the importance of considering variables over time.…”

Selected determinants of strategies to cope with the disease among women treated for gynecological cancer

“…The following example shows how to change the mental attitude approach to the disease, and thus the effects of treatment. Literature says that the strategies of adaptation to the disease and its acceptance play a key role in the process of treatment and recovery [1,2,9,12]. In health care for patients with cancer, healthcare professionals should therefore remember this important relationship.…”

“…The sick woman creates her own personal image of disease, ranging from diagnosis through the entire therapy. In the treatment process, it is important to learn how to function with the illness, how to attain the recovery and how to develop a style of coping with difficulties [1][2][3].…”

Depression in Cancer Care

“…Key risk factors for developing depression include, but are not limited to, a history of depression, lower levels of social support, advanced stages of illness, higher symptom burden, and more frequent unmet needs. 7,[9][10][11][12] Other predisposing risk factors include younger age, neurotic personality, and low education history; [12][13][14] however, these predisposing factors are unmodifiable, and, therefore, clinicians should focus on the modifiable key risk factors that are mentioned above.…”