Anxiety disorders in advanced cancer patients

Spencer, Ryan; Nilsson, Matthew; Wright, Alexi A.; Pirl, William F.; Prigerson, Holly G.

doi:10.1002/cncr.24954

Cited by 106 publications

(54 citation statements)

References 54 publications

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“…Those with untreated psychological distress are less able to participate effectively in end of life planning (9) and report a desire for hastened death (10). Specifically, patients with cancer and anxiety have difficulty engaging in effective decision-making (11), report worse relationships with their physicians (12), experience disruptions in their cancer care (13), and have worse physical functioning (14), which may lead to poorer clinical outcomes (12). Those with depression have elevated risk for suicide (15,16) cancer-related death, and early overall mortality (17,18).…”

Section: Introductionmentioning

confidence: 99%

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Distress is Interdependent in Patients and Caregivers with Newly Diagnosed Incurable Cancers

et al. 2017

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Background Individuals with advanced, incurable cancer often experience high physical and psychological symptom burden. Family and friend caregivers are at risk for emotional distress. Purpose To investigate the interrelationship of distress in patient-caregiver dyads at the time of newly diagnosed incurable cancer. Methods From May 2011 to July 2015, within 8 weeks of diagnosis of advanced lung or non-colorectal gastrointestinal cancer, 350 patients and 275 family caregivers were enrolled in a randomized controlled trial of early palliative care. Actor-Partner Interdependence Modeling was used to examine relationships between dyad’s self-reported anxiety and depressive symptoms on the Hospital Anxiety and Depression Scale at baseline. Results Comparing patients with caregivers, patients reported more depressive symptoms (Mdiff=.84; t[274]=3.17, p=.002, d=.22) and caregivers reported more anxiety symptoms (Mdiff=1.62,t[274]=4.91, p<.001, d=.39). Dyads’ anxiety symptoms were positively associated, as were depressive symptoms (rs=.21, ps≤.001). Actor Partner Interdependence Modeling showed that patients’ anxiety symptoms were positively associated with their own depressive symptoms, with an equal effect for caregivers (actor effect βs=0.52, ps<0.001). Patients’ own anxiety was concurrently positively associated with their caregivers’ depressive symptoms, with an equal effect for caregivers to patients (partner effect βs=0.08, ps=0.008). Conclusions In the context of newly diagnosed incurable cancer, caregivers experience more pronounced anxiety, while patients report greater depressive symptoms. Findings indicate that anxiety and depressive symptoms are interrelated among dyads facing newly diagnosed incurable disease. Results emphasize the importance of addressing distress in both patients and caregivers. Future research should discern when dyadic versus individual psychosocial interventions would be optimal.

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Section: Introductionmentioning

confidence: 99%

“…Overall, anxiety in advanced cancer has been understudied, though it may be prevalent in caregivers (12,25). The psychological needs of patients are greatest following diagnosis and while beginning treatment (30).…”

Section: Introductionmentioning

confidence: 99%

Distress is Interdependent in Patients and Caregivers with Newly Diagnosed Incurable Cancers

et al. 2017

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“…Moreover, the rate of anxiety indicators in this study is high compared to a previous study that diagnosed 7.6% of cancer patients with an anxiety disorder using a diagnostic interview [38]. However, the choice of instrument may explain this difference, and the present study used screening instruments that measure anxiety symptoms rather than specific disorders.…”

Section: Discussionmentioning

confidence: 74%

Indicators of Psychiatric Disorders in Different Oncology Specialties: A Prevalence Study

Lima

Osório

2014

Journal of Oncology

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Objective. This study evaluated the prevalence of various indicators of psychiatric disorders in Brazilian outpatients with cancer and assessed possible associations with sociodemographic indicators. Materials and Methods. A total of 1,385 patients were evaluated using the following instruments: Patient Health Questionnaire-4 (PHQ-4), Generalized Anxiety Disorder (GAD-7), Fagerström Test for Nicotine Dependence (FTND), and Fast Alcohol Screening Test (FAST). Results. The sample was composed of both genders with a slight predominance of women (55.8%), subjects with incomplete/completed elementary school (59%), married (67.4%), with children (94%), not active from a labor viewpoint (61.6%), and following some type of religion (79.5%). The prevalence of anxiety for the total sample varied between 21.5 and 27.4%. The prevalence of depression was 21.1%, tobacco abuse/dependence was 40.2%, and alcohol was 20.3%. Women had significantly higher levels of anxiety and depression than men. Men had higher levels of substance abuse/dependence indicators than women. Conclusion. These results are consistent with the literature, which attests to the high prevalence of psychiatric disorder indicators in cancer patients, especially compared to the general population.

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“…Most of these studies evaluated patients and FCs at the time of diagnosis or at the initiation of new treatments. In patients, higher levels of state anxiety were associated with increased levels of dyspnea [6], fatigue [7], nausea and pain [8,9], and decreased emotional, social, and cognitive function [10,11]. Moreover, increased anxiety was associated with decreased treatment adherence [12], longer hospital stays [13], and poorer quality of life (QOL) [10].…”

Section: Introductionmentioning

confidence: 99%

Cytokine gene variations associated with trait and state anxiety in oncology patients and their family caregivers

Miaskowski

Cataldo

Baggott

et al. 2014

Support Care Cancer

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Purpose-Anxiety is common among cancer patients and their family caregivers (FCs) and is associated with poorer outcomes. Recently, associations between inflammation and anxiety were identified. However, the relationship between variations in cytokine genes and anxiety warrants investigation. Therefore, phenotypic and genotypic characteristics associated with trait and state anxiety were evaluated in a sample of 167 oncology patients with breast, prostate, lung, or brain cancer and 85 of their FCs.Methods-Using multiple regression analyses, the associations between participants' demographic and clinical characteristics, as well as variations in cytokine genes and trait and state anxiety were evaluated.Results-In the bivariate analyses, a number of phenotypic characteristics were associated with both trait and state anxiety (e.g., age, functional status). However, some associations were specific only to trait anxiety (e.g., number of comorbid conditions) or state anxiety (e.g., participation with a FC). Variations in three cytokine genes (i.e., interleukin (IL) 1 beta, IL1 receptor 2 (IL1R2), nuclear factor kappa beta 2 (NFKB2)) were associated with trait anxiety and variations in two genes (i.e., IL1R2, tumor necrosis factor alpha (TNFA)) were associated with state anxiety.Conclusions-These findings suggest that both trait and state anxiety need to be assessed in oncology patients and their FCs. Furthermore, variations in cytokine genes may contribute to higher levels of anxiety in oncology patients and their FCs.

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Anxiety disorders in advanced cancer patients

Cited by 106 publications

References 54 publications

Distress is Interdependent in Patients and Caregivers with Newly Diagnosed Incurable Cancers

Distress is Interdependent in Patients and Caregivers with Newly Diagnosed Incurable Cancers

Indicators of Psychiatric Disorders in Different Oncology Specialties: A Prevalence Study

Cytokine gene variations associated with trait and state anxiety in oncology patients and their family caregivers

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