Anxiety Disorders in Cancer Patients: Their Nature, Associations, and Relation to Quality of Life
ABSTRACT We aimed to estimate the prevalence and types of anxiety disorders diagnosed according to standardized criteria in cancer patients, to compare screening tools in detecting them, and to examine their demographic, oncologic, and psychosocial associations.
In this cross-sectional observational study of 178 subjects with lymphoma, renal cell carcinoma, malignant melanoma, or plasma cell dyscrasia, we related responses to questionnaires (administered by computer touch-screen) measuring psychological symptoms, quality of life (QOL), and social support to standardized psychiatric interviews and cancer management.
Forty-eight percent of subjects reported sufficient anxiety for anxiety disorder to be considered. At subsequent diagnostic interview, 18% fulfilled International Classification of Disorders, 10th Revision criteria for anxiety disorder, including 6% of patients who reported low levels of anxiety by questionnaire. When subjects reported anxiety by questionnaire, if disruptive somatic anxiety was present, this increased the probability of diagnosable anxiety disorder from.31 to.7. The most accurate screening questionnaires were the trait scale of the State-Trait Anxiety Inventory and the Hospital Anxiety and Depression scale. Female sex and negative aspects of social support were associated with anxiety disorder in multivariate analyses. Anxiety disorder was independently associated with a deficit in QOL, particularly insomnia.
Anxiety symptoms are common in cancer patients. Screening by questionnaire seems to assess anxiety symptoms adequately but discriminates abnormal anxiety inadequately. To improve this, we may need to use criteria such as disruption from anxiety, as illustrated by the impact of anxiety disorders on QOL. There seem to be few oncologic variables that could target screening for anxiety disorders.
- SourceAvailable from: Vittorio Giusti
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- "The following cutoff values were used for grouping total BDI-II scores: 0–9 not depressed; 10–15 mildly depressed; 16– 24 moderately depressed; ≥25 severely depressed . For the STAI-Y, considering the sex and the mean age of our cohort, a value ≥40 was applied to define clinically significant symptoms of transient and enduring levels of anxiety   . For the RAS, a score ≥105 was considered representative of a low degree of assertiveness, as proposed by Bouvard and Cottraux in the French version of the questionnaire . "
ABSTRACT: Objective. The aim of this study is to analyse associations between eating behaviour and psychological dysfunctions in treatment-seeking obese patients and identify parameters for the development of diagnostic tools with regard to eating and psychological disorders. Design and Methods. Cross-sectional data were analysed from 138 obese women. Bulimic Investigatory Test of Edinburgh and Eating Disorder Inventory-2 assessed eating behaviours. Beck Depression Inventory II, Spielberger State-Trait Anxiety Inventory, form Y, Rathus Assertiveness Schedule, and Marks and Mathews Fear Questionnaire assessed psychological profile. Results. 61% of patients showed moderate or major depressive symptoms and 77% showed symptoms of anxiety. Half of the participants presented with a low degree of assertiveness. No correlation was found between psychological profile and age or anthropometric measurements. The prevalence and severity of depression, anxiety, and assertiveness increased with the degree of eating disorders. The feeling of ineffectiveness explained a large degree of score variance. It explained 30 to 50% of the variability of assertiveness, phobias, anxiety, and depression. Conclusion. Psychological dysfunctions had a high prevalence and their severity is correlated with degree of eating disorders. The feeling of ineffectiveness constitutes the major predictor of the psychological profile and could open new ways to develop screening tools.International Journal of Endocrinology 03/2014; 2014:356289. DOI:10.1155/2014/356289 · 1.52 Impact Factor
EJC Supplements 09/2013; 11(2):216–224. DOI:10.1016/j.ejcsup.2013.07.009 · 9.39 Impact Factor
- "In large studies using standardised psychiatric interviews and applying research diagnostic criteria, estimates of abnormal anxiety in cancer populations ranged from 10% to 30% . Some researchers have found that up to 44% of patients with cancer reported some anxiety, and 23% reported significant levels of anxiety  . Variation in reported prevalence is due largely to limitations in research methodology: differing study populations (single versus mixed cancer diagnosis, differing tumour sites, early-versus late-stage disease, outpatient versus inpatient; etc.), varying diagnostic criteria and assessment instruments and studies failing to separate anxiety from depression, etc. "
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- "Patients with epilepsy also scored significantly higher on the trait anxiety scale, t(139) = 2.29, p b .05, but state anxiety scores which are most predictive of Generalized Anxiety Disorder    were not significantly different between patients and non-patients (p > .20). Finally, chi-square analysis between patient and non-patient groups revealed no significant differences in their use of substances such as tobacco (p > .09) "
ABSTRACT: This study investigated aspects of psychosocial adjustment in epilepsy patients in Cyprus. Sixty-three patients under 55years of age with idiopathic or symptomatic epilepsy and 89 neurologically matched healthy volunteers participated. Subjects completed the State and Trait Anxiety Inventory and the Beck Depression Inventory; patients with epilepsy also completed the Epilepsy Foundation Concerns Index. Results showed that patients with symptomatic epilepsy had significantly higher scores on state and trait anxiety and depressive symptoms. Sociodemographic characteristics including gender, marital status, and education levels contributed to differences in trait and state anxiety, depressive symptom scales, autonomy concerns, and fear for seizure recurrence. Variables such as poor seizure control and use of polytherapy were associated with lower adjustment scores and reduced psychosocial outcome. Finally, patients with epilepsy scored significantly higher on depression and anxiety symptoms. The results provide further evidence on challenges patients with epilepsy face and on the need for implementing psychosocial prevention programs.Epilepsy & Behavior 08/2012; 25(1):98-104. DOI:10.1016/j.yebeh.2012.05.022 · 2.06 Impact Factor