Patient-reported distress and problems among elderly patients with hematological malignancy in Korea.

PURPOSE: Treatment for hematological malignancies (HMs) and functional decline associated with age can cause distress in elderly patients with HMs. However, information about the nature and effects of distress in this population is scarce. Therefore, this study examined the level of distress, its source, and the practical/familial/physical/emotional problems among elderly patients with HMs. METHODS: We conducted a cross-sectional study of patients with HMs aged ≥ 65 years who visited an outpatient clinic at a tertiary medical center in Korea between November 2019 and March 2020. Patient-reported distress and problems were measured using the distress thermometer (DT) and 39-item Problem List by the National Comprehensive Cancer Network. Descriptive statistics, χ2 test or Fisher's exact test, and multivariate logistic regression analyses were conducted (N = 132). RESULTS: In total, 62.1% of patients had moderate to severe distress (DT score ≥ 4), experiencing an average of nine problems. Significant sources of distress on multivariate logistic analysis included problems with transportation, depression, and constipation, accounting for 47% of distress variance. Most patients had physical (97.0%) or emotional problems (79.5%). Among these, fatigue (60.6%), worry (59.8%), tingling (59.8%), difficulty with mobility (47.0%), and memory/concentration (40.2%) were the most frequently reported problems. CONCLUSIONS: Elderly patients with HMs have a high burden of distress, which is affected by different sources, compared with younger patients with solid tumors. Thus, in this population, assessment and management of distress need to be conducted considering the unique features of their source and burden. Further research on distress should consider the cancer type and population age.

Relationship of early-life stress and resilience to military adjustment in a young adulthood population.

PURPOSE: Early-life stress (ELS) may mediate adjustment problems while resilience may protect individuals against adjustment problems during military service. We investigated the relationship of ELS and resilience with adjustment problem factor scores in the Korea Military Personality Test (KMPT) in candidates for the military service. METHODS: Four hundred and sixty-one candidates participated in this study. Vulnerability traits for military adjustment, ELS, and resilience were assessed using the KMPT, the Korean Early-Life Abuse Experience Questionnaire, and the Resilience Quotient Test, respectively. Data were analyzed using multiple linear regression analyses. RESULTS: The final model of the multiple linear regression analyses explained 30.2 % of the total variances of the sum of the adjustment problem factor scores of the KMPT. Neglect and exposure to domestic violence had a positive association with the total adjustment problem factor scores of the KMPT, but emotion control, impulse control, and optimism factor scores as well as education and occupational status were inversely associated with the total military adjustment problem score. CONCLUSIONS: ELS and resilience are important modulating factors in adjusting to military service. We suggest that neglect and exposure to domestic violence during early life may increase problem with adjustment, but capacity to control emotion and impulse as well as optimistic attitude may play protective roles in adjustment to military life. The screening procedures for ELS and the development of psychological interventions may be helpful for young adults to adjust to military service.

Linear and non-linear EEG analysis of adolescents with attention-deficit/hyperactivity disorder during a cognitive task.

OBJECTIVE: We aimed to investigate whether electroencephalograph (EEG) dynamics differ in adolescents with attention-deficit/hyperactivity disorder (ADHD) compared with healthy subjects during the performance of a cognitive task. METHODS: We recorded EEGs from 19 scalp electrodes in 11 adolescent boys with ADHD and 12 age-matched healthy boys while the subjects were at rest and during a continuous performance test (CPT). The approximate entropy (ApEn), a non-linear information-theoretic measure, was calculated to quantify the complexity of the EEGs. RESULTS: The mean ApEn of the ADHD patients was significantly lower than the healthy subjects over the right frontal regions (Fp2 and F8) during the performance of the cognitive task, but not at rest. The spectral analysis showed significant differences between the two groups in the P3 and T4 regions at rest and the Fp2 and F8 regions during task performance. CONCLUSIONS: The differences in EEG complexity between the two groups suggest that cortical information processing is altered in ADHD adolescents, and thus their levels of cortical activation may be insufficient to meet the cognitive requirements of attention-demanding tasks. SIGNIFICANCE: This study suggests that a non-linear measure such as ApEn is useful for investigating neural dysfunctions in adolescents with ADHD.