Risk for anxiety and depression among individuals with ovarian cancer: The interplay between age and distress

Donziger, Marcia; Zaleta, Alexandra K.; McManus, Shauna; Olson, Jon E.; Salani, Ritu; Lee, N.K.; Santiago, Kristen; Sullivan, G.; Smith, Mary Lou; DeFeo, Sarah; Stein, Kevin

doi:10.1016/j.ygyno.2019.04.397

Cited by 2 publications

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“… 25 37 Over half of women with epithelial ovarian cancer are at risk of clinically significant anxiety and over a third are vulnerable to depression (compared with 19.8% depression prevalence in the general public). 25 29 In particular, younger women with epithelial ovarian cancer with relationship concerns are particularly vulnerable to anxiety (p<0.05), 29 and anxiety and fear are associated with pain during sex (dyspareunia) leading to reduced intimate touching. 25 Unfortunately, no study evaluated how treatment of such anxiety and depression might improve psychosexual morbidity.…”

Section: Resultsmentioning

confidence: 99%

“…5 Psychological therapies (such as cognitive behavioral therapy) may help to tackle body image difficulties, especially in younger women in whom body image is worse 34 and relationship concerns predict anxiety risk. 29 Vaginal lubricants provide a simple mechanical intervention to alleviate dyspareunia from vaginal dryness and vaginal moisturizers can improve long-term tissue health (also reducing systemic absorption of local hormonal treatments from the vaginal epithelium). 5 The reduction in estrogen that occurs through surgically-induced menopause has a significant effect on psychosexual dysfunction.…”

Section: Discussionmentioning

confidence: 99%

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Psychosexual morbidity in women with ovarian cancer

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Pugh

Jayson

2020

Int J Gynecol Cancer

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Increasing numbers of women are surviving for longer with epithelial ovarian cancer. Consequently, there is increased focus on long-term quality of life in national guidance. Psychosexual morbidity including vaginal dryness, pain during intercourse (dyspareunia), reduced libido, and negative perceived body image exacerbate stress and anxiety and impact intimate relationships. Although a priority for women with epithelial ovarian cancer, clinicians seldom discuss sexual problems. Therefore, psychosexual morbidity and the associated distress remain unaddressed. We synthesize evidence from primary qualitative and quantitative research studies exploring psychosexual morbidity in women with epithelial ovarian cancer to identify potential risk factors and common symptoms, to facilitate the identification and management of sexual problems in clinic. Literature (2008–19) from 10 databases identified 29 suitable publications (4116 patients). The papers were assessed to answer the question: “What are the key potential risk factors and presentations of psychosexual morbidity in women with epithelial ovarian cancer?” Current literature lacks consensus in defining clinically significant psychosexual morbidity in women with epithelial ovarian cancer. Discrepancies in measurement tools, questionnaires, and primary outcome measures confound result interpretation, limiting wider application. Key potential risk factors identified included: younger age (<53 years); pre-menopausal status at diagnosis; aim of treatment; extent of surgery; more courses of chemotherapy; cardiovascular co-morbidities; and anxiety and depression. Up to 75% of women with epithelial ovarian cancer reported adverse changes in their sex lives following diagnosis and, of the sexually active, vaginal dryness affected 81–87% and pain 77%. Other prevalent symptoms included: reduced sexual desire and activity, impaired orgasm, diminished perceived body image, and reduced partner intimacy. Psychosexual morbidity represents a significant unmet need for women with epithelial ovarian cancer. Effective treatment necessitates a multimodal approach encompassing medical, psychoeducational, and physiotherapy-based strategies. Future studies need agreement in their questionnaires, definitions, thresholds, and primary outcome measures for meaningful interstudy comparisons to be drawn.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Psychosexual morbidity in women with ovarian cancer

Logue

Pugh

Jayson

2020

Int J Gynecol Cancer

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“…5 Over half of women with ovarian cancer are at risk of anxiety and over a third are vulnerable to depression. 6,7 We recently identified potential risk factors for psychosexual morbidity in women with ovarian cancer: younger age; premenopausal status at diagnosis; noncurative aim of treatment; extensive surgery; high courses of chemotherapy; cardiovascular comorbidities; anxiety, and depression. 5 Women with ovarian cancer are living longer with the side effects of treatment; the latest U.K. data shows 5-year survival increased from 42.3% to 46.2% (2006−2011).…”

Section: Introductionmentioning

confidence: 99%

Psychosexual Morbidity in Women With Ovarian Cancer: Evaluation by Germline BRCA Gene Mutational Status

et al. 2021

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Introduction: Up to 75% of women with ovarian cancer experience psychosexual morbidity and approximately 15−20% of women with ovarian cancer have a germline BRCA1/2 mutation (gBRCAm). However, psychosexual morbidity remains unexplored in women with gBRCAm ovarian cancer. Aim: Given their younger age, genetic diagnosis, breast cancer risk, and increased prevalence of surgicallyinduced menopause, we aim to assess whether women with gBRCAm ovarian cancer experience distinct psychosexual morbidity. Methods: Psychosexual morbidity was investigated in 2 cohorts of women with ovarian cancer: women with gBRCAm ovarian cancer vs women with gBRCA wildtype (gBRCAwt) ovarian cancer. Between August 2019 and March 2020, women with high-grade serous carcinoma of the ovary, Fallopian tube or primary peritoneum were approached in clinic or telephoned and invited to take part. Exclusion criteria included: women with alternative histology; women admitted from clinic; and women who lacked capacity to independently complete the questionnaire. The Female Sexual Function Index (FSFI) and background information were collected at a single time-point per patient. Scores below 26.55 were interpreted to suggest psychosexual dysfunction. Main Outcome Measure: Responses including total and domain FSFI scores, self-reported psychosexual problems and interest in psychosexual support were compared. Results: Of 103 women approached, 53% returned questionnaires. In this exploratory analysis, women with gBRCAm ovarian cancer were significantly younger (51−60 years vs 61−70 years, gBRCAwt, P = .010). There was a trend towards increased prevalence of surgical menopause (57% vs 27%, P = .097) and breast surgery (53% vs 22%, P = .132, gBRCAm vs gBRCAwt, respectively). Women with gBRCAm ovarian cancer scored higher in the FSFI questionnaire, particularly women under 60 years (15.1 vs 2.7, P = .070), approaching significance. Women with gBRCAm ovarian cancer expressed more interest for face-to-face services (P = .018), especially psychosexual therapy (65% vs 30%) and more often felt the service was insufficient, approaching significance (71% vs 44%, gBRCAm vs gBRCAwt, respectively, P = .076). Conclusion: Women with gBRCAm ovarian cancer are younger, express more interest for specialist psychosexual support and potentially different psychosexual problems, warranting further exploration.

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Risk for anxiety and depression among individuals with ovarian cancer: The interplay between age and distress

Cited by 2 publications

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Psychosexual morbidity in women with ovarian cancer

Psychosexual morbidity in women with ovarian cancer

Psychosexual Morbidity in Women With Ovarian Cancer: Evaluation by Germline BRCA Gene Mutational Status

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