Anxiety and Depression in Advanced and Metastatic Lung Cancer Patients—Correlations with Performance Status and Type of Treatment
Abstract
:1. Introduction
2. Materials and Methods
- -
- Adult patients (>18 years old) diagnosed with lung cancer in the two centers from Bucharest and Galati
- -
- Patients who agreed to be evaluated with the HADS scale.
- -
- Patients admitted and treated in the other oncologic departments of the two hospitals
- -
- Patients who did not agree to be evaluated for anxiety and depression.
- -
- I feel tense or ‘wound up.’
- -
- I get a sort of frightened feeling as if something awful is about to happen.
- -
- Worrying thoughts go through my mind.
- -
- I can sit at ease and feel relaxed.
- -
- I get a sort of frightened feeling like ‘butterflies’ in the stomach.
- -
- I feel restless as if I have to move.
- -
- I get sudden feelings of panic.
- -
- I still enjoy the things I used to enjoy.
- -
- I can laugh and see the funny side of things.
- -
- I feel cheerful.
- -
- I feel as if I am slowed down.
- -
- I have lost interest in my appearance.
- -
- I look forward to enjoying things.
- -
- I can enjoy a good book or radio or TV program [15].
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Kim, J.; Lee, H.; Huang, B.W. Lung Cancer: Diagnosis, Treatment Principles, and Screening. Am. Fam. Physician 2022, 105, 487–494. [Google Scholar]
- Meneguin, S.; Alves, I.G.; Camargo, H.T.F.; Pollo, C.F.; Segalla, A.V.Z.; de Oliveira, C. Comparative Study of the Quality of Life and Coping Strategies in Oncology Patients. Eur. J. Investig. Health Psychol. Educ. 2024, 14, 339–350. [Google Scholar] [CrossRef] [PubMed]
- Rebegea, L.F.; Firescu, D.; Anghel, R.M.; Gales, L.; Ilie, A.M.; Dumitru, M.E.; Craescu, M.; Niculet, E.; Tatu, A.L.; Cretu, M.S.; et al. Clinical, histological and therapeutical aspects in the management of uterine and extrauterine stromal sarcomas: Case reports. Exp. Ther. Med. 2021, 22, 1456. [Google Scholar] [CrossRef] [PubMed]
- Temel, J.S.; Petrillo, L.A.; Greer, J.A. Patient-Centered Palliative Care for Patients with Advanced Lung Cancer. J. Clin. Oncol. 2022, 40, 626–634. [Google Scholar] [CrossRef]
- Petruželka, L.; Špaček, J.; Křížová, L. Future of lung cancer treatment. Klin. Onkol. 2021, 34 (Suppl. 1), 71–81. [Google Scholar] [CrossRef] [PubMed]
- Rahnea-Nita, R.-A.; Stoian, A.-R.; Anghel, R.-M.; Rebegea, L.-F.; Ciuhu, A.-N.; Bacinschi, X.-E.; Zgura, A.-F.; Trifanescu, O.-G.; Toma, R.-V.; Constantin, G.B.; et al. The Efficacy of Immunotherapy in Long-Term Survival in Non-Small Cell Lung Cancer (NSCLC) Associated with the Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH). Life 2023, 13, 1279. [Google Scholar] [CrossRef]
- Tariq, S.; Kim, S.Y.; Monteiro de Oliveira Novaes, J.; Cheng, H. Update 2021: Management of Small Cell Lung Cancer. Lung 2021, 199, 579–587. [Google Scholar] [CrossRef]
- Polański, J.; Chabowski, M.; Chudiak, A.; Uchmanowicz, B.; Janczak, D.; Rosińczuk, J.; Mazur, G. Intensity of Anxiety and Depression in Patients with Lung Cancer in Relation to Quality of Life. Adv. Exp. Med. Biol. 2018, 1023, 29–36. [Google Scholar]
- Naser, A.Y.; Hameed, A.N.; Mustafa, N.; Alwafi, H.; Dahmash, E.Z.; Alyami, H.S.; Khalil, H. Depression and Anxiety in Patients With Cancer: A Cross-Sectional Study. Front. Psychol. 2021, 12, 585534. [Google Scholar] [CrossRef]
- Dean, E. Anxiety. Nurs. Stand. 2016, 30, 15. [Google Scholar] [CrossRef]
- Chand, S.P.; Arif, H. Depression. In StatPearls [Internet]; StatPearls Publishing: Treasure Island, FL, USA, 2024. [Google Scholar]
- Więckiewicz, G.; Weber, S.; Florczyk, I.; Gorczyca, P. Socioeconomic Burden of Psychiatric Cancer Patients: A Narrative Review. Cancers 2024, 16, 1108. [Google Scholar] [CrossRef] [PubMed]
- Hu, K.; Liu, Q.; László, K.D.; Wei, D.; Yang, F.; Fall, K.; Adami, H.O.; Ye, W.; Valdimarsdóttir, U.A.; Li, J. Risk of Psychiatric Disorders Among Spouses of Patients with Cancer in Denmark and Sweden. JAMA Netw. Open 2023, 6, e2249560. [Google Scholar] [CrossRef] [PubMed]
- Chang, W.H.; Lai, A.G. Cumulative burden of psychiatric disorders and self-harm across 26 adult cancers. Nat. Med. 2022, 28, 860–870. [Google Scholar] [CrossRef] [PubMed]
- Zigmond, A.S.; Snaith, R.P. The Hospital Anxiety and Depression Scale. Acta Psychiatr. Scand. 1983, 67, 361–370. [Google Scholar] [CrossRef] [PubMed]
- Bjelland, I.; Dahl, A.A.; Haug, T.T.; Neckelmann, D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J. Psychosom. Res. 2002, 52, 69–77. [Google Scholar] [CrossRef] [PubMed]
- Sewtz, C.; Muscheites, W.; Grosse-Thie, C.; Kriesen, U.; Leithaeuser, M.; Glaeser, D.; Hansen, P.; Kundt, G.; Fuellen, G.; Junghanss, C. Longitudinal observation of anxiety and depression among palliative care cancer patients. Ann. Palliat. Med. 2021, 10, 3836–3846. [Google Scholar] [CrossRef] [PubMed]
- Fernández-de-Las-Peñas, C.; Rodríguez-Jiménez, J.; Palacios-Ceña, M.; de-la-Llave-Rincón, A.I.; Fuensalida-Novo, S.; Florencio, L.L.; Ambite-Quesada, S.; Ortega-Santiago, R.; Arias-Buría, J.L.; Liew, B.X.W.; et al. Psychometric Properties of the Hospital Anxiety and Depression Scale (HADS) in Previously Hospitalized COVID-19 Patients. Int. J. Environ. Res. Public Health 2022, 19, 9273. [Google Scholar] [CrossRef] [PubMed]
- Rahnea-Nita, G.; Badiu, D.C.; Popescu, C.G.; Grigorean, V.T.; Serban, D.; Smarandache, C.G.; Rahnea-Nita, R.A.; Ciuhu, A.N.; Mandu, M.; Andronache, L.F.; et al. The impact of Coronavirus disease 2019 pandemic on the treatment of cancer patients: The first steps in this fight. Mediterr. J. Clin. Psychol. 2021, 9, 1. [Google Scholar] [CrossRef]
- Savard, J.; Laberge, B.; Gauthier, J.G.; Ivers, H.; Bergeron, M.G. Evaluating anxiety and depression in HIV-infected patients. J. Pers. Assess. 1998, 71, 349–367. [Google Scholar] [CrossRef]
- Michopoulos, I.; Douzenis, A.; Kalkavoura, C.; Christodoulou, C.; Michalopoulou, P.; Kalemi, G.; Fineti, K.; Patapis, P.; Protopapas, K.; Lykouras, L. Hospital Anxiety and Depression Scale (HADS): Validation in a Greek general hospital sample. Ann. Gen. Psychiatry 2008, 7, 4. [Google Scholar] [CrossRef]
- Oken, M.M.; Creech, R.H.; Tormey, D.C.; Horton, J.; Davis, T.E.; McFadden, E.T.; Carbone, P.P. Toxicity and Response Criteria of the Eastern Cooperative Oncology Group. Am. J. Clin. Oncol. 1982, 5, 649–655. [Google Scholar] [CrossRef] [PubMed]
- Zeng, Y.; Hu, C.H.; Li, Y.Z.; Zhou, J.S.; Wang, S.X.; Liu, M.D.; Qiu, Z.H.; Deng, C.; Ma, F.; Xia, C.F.; et al. Association between pretreatment emotional distress and immune checkpoint inhibitor response in non-small-cell lung cancer. Nat. Med. 2024, 30, 1680–1688. [Google Scholar] [CrossRef]
- Smith, H.R. Depression in cancer patients: Pathogenesis, implications and treatment (Review). Oncol Lett. 2015, 9, 1509–1514. [Google Scholar] [CrossRef]
- Linden, W.; Vodermaier, A.; Mackenzie, R.; Greig, D. Anxiety and depression after cancer diagnosis: Prevalence rates by cancer type, gender, and age. J. Affect. Disord. 2012, 141, 343–351. [Google Scholar] [CrossRef] [PubMed]
- Zeilinger, E.L.; Oppenauer, C.; Knefel, M.; Kantor, V.; Schneckenreiter, C.; Lubowitzki, S.; Krammer, K.; Popinger, C.; Kitta, A.; Kum, L.; et al. Prevalence of anxiety and depression in people with different types of cancer or haematologic malignancies: A cross-sectional study. Epidemiol. Psychiatr. Sci. 2022, 31, e74. [Google Scholar] [CrossRef]
- Hansen, J.M.; Kjaer, T.K.; Mellemgård, A.; Oksen, M.S.; Andersen, I.; Dalton, S.O. Association between anxiety and depression symptoms and completion of first-line treatment in newly diagnosed lung cancer patients. Acta Oncol. 2023, 62, 820–824. [Google Scholar] [CrossRef]
- Duan, L.; Cui, H.; Zhang, W.; Wu, S. Symptoms and experiences of frailty in lung cancer patients with chemotherapy: A mixed-method approach. Front. Oncol. 2022, 12, 1019006. [Google Scholar] [CrossRef] [PubMed]
- Prapa, P.; Papathanasiou, I.V.; Bakalis, V.; Malli, F.; Papagiannis, D.; Fradelos, E.C. Quality of Life and Psychological Distress of Lung Cancer Patients Undergoing Chemotherapy. World J. Oncol. 2021, 12, 61–66. [Google Scholar] [CrossRef] [PubMed]
- McFarland, D.C. New lung cancer treatments (immunotherapy and targeted therapies) and their associations with depression and other psychological side effects as compared to chemotherapy. Gen. Hosp. Psychiatry 2019, 60, 148–155. [Google Scholar] [CrossRef]
- Constantin, G.B.; Firescu, D.; Mihailov, R.; Constantin, I.; Ștefanopol, I.A.; Iordan, D.A.; Ștefănescu, B.I.; Bîrlă, R.; Panaitescu, E. A Novel Clinical Nomogram for Predicting Overall Survival in Patients with Emergency Surgery for Colorectal Cancer. J. Pers. Med. 2023, 13, 575. [Google Scholar] [CrossRef]
- Ciuhu, A.N.; Badica, R.; Popescu, M.; Radoi, M.; Rahnea-Nita, R.A.; Rahnea-Nita, G. Defense mechanisms and coping style at very next diagnostic period in advanced and metastatic cancer. J. Clin. Oncol. 2016, 34, e21610. [Google Scholar] [CrossRef]
- Nanni, M.G.; Caruso, R.; Travado, L.; Ventura, C.; Palma, A.; Berardi, A.M.; Meggiolaro, E.; Ruffilli, F.; Martins, C.; Kissane, D.; et al. Relationship of demoralization with anxiety, depression, and quality of life: A Southern European study of Italian and Portuguese cancer patients. Psychooncology 2018, 27, 2616–2622. [Google Scholar] [CrossRef] [PubMed]
- Arvanitou, E.; Nikoloudi, M.; Tsoukalas, N.; Parpa, E.; Mystakidou, K. Factors associated with anxiety and depression in cancer patients: Demographic factors and the role of demoralization and satisfaction with care. Psychooncology 2023, 32, 712–720. [Google Scholar] [CrossRef] [PubMed]
Patients’ Characteristics | No of Patients (%), N = 105 |
---|---|
Median age (range) (year) | 66.5 (48–86) |
Gender | |
Male | 74 (70.48) |
Female | 31 (29.52) |
Life environment | |
Urban | 57 (54.29) |
Rural | 48 (45.71) |
Type of hospitalization | |
Day care | 76 (72.38) |
Continuous care | 29 (27.62) |
Studies | |
Elementary school | 45 (42.86) |
High school | 57 (54.29) |
University | 3 (2.85) |
ECOG Performance status | |
ECOG = 0–2 | 45 (42.86) |
ECOG = 3–4 | 60 (57.14) |
Treatment type | |
Chemotherapy | 39 (37.5) |
Palliative treatment | 23 (22.12) |
Immunotherapy | 30 (28.82) |
Tyrosine kinase | 4 (3.85) |
Radiotherapy | 8 (7.69) |
Normal (N/%) | Borderline (N/%) | Abnormal (N/%) | |
---|---|---|---|
Anxiety | 60/57.14% | 22/20.95% | 23/21.91% |
Depression | 62/59.05% | 17/16.19% | 26/24.76% |
Anxiety-Normal | Anxiety-Borderline | Anxiety-Abnormal | Depression-Normal | Depression-Borderline | Depression-Abnormal | |
---|---|---|---|---|---|---|
Male: 74 patients | 43 (58.11%) | 16 (21.62%) | 15 (20.27%) | 46 (62.16%) | 14 (18.92%) | 14 (18.92%) |
Female: 31 patients | 17 (54.84%) | 6 (19.35%) | 8 (25.81%) | 16 (51.61%) | 3 (9.68%) | 12 (38.71%) |
ECOG = 0–2 60 patients | 41 (68.33%) | 13 (21.67%) | 6 (10%) | 46 (76.67%) | 7 (11.67%) | 7 (11.67%) |
ECOG = 3–4 45 patients | 19 (45.22%) | 9 (20%) | 17 (37.78%) | 16 (35.56%) | 10 (22.22%) | 19 (42.22%) |
Day care: 28 patients | 19 (67.86%) | 5 (17.86%) | 4 (14.29%) | 20 (71.43%) | 4 (14.29%) | 4 (14.29%) |
Continuous care: 77 patients | 41 (53.25%) | 17 (41.46%) | 19 (24.68%) | 42 (54.55%) | 13 (16.88%) | 22 (28.57%) |
elementary school: 45 patients | 25 (55.56%) | 12 (26.67%) | 8 (17.78%) | 26 (57.78%) | 8 (14.78%) | 11 (24.44%) |
high school: 57 patients | 34 (59.65%) | 9 (15.79%) | 14 (24.56%) | 3 (56.65%) | 9 (15.79%) | 14 (24.56%) |
university: 3 patients | 1 (33.33%) | 1 (33.33%) | 1 (33.33%) | 2 (66.67%) | 0 (0%) | 1 (33.33%) |
Urban: 58 patients | 33 (56.90%) | 11 (18.97%) | 14 (24.14%) | 32 (55.17%) | 9 (15.51%) | 17 (29.31%) |
Rural: 47 patients | 27 (57.45%) | 11 (23.4%) | 9 (19.15%) | 30 (63.83%) | 8 (17.02%) | 9 (19.15%) |
Variables | Anxiety Normal | Depression Normal | Anxiety Borderline | Depression Borderline | Anxiety Abnormal | Depression Abnormal |
---|---|---|---|---|---|---|
Type of treatment | ||||||
CMT | 0.32 (p < 0.03) | 0.16 (p = 0.04) | 0.22 (p = 0.04) | 0.12 (p = 0.4) | 0.2 (p = 0.04) | 0.4 (p = 0.04) |
Palliative | 0.12 (p < 0.01) | 0.22 (p < 0.01) | 0.32 (p = 0.02) | 0.45 (p = 0.01) | 0.49 (p < 0.01) | 0.62 (p < 0.01) |
RT | 0.38 (p = 0.5) | 0.52 (p < 0.01) | 0.26 (p = 0.09) | 0.46 (p = 0.89) | 0.36 (p = 0.69) | 0.16 (p = 0.09) |
IT | 0.82 (p < 0.001) | 0.86 (p < 0.001) | 0.39 (p = 0.7) | 0.239 (p = 0.7) | 0.29 (p = 0.6) | 0.39 (p = 0.7) |
TKI | 0.3 (p = 0.4) | 0.15 (p = 0.1) | 0.4 (p = 0.08) | 0.4 (p = 0.08) | 0.4 (p = 0.08) | 0.5 (p = 0.08) |
ECOG performance status | ||||||
ECOG = 0–2 | 0.65 (p < 0.001) | 0.52 (p < 0.005) | 0.35 (p = 0.06) | 0.25 (p = 0.06) | 0.15 (p = 0.06) | 0.18 (p = 0.06) |
ECOG = 3–4 | 0.3 (p = 0.4) | 0.1 (p = 0.4) | 0.32 (p = 0.4) | 0.28 (p = 0.4) | 0.8 (p = 0.04) | 0.6 (p = 0.03) |
Type of hospitalization | ||||||
Day care | 0.78 (p < 0.001) | 0.62 (p < 0.005) | 0.25 (p = 0.06) | 0.18 (p = 0.06) | 0.4 (p = 0.06) | 0.3 (p = 0.06) |
Continuos care | 0.2 (p = 0.5) | 0.3 (p = 0.5) | 0.42 (p = 0.5) | 0.35 (p = 0.4) | 0.78 (p = 0.04) | 0.86 (p = 0.03) |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2024 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Rahnea-Nita, R.-A.; Rebegea, L.-F.; Dumitru, M.; Mitrica, R.-I.; Nechifor, A.; Firescu, D.; Maier, A.-C.; Constantin, G.B.; Grigorean, V.-T.; Rahnea-Nita, G. Anxiety and Depression in Advanced and Metastatic Lung Cancer Patients—Correlations with Performance Status and Type of Treatment. Medicina 2024, 60, 1472. https://doi.org/10.3390/medicina60091472
Rahnea-Nita R-A, Rebegea L-F, Dumitru M, Mitrica R-I, Nechifor A, Firescu D, Maier A-C, Constantin GB, Grigorean V-T, Rahnea-Nita G. Anxiety and Depression in Advanced and Metastatic Lung Cancer Patients—Correlations with Performance Status and Type of Treatment. Medicina. 2024; 60(9):1472. https://doi.org/10.3390/medicina60091472
Chicago/Turabian StyleRahnea-Nita, Roxana-Andreea, Laura-Florentina Rebegea, Mihaela Dumitru, Radu-Iulian Mitrica, Alexandru Nechifor, Dorel Firescu, Adrian-Cornel Maier, Georgiana Bianca Constantin, Valentin-Titus Grigorean, and Gabriela Rahnea-Nita. 2024. "Anxiety and Depression in Advanced and Metastatic Lung Cancer Patients—Correlations with Performance Status and Type of Treatment" Medicina 60, no. 9: 1472. https://doi.org/10.3390/medicina60091472