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1.
Article in English | MEDLINE | ID: mdl-35409525

ABSTRACT

Stress management interventions aim to reduce the disease risk that is heightened by work stress. Possible pathways of risk reduction include improvements in the autonomous nervous system, which is indexed by the measurement of heart rate variability (HRV). A randomized controlled trial on improving stress management skills at work was conducted to investigate the effects of intervention on HRV. A total of 174 lower management employees were randomized into either the waiting list control group (CG) or the intervention group (IG) receiving a 2-day stress management training program and another half-day booster after four and six months. In the trial, 24 h HRV was measured at baseline and after 12 months. Heart rate (HR), root mean square of successive differences (RMSSD), standard deviation of normal-to-normal intervals (SDNN), and standard deviation of the average of normal-to-normal intervals (SDANN) were calculated for 24 h and nighttime periods. Age-adjusted multilevel mixed effects linear regressions with unstructured covariance, time as a random coefficient, and time × group interaction with the according likelihood-ratio tests were calculated. The linear mixed-effect regression models showed neither group effects between IG and CG at baseline nor time effects between baseline and follow-up for SDANN (24 h), SDNN (24 h and nighttime), RMSSD (24 h and nighttime), and HR (24 h and nighttime). Nighttime SDANN significantly improved in the intervention group (z = 2.04, p = 0.041) compared to the control group. The objective stress axis measures (SDANN) showed successful stress reduction due to the training. Nighttime SDANN was strongly associated with minimum HR. Though the effects were small and only visible at night, it is highly remarkable that 3 days of intervention achieved a measurable effect considering that stress is only one of many factors that can influence HR and HRV.


Subject(s)
Heart Rate , Heart Rate/physiology
2.
Psychooncology ; 31(5): 770-778, 2022 05.
Article in English | MEDLINE | ID: mdl-34894364

ABSTRACT

OBJECTIVE: To improve allocation of psychosocial care and to provide patient-oriented support offers, identification of determinants of elevated distress is needed. So far, there is a lack of evidence investigating the interplay between individual disposition and current clinical and psychosocial determinants of distress in the inpatient setting. METHODS: In this cross-sectional study, we investigated 879 inpatients with different cancer sites treated in a German Comprehensive Cancer Center. Assessment of determinants of elevated distress included sociodemographic, clinical and psychosocial characteristics as well as dimensions of personality. Multiple linear regression was applied to identify determinants of psychosocial distress. RESULTS: Mean age of the patients was M = 61.9 (SD = 11.8), 48.1% were women. In the multiple linear regression model younger age (ß = -0.061, p = 0.033), higher neuroticism (ß = 0.178, p = <0.001), having metastases (ß = 0.091, p = 0.002), being in a worse physical condition (ß = 0.380, p = <0.001), depressive symptoms (ß = 0.270, p = <0.001), not feeling well informed about psychological support (ß = 0.054, p = 0.046) and previous uptake of psychological treatment (ß = 0.067, p = 0.020) showed significant associations with higher psychosocial distress. The adjusted R2 of the overall model was 0.464. CONCLUSION: Controlling for sociodemographic characteristics and dispositional vulnerability, that is neuroticism, current clinical and psychosocial characteristics were still associated with hospitalized patients' psychosocial distress. Psycho-oncologists should address both, the more transient emotional responses, such as depressive symptoms, as well as more enduring patient characteristics, like neuroticism.


Subject(s)
Neoplasms , Cross-Sectional Studies , Female , Humans , Inpatients/psychology , Male , Neoplasms/psychology , Neuroticism , Personality , Stress, Psychological/psychology
3.
Front Psychol ; 12: 648623, 2021.
Article in English | MEDLINE | ID: mdl-34456783

ABSTRACT

Background: Fear of progression (FoP), or fear of cancer recurrence (FCR), is characterized by worries or concerns about negative illness-related future events. Actually, to worry is a common cognitive process that, in its non-pathological form, belongs to daily life. However, worry can also become pathological appearing as a symptom of mental disorders. This study aimed at investigating the associations among daily worry, pathological worry, and FoP in patients with cancer. Methods: This is a cross-sectional study that includes 328 hospitalized patients with cancer. Patients filled out the FoP Questionnaire (FoP-Q), the Worry Domains Questionnaire (WDQ) for the assessment of daily worry, and the Penn State Worry Questionnaire (PSWQ) for the assessment of pathological worry. Depressive, anxiety, and somatic symptoms were measured with modules of the Patient Health Questionnaire [Patient Health Questionnaire-Depressive Symptoms (PHQ-2), Generalized Anxiety Disorder-2 (GAD-2), and Patient Health Questionnaire-Somatic Symptoms (PHQ-15)]. Furthermore, a structured clinical interview was conducted for the assessment of anxiety disorders. The hierarchical multiple linear regression analysis was used to identify factors independently associated with FoP. Results: Mean age of the participants was M = 58.5 years (SD = 12.8), and 64.6% were men. FoP and worry were significantly intercorrelated (r = 0.58-0.78). The level of FoP was most strongly associated with daily worry (ß = 0.514, p < 0.001), followed by pathological worry (ß = 0.221, p < 0.001). Further significant determinants were younger age and depressive and anxiety symptoms. Clinical variables were not independently associated with FoP. The final model explained 74% of the variance. Discussion: Fear of progression is strongly associated with daily worry and pathological worry. These results bring up the question of whether FoP is an expression of a general tendency to worry. Whether a general tendency to worry, in fact, represents an independent vulnerability factor for experiencing FCR/FoP needs to be investigated in a longitudinal research design.

4.
Support Care Cancer ; 29(8): 4451-4460, 2021 Aug.
Article in English | MEDLINE | ID: mdl-33447865

ABSTRACT

PURPOSE: Benefit finding (BF) represents possible positive changes that people may experience after cancer diagnosis and treatment and has proven to be valuable to the psychological outcome. Knowledge of such beneficial consequences of prostate cancer (PCa) is limited in long-term survivors (> 5 years). Thus, the present study investigated the occurrence of benefit finding (BF) and its determinants in a large sample of (very-) long-term PCa survivors. METHODS: BF was assessed in 4252 PCa survivors from the German database "Familial Prostate Cancer" using the German version of the Benefit Finding Scale (BFS). Associations between BF and sociodemographic, clinical, and psychosocial (e.g., depressive and anxiety symptoms and perceived severity of the disease experience) variables were analyzed using hierarchical multiple linear regression analysis. RESULTS: Mean age at survey was 77.4 years (SD = 6.2) after a mean follow-up of 14.8 years (SD = 3.8). Mean BFS score was 3.14 (SD = 1.0); the prevalence of moderate-to-high BF (score ≥ 3) was 59.7%. Younger age at diagnosis, lower educational level, and higher perceived severity of the disease experience were predictive of BF. Objective disease severity or family history of PCa was not uniquely associated with BF. CONCLUSIONS: BF occurs in older, (very-) long-term PCa survivors. Our findings suggest that the self-asserted severity of the disease experience in a patient's biography is linked to BF in the survivorship course above all tangible sociodemographic and clinical factors. IMPLICATIONS FOR CANCER SURVIVORS: PCa survivors may express BF regardless of clinical disease severity. Treating urologists should consider inquiring BF to enrich a patient's cancer narrative.


Subject(s)
Cancer Survivors/psychology , Prostatic Neoplasms/psychology , Quality of Life/psychology , Aged , Humans , Male , Prostatic Neoplasms/mortality
5.
Front Psychiatry ; 11: 00867, 2020.
Article in English | MEDLINE | ID: mdl-33101069

ABSTRACT

Employees' mental health impairments are a leading reason for sickness-leave and early retirement. This is why a large number of different intervention programmes have evolved in recent years with the aim of counteracting this development. Our study evaluates a short-term cognitive-behavioral psychotherapeutic intervention off the workplace. We investigated improvement of mental and physical health in psychologically strained employees of a white collar company. Depressive symptoms (PHQ-9), anxiety symptoms (GAD-7), somatic symptoms (PHQ-15), and perceived stress (PSQ-20) were assessed at the beginning and after the intervention. Patient satisfaction (recommendation - likeliness) was also measured after the intervention. In a second step, we have looked at potential determinants of therapy outcome. Changes in the symptom measures were assessed using t-tests, MANOVA, and Chi²-tests. Cohen's d was computed as effect size measure. One-hundred twenty-seven participants completed the assessment before, and 66 participants post intervention. Mean age of the participants was 44.6 (SD = 9.8) years, 54% were men. 89.7% of the patients attended one to five sessions. Depressive, anxiety, somatic symptoms, and perceived stress significantly declined from baseline to end of intervention. Effect sizes ranged from d = 0.49 (perceived stress) to d = 0.72 (depressive symptoms). Moreover, 93% of the patients stated that they were satisfied with the intervention and would recommend it to a friend. Previous uptake of psychiatric/psychotherapeutic treatment moderated the effect of the intervention on depressive symptoms, i.e., patients without previous experience showed a stronger reduction in symptoms of depression. The results tentatively suggest that the intervention is effective in reducing a broad range of psychological symptoms. Future research could investigate preferences and different outcomes of on-site and off-site work place interventions.

6.
Psychooncology ; 29(4): 703-710, 2020 04.
Article in English | MEDLINE | ID: mdl-31876011

ABSTRACT

OBJECTIVES: Psychosocial distress is common in cancer patients and survivors and encompasses a broad range of concerns and psychological symptoms. The aim of the current study was to identify subgroups of respondents who experience a specific constellation of distress symptoms. METHODS: This study uses data from a large data base (n = 21 680) of cancer patients from diverse settings who provided data in the Questionnaire on Distress in Cancer Patients-Short Form (QSC-R10). Cluster analysis was applied to identify subgroups with a distinct constellation of distress symptoms. RESULTS: The results showed five distinct clusters: minimally distressed patients (46.6% of the sample), highly distressed patients (12.7%), mainly physically distressed patients (15.2%), mainly psychologically distressed patients (15.6%), and mainly socially distressed patients (9.9%). These groups differed with regard to age, sex, cancer site, treatment setting, and disease progression. CONCLUSION: The results revealed large heterogeneity in the experience of distress. Distress clusters were associated with socio-demographic and clinical variables. These associations might aid a clinician to tailor interventions and to address specific types of distress.


Subject(s)
Cancer Survivors/psychology , Cancer Survivors/statistics & numerical data , Neoplasms/epidemiology , Neoplasms/psychology , Psychological Distress , Adult , Female , Humans , Male , Middle Aged , Risk
7.
Psychooncology ; 28(10): 2049-2059, 2019 10.
Article in English | MEDLINE | ID: mdl-31368613

ABSTRACT

OBJECTIVE: Many distressed cancer patients do not want or, finally, do not use psychological support. This study aimed at identifying factors associated with the decline of psychological support during hospital stay. METHODS: This cross-sectional study included inpatients with different cancer diagnoses. Distress was assessed using the short form of the Questionnaire on Stress in Cancer Patients-Revised (QSC-R10) and the Distress Thermometer (DT). Multivariable logistic regression was used to identify factors associated with decline. RESULTS: Of 925 patients, 71.6% (n = 662) declined psychological support. Male sex (OR = 2.54, 95% CI = 1.69-3.80), low psychosocial distress (OR = 3.76, CI = 2.50-5.67), not feeling depressed (OR = 1.93, CI = 1.24-2.99), perceived overload (OR = 3.37, CI = 2.19-5.20), no previous psychological treatment (OR = 1.88, CI = 1.25-2.83), and feeling well informed about psychological support (OR = 1.66, CI = 1.11-2.46) were associated with decline. Among the patients who indicated clinical distress (46.2%), 53.9% declined psychological support. Male sex (OR = 2.96, CI = 1.71-5.12), not feeling depressed (OR = 1.87, CI = 1.12-3.14), perceived overload (OR = 5.37, CI = 3.07-9.37), agreeableness (OR = 0.70, CI = 0.51-0.95), and feeling well informed about psychological support (OR = 1.81, CI = 1.07-3.07) were uniquely associated with decline in this subgroup. CONCLUSIONS: Decline of psychological support is primarily due to psychological factors. Feeling well informed about support emerged as a relevant factor associated with decline. Thus, design of informational material and education about available psychological services seem crucial.


Subject(s)
Anxiety/psychology , Depression/psychology , Inpatients/psychology , Neoplasms/psychology , Stress, Psychological/psychology , Adaptation, Psychological , Adult , Aged , Anxiety/etiology , Counseling , Cross-Sectional Studies , Depression/etiology , Female , Humans , Male , Middle Aged , Neoplasms/complications , Stress, Psychological/etiology , Surveys and Questionnaires
9.
Psychol Health Med ; 23(7): 823-830, 2018 08.
Article in English | MEDLINE | ID: mdl-29430957

ABSTRACT

HIV infection has evolved from a fatal to a treatable condition, leading to an increase in the rate of elderly People Living with HIV (PLWH). However, little is known about the psychosocial burden of elderly PLWH. Thus, the aim of this longitudinal multi-center cohort study was to investigate whether elderly PLWH experience more anxiety and depression and reduced health related quality of life (HRQOL) compared to elderly patients with other chronic conditions. PLWH were compared to diabetes patients (DM) and patients with minor health conditions (MHC), e.g. patients with hypertension or allergic conditions. All patients were over 50 years old. Anxiety and depression (HADS) as well as HRQOL (SF-36) were assessed at baseline and after 12 months. 218 PLWH, 249 DM and 254 MHC were included. At baseline, the study groups did not differ in anxiety, depression, and physical HRQOL. However, PLWH indicated lower mental HRQOL than DM and MHC patients (p = 0.001). We did not obtain any moderating effects showing a differential effect of patient characteristics on anxiety, depression, and HRQOL in the three patient groups. At follow-up, the level of anxiety, depression, and HRQOL did not change significantly. The prevalence of anxiety ranged between 27 and 35%, and that of depression between 17 and 28%. Thus, the results of our investigation tentatively suggest that the psychosocial adaptation to HIV among elderly PLWH resembles those of other chronic diseases. There may be some subtle impairments, though, as PLWH experienced lower mental HRQOL.


Subject(s)
Anxiety/psychology , Depression/psychology , Diabetes Mellitus/psychology , HIV Infections/psychology , Quality of Life/psychology , Aged , Aging/psychology , Anxiety/epidemiology , Anxiety Disorders , Chronic Disease , Cohort Studies , Depression/epidemiology , Depressive Disorder , Diabetes Mellitus/epidemiology , Female , HIV Infections/epidemiology , Health Status , Humans , Hypersensitivity/epidemiology , Hypersensitivity/psychology , Hypertension/epidemiology , Hypertension/psychology , Longitudinal Studies , Male , Middle Aged , Prevalence
10.
J Cancer Surviv ; 11(6): 800-807, 2017 Dec.
Article in English | MEDLINE | ID: mdl-28528448

ABSTRACT

PURPOSE: Knowledge of the psychological distress of long- and very long-term (>10 years) prostate cancer (PC) survivors is limited. This study intended to examine the parameters influencing anxiety related to prostate-specific antigen (PSA) and PC in long-term survivors after radical prostatectomy. METHODS: We surveyed 4719 PC survivors from the German multicenter prospective database "Familial Prostate Cancer." We evaluated the association of PC-related anxiety (MAX-PC) with sociodemographic characteristics, family history of PC, global health status/quality of life (EORTC QLQ-C30), depression and anxiety (PHQ-2; GAD-2), latest PSA level, time since radical prostatectomy, and current therapy. RESULTS: The survey participants' mean age was 75.2 years (SD = 6.5). Median follow-up was 11.5 years, and 19.5% of participants had survived more than 15 years since the initial treatment. The final regression analysis found that younger age, lower global health status/quality of life, higher depression and anxiety scores, higher latest PSA level, and shorter time since radical prostatectomy predicted increased PSA-related anxiety and PC anxiety. Familial PC was predictive only of PSA anxiety (all p < 0.05). The final model explained 12% of the variance for PSA anxiety and 24% for PC anxiety. CONCLUSIONS: PC-related anxiety remained relevant many years after prostatectomy and was influenced by younger age, psychological status, rising PSA level, and shorter time since initial treatment. IMPLICATIONS FOR CANCER SURVIVORS: Survivors with these characteristics are at increased risk of PC-related anxieties, which should be considered by the treating physician during follow-up.


Subject(s)
Anxiety/etiology , Prostatectomy/methods , Prostatic Neoplasms/psychology , Quality of Life/psychology , Aged , Humans , Male , Prospective Studies , Prostatectomy/mortality , Prostatic Neoplasms/mortality , Prostatic Neoplasms/surgery , Surveys and Questionnaires , Survivors
11.
Physiol Behav ; 175: 1-8, 2017 06 01.
Article in English | MEDLINE | ID: mdl-28322910

ABSTRACT

This study aimed to investigate long-term stability and variability of diurnal cortisol and alpha-amylase patterns. Diurnal cortisol and alpha-amylase secretion patterns were assessed on a single workday with three waves of measurement across a total time period of 24months in 189 participants. Separate hierarchical linear models were analyzed, with and without a number of potential predictor variables (age, BMI, smoking, chronic stress, stress reactivity). While low long-term stability was found in diurnal cortisol, the stability of diurnal alpha-amylase was moderate across the time period of 24months. Several predictor variables had a positive impact on diurnal cortisol and alpha-amylase secretion patterns averaged across waves. Our findings underpin the notion that long-term stability is not necessarily warranted in longitudinal studies. It is important to choose an appropriate study design when attempting to disentangle clinically and biologically relevant changes from naturally occurring variations in diurnal cortisol and alpha-amylase.


Subject(s)
Circadian Rhythm/physiology , Hydrocortisone/metabolism , Saliva/metabolism , alpha-Amylases/metabolism , Adult , Female , Humans , Linear Models , Longitudinal Studies , Male , Middle Aged , Young Adult
12.
Atherosclerosis ; 257: 224-231, 2017 02.
Article in English | MEDLINE | ID: mdl-28110940

ABSTRACT

BACKGROUND AND AIMS: Depressed mood and exhaustion (DEEX) have gained attention as a risk predictor for cardiovascular disease (CVD). Studies to estimate its ranking in prediction models are sparse. METHODS: The study included 3428 men aged 45-74 years who participated in one of three population-based MONICA/KORA Augsburg surveys conducted between 1984 and 1995. Within a follow-up time of 10 years (31,791 person-years), 557 cases of all-cause mortality and 269 fatal CVD events were observed. Adjusted Cox proportional hazards models were used to assess mortality risks for DEEX and five classical cardiovascular risk factors. The predictive ability was evaluated by the area under the receiver-operating characteristic curve, the integrated discrimination improvement statistics and the net classification improvement. RESULTS: The (crude) absolute mortality risk for DEEX was 23.1 cases per 1000 person-years for all-cause and 11.2 for CVD mortality. The adjusted hazard ratios of 1.52 for all-cause and 1.52 for CVD mortality (p < 0.01) were higher than those for hypercholesterolemia and obesity, but lower than for hypertension, smoking and diabetes. The improvements in risk prediction from DEEX were comparable to those of hypercholesterolemia and obesity, but substantially lower than those of hypertension, smoking and diabetes. The adjusted population-attributable risk (PAR) for DEEX accounted for about 15% for all-cause and CVD mortality, which gives DEEX a middle ranking amongst the classical risk factors. CONCLUSIONS: DEEX is a strong predictor of mortality risk, ranking in a medium position amongst classical somatic risk factors.


Subject(s)
Affect , Cardiovascular Diseases/mortality , Depression/psychology , Mental Fatigue/psychology , Aged , Area Under Curve , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/etiology , Cardiovascular Diseases/psychology , Depression/complications , Depression/diagnosis , Depression/mortality , Diabetes Complications/etiology , Germany , Humans , Hypercholesterolemia/complications , Hypertension/complications , Male , Mental Fatigue/complications , Mental Fatigue/diagnosis , Mental Fatigue/mortality , Middle Aged , Obesity/complications , Prognosis , Proportional Hazards Models , ROC Curve , Risk Assessment , Risk Factors , Sex Factors , Smoking/adverse effects
13.
Psychooncology ; 24(6): 653-60, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25346529

ABSTRACT

BACKGROUND: The aim of this study is to validate the Basic Documentation for Psycho-Oncology Short Form (PO-Bado SF), a six item interview-based expert rating scale for distress screening in cancer patients. METHODS: Using a heterogeneous multicenter study sample (n = 1551), we examined validity, reliability, and dimensionality of the PO-Bado SF. The Hospital Anxiety and Depression Scale (HADS), the Distress Thermometer, the Questionnaire on Stress in Cancer, and the Patient Health Questionnaire were used to investigate convergent validity. Confirmatory factor analysis was applied to address unidimensionality. An optimal cutoff point was determined by ROC analysis and the maximum of Youden's index. An additional study with n = 41 audio recorded PO-Bado SF interviews was carried out to assess inter-rater reliability. RESULTS: Mean age of the study sample was 64.0 (SD = 12.0), 42% were women. About 24% of the patients suffered from metastases. The one-factor solution was confirmed; internal consistency of the PO-Bado SF was high (α = 0.84). The PO-Bado SF total score correlated significantly with all psychosocial measures, the highest correlation was with the HADS total score (r = 0.64). Patients with severe disease conditions (metastases, psychological/psychiatric treatment in the past, low performance status) received higher distress ratings (p < 0.001). Using HADS total score (>13) as external criterion, an optimal PO-Bado SF cutoff score of >9 emerged (sensitivity 0.75; specificity 0.82). Inter-rater reliability was satisfactory for each of the six items (intra class correlation of 0.75 to 0.85). CONCLUSIONS: The PO-Bado SF is a short, reliable and valid expert rating scale to identify distressed cancer patients.


Subject(s)
Anxiety/diagnosis , Depression/diagnosis , Neoplasms/psychology , Stress, Psychological/diagnosis , Adolescent , Adult , Aged , Aged, 80 and over , Anxiety/psychology , Cohort Studies , Cross-Sectional Studies , Depression/psychology , Female , Humans , Male , Mass Screening , Middle Aged , Psychiatric Status Rating Scales , Psychometrics , ROC Curve , Reproducibility of Results , Sensitivity and Specificity , Stress, Psychological/psychology , Surveys and Questionnaires , Young Adult
14.
Gen Hosp Psychiatry ; 36(6): 613-9, 2014.
Article in English | MEDLINE | ID: mdl-25213227

ABSTRACT

OBJECTIVE: The relation between fear of progression (FoP) and anxiety disorders remains unclear. Therefore, we investigated the comorbidity between clinical FoP and psychiatric anxiety disorders. METHOD: In this cross-sectional study, 341 cancer patients undergoing acute inpatient care participated. A structured clinical interview (Structured Clinical Interview for DSM-IV Axis I) was used to identify Diagnostic and Statistical Manual of Mental Disorders: Fourth Edition anxiety disorders and hypochondriasis. Patients completed measures of FoP (Fear of Progression Questionnaire), worries (Penn State Worry Questionnaire, Worry Domains Questionnaire), depression [Patient Health Questionnaire (PHQ): Depression], anxiety (PHQ: General Anxiety Disorder) and somatic symptoms (PHQ: Somatic Symptoms). We cross-tabulated FoP with the presence of anxiety disorders and studied associated variables. RESULTS: Of all patients studied, 17.6% suffered from an anxiety disorder. With regard to comorbidity, 68.3% suffered neither from clinical FoP nor from any anxiety disorder, 13.4% had not been diagnosed with an anxiety disorder but experienced clinical FoP, and 11.6% only suffered from an anxiety disorder. The remaining 6.7% suffered from FoP that was comorbid with an anxiety disorder. Patients with a pure FoP did not differ from patients with a pure anxiety disorder on nearly all symptom measures. Only a few associations between the comorbidity pattern and sociodemographic and clinical variables emerged. CONCLUSION: Clinical FoP appears to be a distinct phenomenon. It does not differ from anxiety disorders in its psychological and somatic burdens.


Subject(s)
Anxiety Disorders/psychology , Disease Progression , Fear/psychology , Neoplasms/psychology , Adult , Aged , Aged, 80 and over , Anxiety Disorders/epidemiology , Comorbidity , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Young Adult
15.
Fam Cancer ; 13(3): 481-8, 2014 Sep.
Article in English | MEDLINE | ID: mdl-24715634

ABSTRACT

Familial clustering is common in prostate cancer (PCa), but the psychosocial consequences of being a PCa patient in an affected family are not well understood. This study investigated the effects of family history of PCa on psychosocial distress and perceived psychosocial treatment need. Data were gathered within the German national research project "Familial Prostate Cancer". 4.123 PCa survivors who had undergone prostatectomy at least 4 years ago received a questionnaire set. 3.623 of the respondents [68.3 % sporadic, sporadic prostate cancer (SPCa); 31.7 % familial, familial prosate cancer (FPCa)] filled in measures of cancer-specific distress (QSC-R10), depression (PHQ-2), and anxiety (GAD-2). Perceived psychosocial treatment need was assessed using a single item. The prevalence of psychosocial distress did not differ between SPCa and FPCa survivors (cancer-specific distress: 16.2 vs. 16.7 %; depression: 5.8 vs. 6.4 %; anxiety: 6.6 vs. 5.8 %; ps ≥ .397). Similarly, psychosocial treatment need did not differ between SPCa (11.8 %) and FPCa (13.1 %) cases (p = .303). However, family history moderated the effect of cancer-specific distress on treatment need (OR 2.67, 95 % CI 1.43-4.96, p = .002). Exploratory analyses for the hereditary subtype (HPCa) revealed that cancer-specific distress was lower in HPCa survivors who had only daughters compared to survivors without any children or with at least one son. No such effect was observed in SPCa survivors (p = .040). PCa survivors with a positive family history do not experience increased psychosocial distress. Nonetheless, family history may exert subtle effects that deserve further research.


Subject(s)
Genetic Predisposition to Disease/psychology , Prostatic Neoplasms/psychology , Survivors/psychology , Aged , Aged, 80 and over , Anxiety/epidemiology , Depression/epidemiology , Humans , Male , Middle Aged , Prostatectomy , Prostatic Neoplasms/genetics , Surveys and Questionnaires
16.
Psychother Psychosom Med Psychol ; 62(7): 276-83, 2012 Jul.
Article in German | MEDLINE | ID: mdl-22777905

ABSTRACT

This study investigated feasibility and acceptance of computer-based assessment for the identification of psychosocial distress in routine radiotherapy care. 155 cancer patients were assessed using QSC-R10, PO-Bado-SF and Mach-9. The congruence between computerized tablet PC and conventional paper assessment was analysed in 50 patients. The agreement between the 2 modes was high (ICC 0.869-0.980). Acceptance of computer-based assessment was very high (>95%). Sex, age, education, distress and Karnofsky performance status (KPS) did not influence acceptance. Computerized assessment was rated more difficult by older patients (p = 0.039) and patients with low KPS (p = 0.020). 75.5% of the respondents supported referral for psycho-social intervention for distressed patients. The prevalence of distress was 27.1% (QSC-R10). Computer-based assessment allows easy identification of distressed patients. Level of staff involvement is low, and the results are quickly available for care providers.


Subject(s)
Diagnosis, Computer-Assisted , Neoplasms/psychology , Patient Acceptance of Health Care , Stress, Psychological/diagnosis , Stress, Psychological/psychology , Surveys and Questionnaires , Activities of Daily Living , Adult , Aged , Aged, 80 and over , Anxiety/etiology , Anxiety/psychology , Emotions/physiology , Fatigue/etiology , Fatigue/psychology , Feasibility Studies , Female , Humans , Karnofsky Performance Status , Male , Microcomputers , Middle Aged , Neoplasms/therapy , Radiotherapy/psychology , Young Adult
17.
Acta Oncol ; 51(8): 1020-8, 2012 Nov.
Article in English | MEDLINE | ID: mdl-22616951

ABSTRACT

BACKGROUND: To investigate the prognostic value of several psychosocial factors for long-term survival in cancer patients. MATERIAL AND METHODS: Baseline data were gathered in routine radiotherapy practice during 44 months. The analysis is based on 938 patients for whom follow-up data were available. Baseline psychosocial distress, depression, health-related quality of life (HRQOL), and life satisfaction were assessed using Questionnaire on Stress in Cancer Patients (QSC-R23), Self-Rating Depression Scale (SDS), Functional Assessment of Therapy - General (FACT-G) questionnaire, and Questions on Life Satisfaction (FLZ(M)). Patients were followed up for 7 to 10 years. Kaplan-Meier plots and Cox proportional hazards models were used to investigate associations between sociodemographic, clinical, psychosocial factors and overall survival (OS). RESULTS: Patients' median survival time was 35 months (95% CI 28.9-41.1). Significant multivariate predictors of OS were age, health insurance type, Karnofsky performance status, cancer site, and cancer stage. Controlling for these variables, HRQOL was the only psychosocial predictor of survival (hazard ratio 0.988, 95% CI 0.979-0.997, p =0.009). The physical well-being and the functional well-being subscales of the FACT-G emerged as the relevant HRQOL facets predictive of survival. CONCLUSION: HRQOL has incremental predictive value for long-term survival in cancer patients.


Subject(s)
Health Status , Neoplasms/mortality , Neoplasms/radiotherapy , Quality of Life , Stress, Psychological/etiology , Adult , Aged , Educational Status , Female , Humans , Kaplan-Meier Estimate , Male , Marital Status , Middle Aged , Multivariate Analysis , Neoplasm Staging , Neoplasms/pathology , Neoplasms/psychology , Odds Ratio , Predictive Value of Tests , Proportional Hazards Models
18.
Soc Psychiatry Psychiatr Epidemiol ; 46(11): 1127-32, 2011 Nov.
Article in English | MEDLINE | ID: mdl-20857085

ABSTRACT

BACKGROUND: Smoking and heavy alcohol use predicts suicidal behaviour. Whether the simultaneous presentation of both conditions induces an amplified effect on risk prediction has not been investigated so far. METHODS: In a community-based cohort study, a total of 12,888 subjects (6,456 men, 6,432 women; age range of 25-74 years at assessment) from three independent population-based cross-sectional MONICA surveys (conducted in 1984/85, 1989/90, and 1994/95), representative for the Southern German population, was followed up until 31 December 2002. Standardized mortality ratios (SMR) for deaths from suicide using German population rates were calculated for smoking and high alcohol consumption. RESULTS: After a mean follow-up time of 12.0 (SD 4.4) years and 154,275 person-years at risk, a total of 1,449 persons had died from all causes and 38 of them from suicide. Compared to the general population, mortality from suicide was increased for risky alcohol consumption (SMR = 2.37; 95% CI 1.14-4.37) and for smoking (SMR = 2.30; 95% CI 1.36-3.63). A substantial increase in suicide mortality (SMR = 4.80; 95% CI 2.07-9.46) was observed for smokers with risky alcohol consumption. CONCLUSIONS: The approximately fourfold increased relative risk for completed suicide in subjects with smoking and risky alcohol consumption indicates a synergistic effect which deserves an increased alertness.


Subject(s)
Alcohol Drinking/epidemiology , Smoking/epidemiology , Suicide/trends , Adult , Aged , Cohort Studies , Female , Germany/epidemiology , Health Surveys , Humans , Male , Middle Aged , Risk Assessment
19.
Occup Environ Med ; 68(2): 126-33, 2011 Feb.
Article in English | MEDLINE | ID: mdl-20833759

ABSTRACT

OBJECTIVE: To examine the long-term effects of a stress management intervention (SMI) based on the effort-reward imbalance (ERI) model, on psychological and biological reactions to work stress. METHODS: 174 lower or middle management employees (99% male) were randomly assigned to an intervention or a waiting control group. The programme comprised 24 × 45 min group sessions (2 full days followed by two 4 × 45 min sessions within the next 8 months) on individual work stress situations. The primary endpoint was perceived stress reactivity (Stress Reactivity Scale, SRS), while secondary endpoints were salivary cortisol and α-amylase, anxiety and depression, and ERI. Assessments were repeated in 154 participants 1 year later. RESULTS: SRS score decreased in both groups. A two-factor ANOVA with repeated measures showed a significant time × group effect (F=5.932; p=0.016) with the greater reduction in the intervention group. For SRS, the effect size (Cohen's d) after 1 year was d=0.416 in the intervention and d=0.166 in the control group. α-Amylase as a measure of sympathetic nervous system activation, decreased more strongly in the intervention group (area under the daytime curve and daytime slope: time × group effect p=0.076 and p=0.075). No difference was observed for cortisol. For depression, anxiety and ERI, improvements were higher in the intervention group but did not reach statistical significance. CONCLUSIONS: SMI based on work stress theory, is effective in reducing perceived stress reactivity and sympathetic activation in lower and middle management employees. Other mental health parameters and ERI show a tendency towards improvement. These beneficial effects are present 1 year later.


Subject(s)
Occupational Diseases/prevention & control , Psychotherapy, Group/methods , Stress, Psychological/prevention & control , Adult , Anxiety/therapy , Depression/therapy , Female , Health Behavior , Humans , Hydrocortisone/metabolism , Male , Middle Aged , Patient Compliance , Psychiatric Status Rating Scales , Reward , Saliva/metabolism , Social Class , Treatment Outcome , Workplace/psychology , alpha-Amylases/metabolism
20.
Psychother Psychosom Med Psychol ; 61(1): 32-7, 2011 Jan.
Article in German | MEDLINE | ID: mdl-21120791

ABSTRACT

Chronically physically ill patients frequently suffer from psychological distress. The realistic fear of progression (FOP) of disease is one of the most important causes of distress in these patients. This study investigates the extent of FOP in patients with diverse diagnoses. 863 Patients answered the FOP-questionnaire, medical and sociodemographic items. Group differences were investigated with t- and F-tests. Determinants for FOP were identified by linear multiple regression. Some diagnostic subgroups differ in degree and profile of FOP. Patients with rheumatic diseases and Parkinson's disease score highest, patients with stroke or chronic peripheric vascular disease lowest in FOP total scores. Age, sex, economic situation and employment effect the level of fear of progression. Systematic studies are needed to verify the importance of FOP for patients with chronic disease and to ascertain clinical indication for psychotherapeutic support.


Subject(s)
Chronic Disease/psychology , Disease Progression , Fear/psychology , Adult , Age Factors , Aged , Aged, 80 and over , Employment , Female , Humans , Male , Middle Aged , Regression Analysis , Sex Factors , Socioeconomic Factors , Surveys and Questionnaires , Young Adult
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