Recognition of Depression and Methods of Depression Screening in People with Cancer

Passik, Steven D.; Lowery, Amy E.

doi:10.1002/9780470972533.ch4

Cited by 20 publications

(9 citation statements)

References 53 publications

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“…Specifically, a breast cancer survivor who avoids managing stressors and feels less confident in her problem‐solving abilities may perceive others as more critical or elicit more critical responses from others. Additionally, fatigue, sleep disturbance, and attentional functioning are common symptoms of depression, and a depressed individual may elicit more negative interactions from others . Longitudinal research is needed to explore the direction of these relationships.…”

Section: Discussionmentioning

confidence: 99%

Avoidant coping and self-efficacy mediate relationships between perceived social constraints and symptoms among long-term breast cancer survivors

et al. 2016

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Objective Many breast cancer survivors feel constrained in discussing their cancer experience with others. Limited evidence suggests that social constraints (e.g., avoidance, criticism) from loved ones may negatively impact breast cancer survivors’ global health, but research has yet to examine relationships between social constraints and common physical symptoms. Informed by social cognitive processing theory, this study examined whether perceived social constraints from partners and health care providers (HCPs) were associated with fatigue, sleep disturbance, and attentional functioning among long-term breast cancer survivors (N=1,052). In addition, avoidant coping and self-efficacy for symptom management were examined as potential mediators of these relationships. Methods Long-term breast cancer survivors (mean years since diagnosis=6) completed questionnaires assessing social constraints from partners and HCPs, avoidant coping, self-efficacy for symptom management, and symptoms (i.e., fatigue, sleep disturbance, attentional functioning). Structural equation modeling was used to evaluate the hypothesized relationships among variables in two models: one focused on social constraints from partners and one focused on social constraints from HCPs. Results Both models demonstrated good fit. Consistent with theory and prior research, greater social constraints from both partners and HCPs were associated with greater symptom burden (i.e., greater fatigue and sleep disturbance, poorer attentional functioning). In addition, all relationships were mediated by avoidant coping and self-efficacy for symptom management. Conclusions Findings are consistent with social cognitive processing theory and suggest that symptom management interventions may be enhanced by addressing the impact of social constraints from survivors’ partners and HCPs on their coping and self-efficacy.

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Section: Discussionmentioning

confidence: 99%

Avoidant coping and self-efficacy mediate relationships between perceived social constraints and symptoms among long-term breast cancer survivors

et al. 2016

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“…In cancer patients, diagnosing depression can also prove to be challenging . The primary source of this difficulty lies in the overlap between the diagnostic criteria for depression, as detailed in the Diagnostic and Statistical Manual for Mental Disorders (DSM ), and the symptoms often attributable to cancer and/or the side effects of treatment . The overlapping symptoms may include: sleep disturbances, decreased interest in sexual activity, and lack of energy .…”

Section: Introductionmentioning

confidence: 99%

Assessing depression in a geriatric cancer population

et al. 2016

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Objective To examine the ability of three popular self-report measures of depression to assess depression in a geriatric cancer setting. Method Cancer patients 70 years or older and on active treatment completed the Geriatric Depression Scale-Short Form, the Hospital Anxiety and Depression Scale, and the Center for Epidemiological Studies Depression Scale—Revised, and were interviewed using the depression module of the Structured Clinical Interview for DSM disorders (SCID) as the ‘gold standard.’ Analyses included calculating internal consistency, ROC curves, and the sensitivity and specificity to detect major depression (MDD) or minor depression (i.e. subthreshold depression). Results In a sample of 201 cancer patients (85% White; 64% completed college degree or higher), all three of the self-report measures produced adequate internal consistency and predicted depression greater than chance. However, the published cutoff scores for detecting MDD produced inadequate sensitivity, suggesting these scores will miss as many as 33%–83% of geriatric cancer patients who are depressed. Revised cutoff scores were lower than published cutoff scores. Conclusion Although these measures produced good internal consistency and were better than chance at predicting depression in a geriatric cancer sample, the published cutoff scores for these measures did not perform well in predicting MDD nor minor depression. Of the three measures, the CES-D appeared to have the most utility. This data suggests that these popular screening measures may be inadequate for reliably identifying depression in a geriatric cancer population. Researchers and clinicians, therefore, should use caution when selecting depression measures for geriatric cancer patients and consider using the lower cut-off scores presented here.

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“…Although somatic symptoms such as weight loss, diminished appetite and fatigue are common among depressed patients, these symptoms can also be consequences of chemotherapy (American Cancer Society, 2015). Likewise, the pain and discomfort associated with cancer can cause sleep disturbance and concentration problems (Passik & Lowery, 2011). One approach to disentangling the influence of cancer and chemotherapy on somatic symptoms is through a comparison of depressed and non-depressed cancer patients.…”

Section: Resultsmentioning

confidence: 99%

“…Despite the high prevalence and deleterious effects of depression, older adults are far less likely to be accurately diagnosed with depression compared to other age groups (Alexopoulos et al, 2002). The failure to recognize depression in older adults is in part because older adults are less likely than younger adults to report some of the classic symptoms of depression, such as sadness, whereas other symptoms may be simply due to normal aging (e.g., fatigue, sleep disturbance, diminished appetite; Passik & Lowery, 2011). Moreover, normal age-related physical changes and the high prevalence of medical comorbidity contribute to the complication of accurate depression assessment in older adults (Fiske et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, the diagnostic complications due to cancer are likely more pronounced than in many common or life-threatening illnesses given the toxicity of treatments, the frequent stigma associated with cancer (e.g., for potentially avoidable cancers such as lung or skin cancer), and the frequent fear of pain, disfigurement or even death (e.g., Gonzalez & Jacobsen, 2012; Lebel & Devens, 2008; Passik, Kirsch, Rosenfeld, McDonald, & Theobald, 2001). The primary source of this difficulty lies in the overlap between the diagnostic criteria for depression (Table 1), as detailed in the Diagnostic and Statistical Manual for Mental Disorders (DSM; American Psychiatric Association, 2013), and the symptoms often attributable to cancer and/or the side effects of treatment (Guo et al, 2006; Kathol, Mutgi, Williams, Clamon, & Noyes, 1990; Passik & Lowery, 2011). The same symptoms may arise from depression, from the cancer itself, from treatment side effects, or from some combination of the three (Koenig, George, Peterson, & Pieper, 1997; McDaniel, Musselman, Porter, Reed, & Nemeroff, 1995).…”

Section: Introductionmentioning

confidence: 99%

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Towards a new conceptualization of depression in older adult cancer patients: a review of the literature

Saracino

Rosenfeld

Nelson

2015

Aging & Mental Health

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Objectives Identifying depression in older adults with cancer presents a set of unique challenges, as it combines the confounding influences of cancer and its treatment with the developmental changes associated with aging. This paper reviews the phenomenology of depression in older adults, and individuals diagnosed with cancer. Method PsychInfo, PubMed, Web of Science, and Google Scholar databases were searched for English-language studies addressing the phenomenology, symptoms, or assessment of depression in older adults and those with cancer. Results The Diagnostic and Statistical Manual for Mental Disorders (DSM) criteria that appear to be relevant to both older adults and cancer patients are anhedonia, concentration difficulties, sleep disturbances, psychomotor retardation/agitation, and loss of energy. Possible alternative criteria that may be important considerations included constructs such as loss of purpose, loneliness, and irritability in older adults. Among cancer patients, tearfulness, social withdrawal, and not participating in treatment despite ability to do so were identified as potentially important symptoms. Conclusions Current DSM criteria may not adequately assess depression in older cancer patients and alternative criteria may be important to inform the understanding and identification of depression in this population. Enhancing diagnostic accuracy of depression is important as both the over-diagnosis and under-diagnosis is accompanied with significant costs. Thus, continued research exploring the phenomenology and identifying effective indicators of depression in older cancer patients is needed.

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Recognition of Depression and Methods of Depression Screening in People with Cancer

Cited by 20 publications

References 53 publications

Avoidant coping and self-efficacy mediate relationships between perceived social constraints and symptoms among long-term breast cancer survivors

Avoidant coping and self-efficacy mediate relationships between perceived social constraints and symptoms among long-term breast cancer survivors

Assessing depression in a geriatric cancer population

Towards a new conceptualization of depression in older adult cancer patients: a review of the literature

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