Positive and negative affect after diagnosis of advanced cancer.

Anxiety and depression are studied thoroughly in patients with advanced cancer. However, little is known about the nature of mood disorders in this stage of the disease. We studied positive and negative affect in patients who have had a diagnosis of advanced cancer, and examined how these are related to anxiety and depression, and to other patient and care factors. One hundred and five patients filled out a written questionnaire and were interviewed personally. The PANAS positive affect scores were lower than those in the general population, but the negative affect scores were fairly similar. We found a rather low prevalence of depression (13%) and anxiety (8%) as measured by the HADS. The emotional problems patients mentioned most frequently were anxiety about metastases (26%), the unpredictability of the future (18%) and anxiety about physical suffering (15%). Both positive and negative affect were most strongly related to patient's sense of meaning and peace. We conclude that distinguishing positive and negative affect enhances the understanding of psychological distress of patients with advanced cancer, that seems to be mainly caused by low levels of positive affect. Several theories are discussed to explain this finding, that may contribute to efforts to improve care for these patients.

Workshops to support the bereavement process.

When a bereaved person is in need of extra support during the bereavement process, at present four types of support can be distinguished: professional individual- and group counseling and non-professional individual- and group counseling. In this article another support facility is proposed: the workshop. It is indicated that the workshop can be considered as a valuable addition to the current counseling alternatives for bereavement and can possibly prevent more serious bereavement problems. After an explanation of bereavement counseling, the set-up of the workshop is described. Special attention is payed to the group dynamic aspects of the workshop.

Psychosocial impact of bereavement after suicide and fatal traffic accident: a comparative two-country study.

This study examines the psychosocial problems of spouses bereaved as a consequence of unnatural causes of death (suicide and traffic fatality) in two countries, Slovenia (n = 53) and The Netherlands (n = 32). Structured interviews consisted of standardized measures for depression, substance use, social reactions, and acceptance and attribution of the loss. Although marked differences in sociodemographic background exist, bereaved subjects from both countries show more similarities than differences. Depressed symptomatology is slightly higher in the Slovene bereaved, but symptom patterns are almost identical. Core indicators of clinical depression, as well as reported substance use, are equally low in both countries, and gender and mode of death do not differ significantly. Social acceptance is more problematic in suicide bereaved, particularly in Slovenia. Methodological considerations of cross-cultural bereavement studies are discussed.

Living with a hereditary form of cancer: experiences and needs of MEN 2 patients and their families.

Unlike the purely medical research done in multiple endocrine neoplasia type 2 (MEN 2) families, little work has been done on the psychosocial aspects of the disease. To assess the severely stressful influences and the consequences of that stress on the family network, a small-scale survey was carried out during a national meeting. The goal of the study was to obtain more information about the experiences and needs of MEN 2 patients and their relatives. Of the 59 respondents, 85% were satisfied with the medical information provided, 81% were satisfied with the medical knowledge of the specialist, but only 12% were satisfied with the medical knowledge of the general practitioner regarding MEN 2. Furthermore, 63% of the parents had difficulties in talking about the disease with their children. The need expressed for contact with fellow sufferers and their families is expected to lead to the establishment of an interest group for MEN 2 families.