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Published in: Supportive Care in Cancer 11/2011

01-11-2011 | Original Article

Comorbid mental disorders and psychosocial distress in patients with brain tumours and their spouses in the early treatment phase

Authors: Simone Goebel, Myrna von Harscher, H. Maximilian Mehdorn

Published in: Supportive Care in Cancer | Issue 11/2011

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Abstract

Purpose

The aim of this study was to examine the prevalence of comorbid mental disorders as well as the extent of psychosocial distress in patients with intracranial tumours and their partners during the early treatment phase. Moreover, we aimed to identify which events are experienced as most distressing in the context of the early diagnosis of brain cancer by patients and spouses.

Methods

Structured clinical interviews for DSM-IV (SCID-IV) were conducted with 26 patients and their partners after the first neurosurgical treatment within the first 3 months after the detection of a brain tumour. Screening measures (NCCN distress thermometer, HADS, IES-R) were used to assess the extent of psychosocial distress as well as anxiety, depression and traumatic stress responses. Distressing experiences were assessed via a structured questionnaire and interview.

Results

Thirty-eight per cent of the patients and 47% of the partners suffered from a psychiatric disorder. Most frequent diagnoses were adjustment disorder and acute stress disorder. The majority of the participants suffered from elevated psychosocial distress. Partners were equally or even more affected than the patients. For the patients, the experience most frequently described as distressing was the first detection of the tumour. The majority of the partners reported to be distressed by the fear of surgery outcomes.

Conclusions

This study revealed that during this very first treatment phase, both brain tumour patients and their spouses show a high prevalence of comorbid mental disorders and psychosocial distress. The findings suggest that research and clinical efforts are needed to address the psychosocial concerns of these populations.
Literature
1.
go back to reference Anderson SI, Taylor R, Whittle IR (1999) Mood disorders in patients after treatment for primary intracranial tumours. Br J Neurosurg 13:480–485PubMed Anderson SI, Taylor R, Whittle IR (1999) Mood disorders in patients after treatment for primary intracranial tumours. Br J Neurosurg 13:480–485PubMed
2.
go back to reference Annunziata MA, Muzzatti B, Bidoli E (2010) Psychological distress and needs of cancer patients: a prospective comparison between the diagnostic and the therapeutic phase. Support Care Cancer p S1433–S7339 (in press) Annunziata MA, Muzzatti B, Bidoli E (2010) Psychological distress and needs of cancer patients: a prospective comparison between the diagnostic and the therapeutic phase. Support Care Cancer p S1433–S7339 (in press)
3.
go back to reference Arnold SD, Forman LM, Brigidi BD, Carter KE, Schweitzer HA, Qiunn HE, Bebe Guill A, Herndon JE, Raynor RH (2008) Evaluation and characterization of generalized anxiety and depression in patients with primary brain tumors. J Neuro-Oncol 10:171–181CrossRef Arnold SD, Forman LM, Brigidi BD, Carter KE, Schweitzer HA, Qiunn HE, Bebe Guill A, Herndon JE, Raynor RH (2008) Evaluation and characterization of generalized anxiety and depression in patients with primary brain tumors. J Neuro-Oncol 10:171–181CrossRef
4.
go back to reference Braun M, Mikulincer M, Rydall A, Walsh A, Rodin G (2007) Hidden morbidity in cancer: spouse caregivers. J Clin Oncol 25:4829–4834PubMedCrossRef Braun M, Mikulincer M, Rydall A, Walsh A, Rodin G (2007) Hidden morbidity in cancer: spouse caregivers. J Clin Oncol 25:4829–4834PubMedCrossRef
5.
go back to reference Caumo W, Schmidt AP, Schneider CN, Bergmann J, Iwamoto CW, Bandeira D, Ferreira MB (2001) Risk factors for preoperative anxiety in adults. Acta Anaesthesiol Scand 45:298–307PubMedCrossRef Caumo W, Schmidt AP, Schneider CN, Bergmann J, Iwamoto CW, Bandeira D, Ferreira MB (2001) Risk factors for preoperative anxiety in adults. Acta Anaesthesiol Scand 45:298–307PubMedCrossRef
7.
go back to reference Deimling GT, Kahana B, Bowman KF, Schaefer ML (2002) Cancer survivorship and psychological distress in later life. Psychooncol 11:479–494CrossRef Deimling GT, Kahana B, Bowman KF, Schaefer ML (2002) Cancer survivorship and psychological distress in later life. Psychooncol 11:479–494CrossRef
8.
go back to reference Derogatis LR, Morrow GR, Fetting J, Penman D, Piasetsky S, Schmale AM, Heinrichs M, Carnicke CL (1983) The prevalence of psychiatric disorders among cancer patients. J Clin Oncol 23:3588–3596 Derogatis LR, Morrow GR, Fetting J, Penman D, Piasetsky S, Schmale AM, Heinrichs M, Carnicke CL (1983) The prevalence of psychiatric disorders among cancer patients. J Clin Oncol 23:3588–3596
9.
go back to reference Dowrick C, Casey P, Dalgard O, Hosman C, Lehtinen V, Vazquez-Barquero JL, Wilkinson G (1998) Outcomes of depression international network (odin). Background, methods and field trials. Odin group. Br J Psychiatry 172:359–363PubMedCrossRef Dowrick C, Casey P, Dalgard O, Hosman C, Lehtinen V, Vazquez-Barquero JL, Wilkinson G (1998) Outcomes of depression international network (odin). Background, methods and field trials. Odin group. Br J Psychiatry 172:359–363PubMedCrossRef
10.
go back to reference Durling M, Milne D, Hutton N, Ryan S (2007) Decreasing patients’ preoperative anxiety: a literature review. Aust Nurs J 14(11):35PubMed Durling M, Milne D, Hutton N, Ryan S (2007) Decreasing patients’ preoperative anxiety: a literature review. Aust Nurs J 14(11):35PubMed
11.
go back to reference First MB, Spitzer RL, Gibbon M, Williams JBW (1996) Structured clinical interview for DSM-IV Axis I disorders—clinician version. American Psychiatric Press, New York First MB, Spitzer RL, Gibbon M, Williams JBW (1996) Structured clinical interview for DSM-IV Axis I disorders—clinician version. American Psychiatric Press, New York
12.
go back to reference Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental-state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198PubMedCrossRef Folstein MF, Folstein SE, McHugh PR (1975) “Mini-mental-state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198PubMedCrossRef
13.
go back to reference Grassi L, Mangelli L, Fava GA, Grandi S, Ottolini F, Porcelli P, Rafanelli C, Rigatelli M, Sonino N (2007) Psychsomatic characterization of adjustment disorders in the medical setting: some suggestions for dsm-v. J Affect Disord 101:251–254PubMedCrossRef Grassi L, Mangelli L, Fava GA, Grandi S, Ottolini F, Porcelli P, Rafanelli C, Rigatelli M, Sonino N (2007) Psychsomatic characterization of adjustment disorders in the medical setting: some suggestions for dsm-v. J Affect Disord 101:251–254PubMedCrossRef
14.
go back to reference Grassi L, Sabato S, Rossi E, Biancosino B, Marmai L (2005) Use of the diagnostic criteria for psychosomatic research in oncology. Psychother Psychosom 74:100–107PubMedCrossRef Grassi L, Sabato S, Rossi E, Biancosino B, Marmai L (2005) Use of the diagnostic criteria for psychosomatic research in oncology. Psychother Psychosom 74:100–107PubMedCrossRef
15.
go back to reference Gustafsson M, Edvardsson T, Ahlström G (2006) The relationship between function, quality of life and coping in patients with low-grade gliomas. Support Care Cancer 14:1205–1212PubMedCrossRef Gustafsson M, Edvardsson T, Ahlström G (2006) The relationship between function, quality of life and coping in patients with low-grade gliomas. Support Care Cancer 14:1205–1212PubMedCrossRef
16.
go back to reference Haddad P, Pitceathly C, Maguire P (1996) Psychlogical morbidity in the partners of cancer patients. Cancer and the family. Wiley, West Sussex Haddad P, Pitceathly C, Maguire P (1996) Psychlogical morbidity in the partners of cancer patients. Cancer and the family. Wiley, West Sussex
17.
go back to reference Hagedoorn M, Sanderman R, Bolks HN, Tuinstra J, Coyne JC (2008) Distress in couples coping with cancer: a meta-analysis and critical review of role and gender effects. Psychol Bull 134:1–30PubMedCrossRef Hagedoorn M, Sanderman R, Bolks HN, Tuinstra J, Coyne JC (2008) Distress in couples coping with cancer: a meta-analysis and critical review of role and gender effects. Psychol Bull 134:1–30PubMedCrossRef
18.
go back to reference Härter M, Reuter K, Aschenbrenner A, Schretzmann B, Marschner N, Hasenburg A, Weis J (2001) Psychiatric disorders and associated factors in cancer: results of an interview study with patients in inpatient, rehabilitation and outpatient treatment. Eur J Cancer 37:1385–1393PubMedCrossRef Härter M, Reuter K, Aschenbrenner A, Schretzmann B, Marschner N, Hasenburg A, Weis J (2001) Psychiatric disorders and associated factors in cancer: results of an interview study with patients in inpatient, rehabilitation and outpatient treatment. Eur J Cancer 37:1385–1393PubMedCrossRef
19.
go back to reference Herrmann-Lingen C, Buss U, Snaith RP (1995) HADS-D—hospital anxiety and depression scale—deutsche version: Ein fragebogen zur erfassung von angst und depressivität in der somatischen medizin Huber, Bern Herrmann-Lingen C, Buss U, Snaith RP (1995) HADS-D—hospital anxiety and depression scale—deutsche version: Ein fragebogen zur erfassung von angst und depressivität in der somatischen medizin Huber, Bern
20.
go back to reference Hodgkinson K, Butow P, Hunt GE, Wyse R, Hobbs KM, Wain G (2007) Life after cancer: couples’ and partners’ psychological adjustment and supportive care needs. Support Care Cancer 15:405–415PubMedCrossRef Hodgkinson K, Butow P, Hunt GE, Wyse R, Hobbs KM, Wain G (2007) Life after cancer: couples’ and partners’ psychological adjustment and supportive care needs. Support Care Cancer 15:405–415PubMedCrossRef
21.
go back to reference Holland JC (2002) History of psycho-oncology: overcoming attitudinal and conceptual barriers. Psychosom Med 64:206–221PubMed Holland JC (2002) History of psycho-oncology: overcoming attitudinal and conceptual barriers. Psychosom Med 64:206–221PubMed
22.
go back to reference Huber W, Poeck K, Weninger D, Willmes K (1983) Der aachener aphasie test (aat). Hogrefe, Göttingen Huber W, Poeck K, Weninger D, Willmes K (1983) Der aachener aphasie test (aat). Hogrefe, Göttingen
23.
go back to reference Janda M, Eakin E, Bailey L, Walker D, Troy K (2006) Supportive care needs of people with brain tumours and their carers. Support Care Cancer 14:1094–1103PubMedCrossRef Janda M, Eakin E, Bailey L, Walker D, Troy K (2006) Supportive care needs of people with brain tumours and their carers. Support Care Cancer 14:1094–1103PubMedCrossRef
24.
go back to reference Janda M, Steginga S, Langbecker D, Dunn J, Walker D, Eakin E (2007) Quality of life among patients with a brain tumour and their carers. J Psychosom Res 63:617–623PubMedCrossRef Janda M, Steginga S, Langbecker D, Dunn J, Walker D, Eakin E (2007) Quality of life among patients with a brain tumour and their carers. J Psychosom Res 63:617–623PubMedCrossRef
25.
go back to reference Kangas M, Henry JL, Bryant RA (2002) Posttraumatic stress disorder following cancer: a conceptual and empirical review. Clin Psychol Rev 22:499–524PubMedCrossRef Kangas M, Henry JL, Bryant RA (2002) Posttraumatic stress disorder following cancer: a conceptual and empirical review. Clin Psychol Rev 22:499–524PubMedCrossRef
26.
go back to reference Kangas M, Henry JL, Bryant RA (2005) The relationship between acute stress disorder and posttraumatic stress disorder following cancer. J Consult Clin Psychol 73:360–364PubMedCrossRef Kangas M, Henry JL, Bryant RA (2005) The relationship between acute stress disorder and posttraumatic stress disorder following cancer. J Consult Clin Psychol 73:360–364PubMedCrossRef
27.
go back to reference Keir ST, Calhoun-Eagan RD, Swartz JJ, Saleh OA, Friedman HS (2008) Screening for distress in patients with brain cancer using the NCCN’s rapid screening measure. Psychooncol 17:621–625CrossRef Keir ST, Calhoun-Eagan RD, Swartz JJ, Saleh OA, Friedman HS (2008) Screening for distress in patients with brain cancer using the NCCN’s rapid screening measure. Psychooncol 17:621–625CrossRef
28.
go back to reference Keir ST, Guill AB, Carter KE, Friedman HS (2006) Stress and intervention preferences of patients with brain tumors. Support Care Cancer 14:1213–1219PubMedCrossRef Keir ST, Guill AB, Carter KE, Friedman HS (2006) Stress and intervention preferences of patients with brain tumors. Support Care Cancer 14:1213–1219PubMedCrossRef
29.
go back to reference Keller M, Henrich G, Sellschopp A, Beutel M (1996) Between distress and support: spouses of cancer patients. Cancer and the family. Wiley, West Sussex Keller M, Henrich G, Sellschopp A, Beutel M (1996) Between distress and support: spouses of cancer patients. Cancer and the family. Wiley, West Sussex
30.
go back to reference Kvale EA, Murthy R, Taylor R, Lee JY, Nabors LB (2009) Distress and quality of life in primary high-grade brain tumor patients. Support Care Cancer 17:793–799PubMedCrossRef Kvale EA, Murthy R, Taylor R, Lee JY, Nabors LB (2009) Distress and quality of life in primary high-grade brain tumor patients. Support Care Cancer 17:793–799PubMedCrossRef
31.
go back to reference Maercker A, Schützwohl M (1998) Erfassung von psychischen belastungsfolgen: die impact of event skala—revidierte version (IES-R). Diagnostica 44:130–141 Maercker A, Schützwohl M (1998) Erfassung von psychischen belastungsfolgen: die impact of event skala—revidierte version (IES-R). Diagnostica 44:130–141
32.
go back to reference McGarvey EL, Canterbury RL, Koopman C, Clavet GJ, Cohen R, Largay K, Spiegler D (1998) Acute stress disorder following diagnosis of cancer. Int J Rehab Health 4:1–15CrossRef McGarvey EL, Canterbury RL, Koopman C, Clavet GJ, Cohen R, Largay K, Spiegler D (1998) Acute stress disorder following diagnosis of cancer. Int J Rehab Health 4:1–15CrossRef
33.
go back to reference Mehnert A, Koch U (2007) Prevalence of acute and posttraumatic stress disorder and comorbid mental disorders in breast cancer patients during primary cancer care: a prospective study. Psycho-Oncol 16:181–188CrossRef Mehnert A, Koch U (2007) Prevalence of acute and posttraumatic stress disorder and comorbid mental disorders in breast cancer patients during primary cancer care: a prospective study. Psycho-Oncol 16:181–188CrossRef
34.
go back to reference Mehnert A, Müller D, Lehmann C, Koch U (2006) Die deutsche version des nccn distress-thermometers—empirische prüfung eines screening-instruments zur erfassung psychosozialer belastungen bei krebspatienten. Z Psychiat Psychol Psychother 54:213–223CrossRef Mehnert A, Müller D, Lehmann C, Koch U (2006) Die deutsche version des nccn distress-thermometers—empirische prüfung eines screening-instruments zur erfassung psychosozialer belastungen bei krebspatienten. Z Psychiat Psychol Psychother 54:213–223CrossRef
35.
go back to reference Moerman N, van Dam FS, Muller MJ, Oosting H (1996) The amsterdam preoperative anxiety and information scale. Anesth Analg 82:445–451PubMed Moerman N, van Dam FS, Muller MJ, Oosting H (1996) The amsterdam preoperative anxiety and information scale. Anesth Analg 82:445–451PubMed
36.
go back to reference NCCN (2003) Distress management clinical practice guidelines. J Natl Compr Canc Netw 1:344–374 NCCN (2003) Distress management clinical practice guidelines. J Natl Compr Canc Netw 1:344–374
37.
go back to reference Newell SA, Sanson-Fisher RW, Savolainen NJ (2002) Systematic review of psychological therapies for cancer patients: overview and recommendations for future research. J Natl Cancer Inst 94:558–584PubMed Newell SA, Sanson-Fisher RW, Savolainen NJ (2002) Systematic review of psychological therapies for cancer patients: overview and recommendations for future research. J Natl Cancer Inst 94:558–584PubMed
38.
go back to reference Pace A, Metro G, Fabi A (2010) Supportive care in neurooncology. Curr Opin Oncol 11:S1531–1703X Pace A, Metro G, Fabi A (2010) Supportive care in neurooncology. Curr Opin Oncol 11:S1531–1703X
39.
go back to reference Palmer SC, Kagee A, Coyne JC, DeMichelle A (2004) Experience of trauma, distress, and posttraumatic stress disorder among breast cancer patients. Psychosom Med 66:258–264PubMedCrossRef Palmer SC, Kagee A, Coyne JC, DeMichelle A (2004) Experience of trauma, distress, and posttraumatic stress disorder among breast cancer patients. Psychosom Med 66:258–264PubMedCrossRef
40.
go back to reference Perks A, Chakravarti S, Manninen P (2009) Preoperative anxiety in neurosurgical patients. J Neurosurg Anesthesiol 21:127–130PubMedCrossRef Perks A, Chakravarti S, Manninen P (2009) Preoperative anxiety in neurosurgical patients. J Neurosurg Anesthesiol 21:127–130PubMedCrossRef
41.
go back to reference Pringle A-A, Taylor R, Whittle IR (1999) Anxiety and depression in patients with an intracranial neoplasm before and after tumour surgery. Br J Neurosurg 13:46–51PubMedCrossRef Pringle A-A, Taylor R, Whittle IR (1999) Anxiety and depression in patients with an intracranial neoplasm before and after tumour surgery. Br J Neurosurg 13:46–51PubMedCrossRef
42.
go back to reference Rooney A, Grant R (2010) Pharmacological treatment of depression in patients with a primary brain tumour. Cochrane Database Syst Rev 3:CD006932PubMed Rooney A, Grant R (2010) Pharmacological treatment of depression in patients with a primary brain tumour. Cochrane Database Syst Rev 3:CD006932PubMed
43.
go back to reference Ross S, Mosher CE, Ronis-Tobin V, Hermele S, Ostroff JS (2010) Psychosocial adjustment of family caregivers of head and neck cancer survivors. Support Care Cancer 18:171–178PubMedCrossRef Ross S, Mosher CE, Ronis-Tobin V, Hermele S, Ostroff JS (2010) Psychosocial adjustment of family caregivers of head and neck cancer survivors. Support Care Cancer 18:171–178PubMedCrossRef
44.
go back to reference Salander P (2010) Facilitating interventions and/or relationships in malignant brain tumors. Adv Ther 27:17–27PubMedCrossRef Salander P (2010) Facilitating interventions and/or relationships in malignant brain tumors. Adv Ther 27:17–27PubMedCrossRef
45.
go back to reference Semprini F, Fava GA, Sonino N (2010) The spectrum of adjustment disorders: too broad to be clinically helpful. CNS Spectr 15:382–388PubMed Semprini F, Fava GA, Sonino N (2010) The spectrum of adjustment disorders: too broad to be clinically helpful. CNS Spectr 15:382–388PubMed
46.
go back to reference Stark D, Kiely M, Smith A, Velikova G, House A, Selby PJ (2002) Anxiety disorders in cancer patients: their nature, associations, and relation to quality of life. J Clin Oncol 20:3137–3148PubMedCrossRef Stark D, Kiely M, Smith A, Velikova G, House A, Selby PJ (2002) Anxiety disorders in cancer patients: their nature, associations, and relation to quality of life. J Clin Oncol 20:3137–3148PubMedCrossRef
47.
go back to reference Trask PC (2004) Assessment of depression in cancer patients. J Natl Cancer Inst Monographs 32:80–92PubMedCrossRef Trask PC (2004) Assessment of depression in cancer patients. J Natl Cancer Inst Monographs 32:80–92PubMedCrossRef
48.
go back to reference Weiss DS, Marmar CR (1996) The impact of event scale—revised. In: Wilson JP, Keane TM (eds) Assessing psychological trauma and ptsd. Guildford Press, New York Weiss DS, Marmar CR (1996) The impact of event scale—revised. In: Wilson JP, Keane TM (eds) Assessing psychological trauma and ptsd. Guildford Press, New York
49.
go back to reference Wittchen HU, Zaudig M, Fydrich T (1997) Skid. Strukturiertes interview für dsm iv. Achse i und ii. Handanweisung. Hogrefe, Göttingen Wittchen HU, Zaudig M, Fydrich T (1997) Skid. Strukturiertes interview für dsm iv. Achse i und ii. Handanweisung. Hogrefe, Göttingen
50.
go back to reference Zabora JR, BrintzenhofeSzoc KM, Curbow B, Hooker C, Piantadosi S (2001) The prevalence of psychological distress by cancer site. Psycho-Oncol 10:19–28CrossRef Zabora JR, BrintzenhofeSzoc KM, Curbow B, Hooker C, Piantadosi S (2001) The prevalence of psychological distress by cancer site. Psycho-Oncol 10:19–28CrossRef
51.
go back to reference Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370PubMedCrossRef Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370PubMedCrossRef
Metadata
Title
Comorbid mental disorders and psychosocial distress in patients with brain tumours and their spouses in the early treatment phase
Authors
Simone Goebel
Myrna von Harscher
H. Maximilian Mehdorn
Publication date
01-11-2011
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 11/2011
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-010-1021-8

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