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Coping strategies and depressive symptoms in cancer patients

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Abstract

Introduction

Depression in cancer patients is prevalent and negatively impacts their quality of life. Likewise, it correlates with lower overall survival. The aim of this work is to analyze whether different coping strategies, as well as sociodemographic and clinical factors are associated with the presence of depressive symptoms in individuals with a resected, non-metastatic neoplasm about to initiate adjuvant chemotherapy.

Methods

NEOcoping is a cross-sectional, prospective, observational, multicenter study. Clinical (tumor site and stage, time to diagnosis, risk of recurrence, and type of adjuvant treatment) and sociodemographic characteristics (age, gender, marital status, educational level, occupational sector, and employment status), coping strategies (Mini-MAC scale), and depressive symptoms (BSI scale) were collected. A two-block linear regression model was performed to determine the predictive variables of depressive symptoms.

Results

524 adults with resected, non-metastatic cancer were recruited. Twenty-six percent of patients have clinically significant depressive symptoms. Being female, < 40 years of age, having breast and stomach cancer, and > 50% chance of recurrence were associated with increased risk of depression. Likewise, depression was associated with greater helplessness and anxious preoccupation, and less fighting spirit. Age, gender, and risk of recurrence accounted for only 7% of the variance in depressive symptoms. Including coping strategies in the regression analysis significantly increased the variance explained (48.5%).

Conclusion

Early psychological intervention in patients with maladaptive coping strategies may modulate the onset of depressive symptoms, especially in those at higher risk for depression.

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References

  1. Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12(2):160–74.

    Article  Google Scholar 

  2. Rieke K, Schmid KK, Lydiatt W, Houfek J, Boilesen E, Watanabe-Galloway S. Depression and survival in head and neck cancer patients. Oral Oncol. 2017;65:76–82.

    Article  Google Scholar 

  3. Suppli NP, Johansen C, Kessing LV, Toender A, Kroman N, Ewertz M, et al. Survival after early-stage breast cancer of women previously treated for depression: a Nationwide Danish cohort study. J Clin Oncol. 2017;35(3):334–42.

    Article  Google Scholar 

  4. Sullivan DR, Forsberg CW, Ganzini L, Au DH, Gould MK, Provenzale D, et al. Longitudinal changes in depression symptoms and survival among patients with lung cancer: a national cohort assessment. J Clin Oncol. 2016;34(33):3984–91.

    Article  Google Scholar 

  5. Vodermaier A, Linden W, MacKenzie R, Greig D, Marshall C. Disease stage predicts post-diagnosis anxiety and depression only in some types of cancer. Br J Cancer. 2011;105(12):1814–7.

    Article  CAS  Google Scholar 

  6. Xiao F, Song X, Chen Q, Dai Y, Xu R, Qiu C, et al. Effectiveness of psychological interventions on depression in patients after breast cancer surgery: a meta-analysis of randomized controlled trials. Clin Breast Cancer. 2017;17(3):171–9.

    Article  Google Scholar 

  7. Okuyama T, Akechi T, Mackenzie L, Furukawa TA. Psychotherapy for depression among advanced, incurable cancer patients: a systematic review and meta-analysis. Cancer Treat Rev. 2017;56:16–27.

    Article  Google Scholar 

  8. Reynolds CF, Thomas SB, Morse JQ, Anderson SJ, Albert S, Dew MA, et al. Early intervention to preempt major depression among older black and white adults. Psychiatr Serv. 2014;65(6):765–73.

    Article  Google Scholar 

  9. Jimenez-Fonseca P, Calderón C, Hernández R, Ramón y Cajal T, Mut M, Ramchandani A, et al. Factors associated with anxiety and depression in cancer patients prior to initiating adjuvant therapy. Clin Transl Oncol. 2018;20(11):1408–15.

    Article  CAS  Google Scholar 

  10. Ferrari M, Ripamonti CI, Hulbert-Williams NJ, Miccinesi G. Relationships among unmet needs, depression, and anxiety in non–advanced cancer patients. Tumor J. 2018;30089161876554.

  11. Dai J, Liao N, Shi J, Tao J-Q. Study of prevalence and influencing factors of depression in tumor patients and the therapeutic effects of fluoxetine. Eur Rev Med Pharmacol Sci. 2017;21(21):4966–74.

    CAS  PubMed  Google Scholar 

  12. Hung M-S, Chen I-C, Lee C-P, Huang R-J, Chen P-C, Tsai Y-H, et al. Incidence and risk factors of depression after diagnosis of lung cancer: a nationwide population-based study. Medicine (Baltimore). 2017;96(19):e6864.

    Article  Google Scholar 

  13. Shaheen Al Ahwal M, Al Zaben F, Khalifa DA, Sehlo MG, Ahmad RG, Koenig HG. Depression in patients with colorectal cancer in Saudi Arabia: depression in colorectal cancer in Saudi Arabia. Psychooncology. 2015;24(9):1043–50.

    Article  Google Scholar 

  14. Bardwell WA, Natarajan L, Dimsdale JE, Rock CL, Mortimer JE, Hollenbach K, et al. Objective cancer-related variables are not associated with depressive symptoms in women treated for early-stage breast cancer. J Clin Oncol. 2006;24(16):2420–7.

    Article  Google Scholar 

  15. Alcalar N, Ozkan S, Kucucuk S, Aslay I, Ozkan M. Association of coping style, cognitive errors and cancer-related variables with depression in women treated for breast cancer. Jpn J Clin Oncol. 2012;42(10):940–7.

    Article  Google Scholar 

  16. Derogatis LR. BSI 18, Brief Symptom Inventory 18: administration, scoring and procedures manual. Bloomberg: NCS Pearson Incorporated; 2001.

    Google Scholar 

  17. Watson M, Law MG, Santos MD, Greer S, Baruch J, Bliss J. The Mini-MAC: further development of the mental adjustment to cancer scale. J Psychosoc Oncol. 1994;12(3):33–46.

    Article  Google Scholar 

  18. Grassi L, Travado L, Moncayo FLG, Sabato S, Rossi E. Psychosocial morbidity and its correlates in cancer patients of the Mediterranean area: findings from the Southern European Psycho-Oncology Study. J Affect Disord. 2004;83(2–3):243–8.

    Article  Google Scholar 

  19. Pereira FMP, Santos CSV de B. Initial validation of the Mini-Mental Adjustment to Cancer (Mini-MAC) scale: study of Portuguese end-of-life cancer patients. Eur J Oncol Nurs. 2014;18(5):534–9.

    Article  Google Scholar 

  20. Mehnert A, Koch U. Prevalence of acute and post-traumatic stress disorder and comorbid mental disorders in breast cancer patients during primary cancer care: a prospective study. Psychooncology. 2007;16(3):181–8.

    Article  Google Scholar 

  21. Nakaya N, Saito-Nakaya K, Akizuki N, Yoshikawa E, Kobayakawa M, Fujimori M, et al. Depression and survival in patients with non-small cell lung cancer after curative resection: a preliminary study. Cancer Sci. 2006;97(3):199–205.

    Article  CAS  Google Scholar 

  22. Uchitomi Y, Mikami I, Kugaya A, Akizuki N, Nagai K, Nishiwaki Y, et al. Depression after successful treatment for nonsmall cell lung carcinoma. Cancer. 2000;89(5):1172–9.

    Article  CAS  Google Scholar 

  23. Hall A, A’Hern R, Fallowfield L. Are we using appropriate self-report questionnaires for detecting anxiety and depression in women with early breast cancer? Eur J Cancer. 1999;35(1):79–85.

    Article  CAS  Google Scholar 

  24. Ell K, Sanchez K, Vourlekis B, Lee P-J, Dwight-Johnson M, Lagomasino I, et al. Depression, correlates of depression, and receipt of depression care among low-income women with breast or gynecologic cancer. J Clin Oncol. 2005;23(13):3052–60.

    Article  Google Scholar 

  25. Horney DJ, Smith HE, McGurk M, Weinman J, Herold J, Altman K, et al. Associations between quality of life, coping styles, optimism, and anxiety and depression in pretreatment patients with head and neck cancer. Head Neck. 2011;33(1):65–71.

    Article  Google Scholar 

  26. Burgess C, Cornelius V, Love S, Graham J, Richards M, Ramirez A. Depression and anxiety in women with early breast cancer: five year observational cohort study. BMJ. 2005;330(7493):702.

    Article  Google Scholar 

  27. Chung J, Ju G, Yang J, Jeong J, Jeong Y, Choi MK, et al. Prevalence of and factors associated with anxiety and depression in Korean patients with newly diagnosed advanced gastrointestinal cancer. Korean J Intern Med. 2018;33(3):585–94.

    Article  Google Scholar 

  28. Kulpa M, Kosowicz M, Stypuła-Ciuba BJ, Kazalska D. Anxiety and depression, cognitive coping strategies, and health locus of control in patients with digestive system cancer. Przeglad Gastroenterol. 2014;9(6):329–35.

    Google Scholar 

  29. Kugaya A, Akechi T, Okamura H, Mikami I, Uchitomi Y. Correlates of depressed mood in ambulatory head and neck cancer patients. Psychooncology. 1999;8(6):494–9.

    Article  CAS  Google Scholar 

  30. van Laarhoven HWM, Schilderman J, Bleijenberg G, Donders R, Vissers KC, Verhagen CAHHVM, et al. Coping, quality of life, depression, and hopelessness in cancer patients in a curative and palliative, end-of-life care setting. Cancer Nurs. 2011;34(4):302–14.

    Article  Google Scholar 

  31. Jensen CG, Elsass P, Neustrup L, Bihal T, Flyger H, Kay SM, et al. What to listen for in the consultation. Breast cancer patients’ own focus on talking about acceptance-based psychological coping predicts decreased psychological distress and depression. Patient Educ Couns. 2014;97(2):165–72.

    Article  Google Scholar 

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Funding

The study was supported by the FSEOM-Onvida for Projects on Long Survivors and Quality of Life. SEOM (Spanish Society of Medical Oncology) 2015.

Author information

Authors and Affiliations

  1. Department of Medical Oncology, Hospital Universitario La Paz, Madrid, Spain

    I. Ghanem, B. Castelo & O. Higuera

  2. Department of Medical Oncology, Hospital Universitario Central de Asturias, Oviedo, Spain

    P. Jimenez-Fonseca

  3. Department of Hematology and Medical Oncology, Hospital Universitario Morales Meseguer, UMU, IMIB, Murcia, Spain

    A. Carmona-Bayonas

  4. Department of Medical Oncology, Hospital Universitario Virgen de La Macarena, Sevilla, Spain

    C. Beato

  5. Department of Medical Oncology, Hospital General Universitario Santa Lucia, Cartagena, Spain

    T. García

  6. Department of Medical Oncology, Hospital Universitario de Canarias, Tenerife, Spain

    R. Hernández

  7. Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Passeig de la Vall d’Hebron 171, 08035, Barcelona, Spain

    C. Calderon

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  1. I. Ghanem
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  2. B. Castelo
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  3. P. Jimenez-Fonseca
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  4. A. Carmona-Bayonas
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  5. O. Higuera
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  6. C. Beato
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  7. T. García
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  9. C. Calderon
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Corresponding author

Correspondence to C. Calderon.

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None to declare. This is an academic study.

Ethical approval

The study has been performed in accordance with the ethical standards of the Declaration of Helsinki and its later amendments. This study is an observational, non-interventional trial.

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Signed informed consent was obtained from all patients.

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Ghanem, I., Castelo, B., Jimenez-Fonseca, P. et al. Coping strategies and depressive symptoms in cancer patients. Clin Transl Oncol 22, 330–336 (2020). https://doi.org/10.1007/s12094-019-02123-w

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  • DOI: https://doi.org/10.1007/s12094-019-02123-w

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