A Prospective Study of Psychosocial Morbidity in Adult Bone Marrow Transplant Recipients

Jenkins, Peter; Lester, H. M. O.; Alexander, Julie; Whittaker, J. A.

doi:10.1016/s0033-3182(94)71757-6

Cited by 61 publications

(29 citation statements)

References 6 publications

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“…Among patients with other types of malignancies, the proportion that exceeded cutoff scores on screening measures of emotional distress varied across studies. For the most part, the levels of distress in the current sample are a bit higher than those reported in investigations that used the same instrument (HADS) to assess patients prior to autologous transplantation, 27,29 or in samples that were mixed for type of transplant [30][31][32] (see Table 5). Among the few exceptions, depressive symptoms were more common (30%) in the Wettergren et al 29 study and cases of anxiety were more prevalent (61%) in the Keogh et al 31 study.…”

Section: Discussionmentioning

confidence: 69%

“…[26][27][28][29] Rates of distress have been similarly elevated among more heterogeneous samples of patients assessed prior to receiving either autologous, allogeneic, or matched unrelated donor transplants. [30][31][32][33] Many patients also appear to experience compromised physical or functional status prior to autologous transplantation, although here too information is limited. 28,34,35 Most studies that evaluated patients prior to autologous PBSCT have relied on small sample sizes and, as noted, individuals with multiple myeloma were rarely included, in part due to exclusion of older patients from transplant regimens.…”

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confidence: 99%

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Psychosocial adjustment and quality of life among multiple myeloma patients undergoing evaluation for autologous stem cell transplantation

Sherman

Simonton

Latif

et al. 2004

Bone Marrow Transplant

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Summary:Stem cell transplantation has assumed a prominent place in the treatment of multiple myeloma, but relative to patients with other malignancies there is surprisingly little information about the adjustment difficulties and qualityof-life changes that these patients experience. This study examined psychosocial and functional deficits among myeloma patients assessed at a uniform period during their initial diagnostic evaluation, prior to beginning protocols at a transplant center. Validated self-report measures and clinician rating scales were used to assess 213 patients. Outcomes evaluated included emotional distress (Hospital Anxiety and Depression Scale, Brief Symptom Inventory), depression (Hamilton Depression Rating Scale), physical functioning, pain, and energy (SF-12). A significant proportion of patients experienced compromised psychosocial and physical functioning. Roughly one-third reported clinically elevated levels of distress, anxiety, and depression. In all, 59% scored below age-adjusted norms for daily physical functioning, 58% reported at least moderate levels of pain, and over 80% noted at least moderate fatigue. Clinical and demographic correlates of these outcomes were examined. These findings are among the first to characterize quality-of-life outcomes among myeloma patients in the transplant setting, and indicate that many patients experience considerable supportive care needs even prior to beginning aggressive regimens. Results highlight the importance of early screening. Bone Marrow Transplantation (2004) 33, 955-962.

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Section: Discussionmentioning

confidence: 69%

mentioning

confidence: 99%

Psychosocial adjustment and quality of life among multiple myeloma patients undergoing evaluation for autologous stem cell transplantation

Sherman

Simonton

Latif

et al. 2004

Bone Marrow Transplant

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“…It has been successfully validated against other psychiatric scales 12,17,29,30 and recommended for use as a screening instrument. 14,19,24,29 Two cut-off points for the definition of cases on each scale are suggested by the authors: 11 a mean scale score of 8 to 10 is defined as a possible case, and 11 or higher is defined as a definite case. The lower threshold was used in this study in order to detect possible cases who might benefit from intervention programs.…”

Section: The Hospital Anxiety and Depression Scale (Hads)mentioning

confidence: 99%

“…22 In the prospective reports, about 30% of patients were defined as clinical cases of anxiety 25 or anxiety and depression combined at baseline. 24 Baseline scores were strong predictors for psychosocial morbidity 6 to 9 months following transplant, 23 while no such predictive power was demonstrated by Jenkins et al 24 The limiting factor in these studies was the small numbers of patients assessed at baseline and the last assessment, respectively; 36 and 16, 23 30 and 12, 24 12 and 8. 25 Furthermore, mean scores from different numbers of patients at baseline and the subsequent assessments were reported.…”

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confidence: 97%

“…[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. 20 Twelve percent of the transplant patients were defined as definite anxiety cases (scale score Ͼ10) and 11% as probable cases (scale score 8 to 10).…”

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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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Depressive symptoms in autologous bone marrow transplant (ABMT) patients with cancer: An exploratory study

et al. 1996

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The purpose of the study was to examine the prevalence of depressive symptoms and related psychosocial and medical factors in patients submitted to autologous bone marrow transplantation (ABMT) for solid tumors. Forty‐four cancer inpatients were assessed for the presence of depression and psychological stress symptoms (Symptom Questionnaire) (SQ) on admission to the hospital (Time 1‐T1) and after ABMT (Time 2‐T2). Coping strategies (Mental Adjustment to Cancer scale), external locus of control and social support (Social Provision Scale) were also evaluated at T1. The prevalence of depression (‘cases’) declined from T1 to T2 (41% to 27%). Patients who were depressed at T2 had higher scores on Anxiety and Depression, External Locus of Control and lower scores on social support at T1 than non‐depressed. Regression analysis indicated that depression and anxiety at T1 and days spent during isolation with fever were the best predictors of depression at T2. These preliminary findings strengthen the importance for clinicians to evaluating psychosocial and medical variables which may favour depression in cancer patients submitted to ABMT.

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A Prospective Study of Psychosocial Morbidity in Adult Bone Marrow Transplant Recipients

Cited by 61 publications

References 6 publications

Psychosocial adjustment and quality of life among multiple myeloma patients undergoing evaluation for autologous stem cell transplantation

Psychosocial adjustment and quality of life among multiple myeloma patients undergoing evaluation for autologous stem cell transplantation

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

Depressive symptoms in autologous bone marrow transplant (ABMT) patients with cancer: An exploratory study

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