Depression profile in cancer patients and patients without a chronic somatic disease

Abstract

Objective

To investigate whether depressed oncology patients show a specific depressive symptom profile, we compared depression symptoms in depressed cancer patients (CANCER-DEP) and depressed patients without a chronic somatic disease (NONCANCER-DEP).

Methods

Of a total of 2493 outpatients from a comprehensive cancer center and a center for psychosocial medicine, 1054 (42.3%) met the DSM-5 criteria for depression, measured with the patient health questionnaire (PHQ-9). Based on the PHQ-9 scores, differences in severity of each of the nine individual DSM-5 depression symptoms between CANCER-DEP (n = 542) and NONCANCER-DEP (n = 512) were examined. Non-depressed cancer patients (CANCER-NONDEP; n = 1216) served as a comparison group for somatic symptoms independent of depression in cancer. To control for depression severity, group comparisons were performed separately for patients with major depression and any depressive disorders.

Results

CANCER-DEP reported significantly lower levels of the cognitive-emotional depression symptoms 'worthlessness' and 'suicidal thoughts' than NONCANCER-DEP. Only one out of five somatic depression symptoms ('changes in appetite') was more pronounced in CANCER-DEP than in NONCANCER-DEP. Confirming previous research, somatic depression symptoms occurred more frequently in CANCER-DEP than in CANCER-NONDEP.

Conclusions

The lower level of cognitive-emotional symptoms in CANCER-DEP than in NONCANCER-DEP is discussed in relation to different psychosocial phenomena. Our results indicate that somatic depression symptoms are similarly pronounced in CANCER-DEP and NONCANCER-DEP, and that CANCER-DEP show greater somatic depression symptoms than CANCER-NONDEP. The presence of high levels of somatic symptoms should alert clinicians to investigate for a potential co-morbid depression in cancer patients.

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Patients’ and family caregivers’ understanding of the cancer stage, treatment goal, and chance of cure: a study with patient-caregiver-physician triad.

Abstract

Background

Accurate understanding of the extent of disease, treatment goal, and prognosis is a prerequisite for the patients with cancer and their caregivers to make informed decision. We sought to evaluate patients' and family caregivers' understanding of the cancer stage, treatment goal, and chance of cure taking their own physician's evaluation as reference.

Methods

A national survey was performed with 750 patient-caregiver dyads (75.5% participation rate) recruited by 134 oncologists in 13 cancer centers (93% participation rate) in Korea. Both patients and caregivers were asked to report their knowledge of patient's cancer stage, treatment goal, and chance of cure. Concordance was evaluated with percentage agreement and weighted κ, and predictors of discordance of patient and caregiver's response with that of physician's were explored by multivariate regression analyses with mixed effect model.

Results

The agreement rates between patient-physician and caregiver-physician were 63.0% and 65.9% for disease stage, 69.0% and 70.0% for treatment goal, and 41.4% and 45.1% for chance of cure. When discordance occurs, patients and caregivers often had optimistic view. Distant stage, older age, female sex, and absence of depression were associated with optimistic view of patients, and there was significant between-physician variance for all three outcomes.

Conclusion

The discordance revealed our study suggests the need for better communication between physician and patients, as well as the caregivers. Research is needed to develop a comprehensive strategy to improve the understanding of the patients and family so that treatment decisions are made based on realistic estimation.

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Persistent lesion hyperintensity on brain diffusion-weighted MRI

http://orlhealth.blogspot.com/2017/06/persistent-lesion-hyperintensity-on.html

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Depression profile in cancer patients and patients without a chronic somatic disease

Abstract

Objective

To investigate whether depressed oncology patients show a specific depressive symptom profile, we compared depression symptoms in depressed cancer patients (CANCER-DEP) and depressed patients without a chronic somatic disease (NONCANCER-DEP).

Methods

Of a total of 2493 outpatients from a comprehensive cancer center and a center for psychosocial medicine, 1054 (42.3%) met the DSM-5 criteria for depression, measured with the patient health questionnaire (PHQ-9). Based on the PHQ-9 scores, differences in severity of each of the nine individual DSM-5 depression symptoms between CANCER-DEP (n = 542) and NONCANCER-DEP (n = 512) were examined. Non-depressed cancer patients (CANCER-NONDEP; n = 1216) served as a comparison group for somatic symptoms independent of depression in cancer. To control for depression severity, group comparisons were performed separately for patients with major depression and any depressive disorders.

Results

CANCER-DEP reported significantly lower levels of the cognitive-emotional depression symptoms 'worthlessness' and 'suicidal thoughts' than NONCANCER-DEP. Only one out of five somatic depression symptoms ('changes in appetite') was more pronounced in CANCER-DEP than in NONCANCER-DEP. Confirming previous research, somatic depression symptoms occurred more frequently in CANCER-DEP than in CANCER-NONDEP.

Conclusions

The lower level of cognitive-emotional symptoms in CANCER-DEP than in NONCANCER-DEP is discussed in relation to different psychosocial phenomena. Our results indicate that somatic depression symptoms are similarly pronounced in CANCER-DEP and NONCANCER-DEP, and that CANCER-DEP show greater somatic depression symptoms than CANCER-NONDEP. The presence of high levels of somatic symptoms should alert clinicians to investigate for a potential co-morbid depression in cancer patients.

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via IFTTT

Patients’ and family caregivers’ understanding of the cancer stage, treatment goal, and chance of cure: a study with patient-caregiver-physician triad.

Abstract

Background

Accurate understanding of the extent of disease, treatment goal, and prognosis is a prerequisite for the patients with cancer and their caregivers to make informed decision. We sought to evaluate patients' and family caregivers' understanding of the cancer stage, treatment goal, and chance of cure taking their own physician's evaluation as reference.

Methods

A national survey was performed with 750 patient-caregiver dyads (75.5% participation rate) recruited by 134 oncologists in 13 cancer centers (93% participation rate) in Korea. Both patients and caregivers were asked to report their knowledge of patient's cancer stage, treatment goal, and chance of cure. Concordance was evaluated with percentage agreement and weighted κ, and predictors of discordance of patient and caregiver's response with that of physician's were explored by multivariate regression analyses with mixed effect model.

Results

The agreement rates between patient-physician and caregiver-physician were 63.0% and 65.9% for disease stage, 69.0% and 70.0% for treatment goal, and 41.4% and 45.1% for chance of cure. When discordance occurs, patients and caregivers often had optimistic view. Distant stage, older age, female sex, and absence of depression were associated with optimistic view of patients, and there was significant between-physician variance for all three outcomes.

Conclusion

The discordance revealed our study suggests the need for better communication between physician and patients, as well as the caregivers. Research is needed to develop a comprehensive strategy to improve the understanding of the patients and family so that treatment decisions are made based on realistic estimation.

from Cancer via ola Kala on Inoreader http://ift.tt/2tb3K4X
via IFTTT

Nausea, vomiting, loss of appetite and oliguria : haemoglobin =12.7 g/dL, indirect bilirubin =2.0 mg/dL, haptoglobin ≤6 mg/dL, platelet count =121 000/μL and schistocytes on peripheral smear.

http://orlhealth.blogspot.com/2017/06/nausea-vomiting-loss-of-appetite-and.html

Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182

6948891480

alsfakia@gmail.com

Ischemic stroke complicating thrombolytic therapy with tenecteplase for ST elevation myocardial infarction: two case reports

Hemorrhagic complications are quite common in the rare cases where thrombolysis is performed. Ischemic stroke in the aftermath of thrombolysis for a ST elevation myocardial infarction is a very rare and parado...

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