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Supportive Care in Cancer
Published in: Supportive Care in Cancer 12/2004

01-12-2004 | Original Article

Depressive symptom patterns and their consequences for diagnosis of affective disorders in cancer patients

Authors: Katrin Reuter, Simone Raugust, Jürgen Bengel, Martin Härter

Published in: Supportive Care in Cancer | Issue 12/2004

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Abstract

Goals of work

In order to obtain references for adequate diagnostic procedures of depressive syndromes in cancer patients, the present study analyzes first the prevalence of somatic, emotional, and cognitive symptoms of depression. In a second part, the ability of diagnostic procedures to discriminate between patients with and without comorbid affective disorder is investigated.

Patients and methods

From a cross-sectional survey investigating comorbid mental disorders in cancer patients with standardized clinical assessment, a subsample of 71 patients with current affective disorders and depressive symptoms according to the Diagnostic and Statistic Manual of Mental Disorders, 4th edition (DSM-IV) were analyzed. In addition to patients’ symptom patterns, a discriminant analysis including all depressive symptoms was conducted.

Main results

Cognitive symptoms are less prevalent in cancer patients than somatic and emotional symptoms. Loss of interest discriminated best between patients with and without diagnosis of comorbid affective disorder. Additionally, decreased energy and fatigue proved to have discriminatory value.

Conclusions

Cognitive symptoms should receive special attention in diagnostic procedures for affective disorders in cancer patients. In spite of possible symptom overlap with the cancer disease and its treatment, fatigue proves to be a useful criteria for diagnosis of depression.
Literature
1.
Akechi T, Nakano T, Akizuki N, Okamura M, Sakuma K, et al (2003) Somatic symptoms for diagnosing major depression in cancer patients. Psychosomatics 44:244–248CrossRefPubMed
2.
American Psychiatric Association (1994) Diagnostic and statistic manual of mental disorders, 4th edn. American Psychiatric Press, Washington, D.C.
3.
Angelino AF, Treisman GJ (2001) Major depression and demoralization in cancer patients: diagnostic and treatment considerations. Support Care Cancer 9:344–9CrossRefPubMed
4.
Antoni MH, Lehman JM, Kilbourn KM, Boyers AE, Culver JL, et al (2001) Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychol 20(1):20–32CrossRefPubMed
5.
Beliles K, Stoudemire A (1998) Psychopharmacologic treatment of depression in the medically ill. Psychosomatics 39:S2–S19PubMed
6.
Berney A, Stiefel F, Mazzocato C, Buclin T (2000) Psychopharmacology in supportive care of cancer: a review for the clinician. III. Antidepressants Support Care Cancer 8:278–286
7.
Berrios GE, Samuel C (1987) Affective disorders in the neurological patient. J Nerv Ment Dis 175:173–176PubMed
8.
Bottomley A (1998) Depression in cancer patients: a literature review. Eur J Cancer 7:181–191CrossRef
9.
Breitbart W (1995) Identifying patients at risk for, and treatment of major psychiatric complications of cancer. Support Care Cancer 3:45–60PubMed
10.
Bukberg J, Penman D, Holland JC (1984) Depression in hospitalized cancer patients. Psychosom Med 45:199–212
11.
Carlson LE; Bultz BD (2003) Cancer distress screening. Needs, models and methods. J Psychosom Res 55:403–409CrossRefPubMed
12.
Chochinov HM, Wilson KG, Enns M, Lander S (1994) Prevalence of depression in the terminally ill: effects of diagnostic criteria and symptom threshold judgements. Am J Psychiatry 151:537–540PubMed
13.
Chochinov HM, Wilson KG, Enns M, Lander S (1997) “Are you depressed?” Screening for depression in the terminally ill. Am J Psychiatry 154:674–676PubMed
14.
Clark DC, Cavanaugh S, Gibbons RD (1983) The core symptoms of depression in medical and psychiatric patients. J Nerv Ment Dis 171:705–713PubMed
15.
Classen C, Butler LD, Koopman C, Miller E, DiMiceli S, et al (2001) Supportive-expressive group therapy and distress in patients with metastatic breast cancer: a randomized clinical intervention trial. Arch Gen Psychiatry 58:494–501
16.
Cohen-Cole SA, Brown RW, McDaniel S (1993) Assessment of depression and grief reactions in the medically ill. In: Stoudemire A, Fogel BS (eds) Psychiatric care of the medical patient. Oxford University Press, New York, pp 53–69
17.
Creed F (1997) Assessing depression in the context of physical illness. In: Robertson MM, Katona CLE (eds) Depression and physical illness. John Wiley & Sons, Chichester, pp 3–19
18.
De Florio LM, Massie MJ (1995) Review of depression in cancer: gender differences. Depression 3:66–80
19.
Endicott J (1984) Measurement of depression in patients with cancer. Cancer 53:2241–2248
20.
Erdal KJ (2001) Depressive symptom patterns in patients with parkinson’s disease and other older adults. J Clin Psychol 57:1559–1569CrossRefPubMed
21.
Fedoroff JP, Starkstein SE, Parikh RM, Price TR, Robinson RG (1991) Are depressive symptoms non-specific in patients with acute stroke? Am J Psychiatry 148:1172–1176PubMed
22.
Freedland KE, Lustmann PJ, Carney RM, Hong BA (1992) Underdiagnosis of depression in patients with coronary artery disease: the role of non-specific symptoms. Int J Psychiat Med 22:221–229
23.
Goodwin PJ, Leszcz M, Ennis M, Koopmans J, Vincent L, et al (2001) The effect of group psychosocial support on survival in metastatic breast cancer. N Engl J Med 345:1719–1726CrossRefPubMed
24.
Grimm LG, Yarnold PR (2000) Reading and understanding more multivariate statistics. American Psychological Association, Washington
25.
Härter M, Reuter K, Aschenbrenner A, Schretzmann B, Marschner N, et al (2001) Psychiatric disorders and associated factors in cancer: results of an interview study with patients in inpatient, rehabilitation and outpatient treatment. Eur J Cancer 37:1385–1393CrossRefPubMed
26.
Hawton K, Mayou R, Feldman E (1990) Significance of psychiatric symptoms in general medical patients with mood disorders. Gen Hosp Psychiatry 12:296–302CrossRefPubMed
27.
Hoogendijk WJG, Sommer IEC, Tissingh G, Deeg DJH, Wolters EC (1998) Depression in Parkinson’s disease: the impact of symptom overlap on prevalence. Psychosomatics 39:416–421PubMed
28.
Keller MB, Hanks DL, Klein DN (1996) Summary of the DSM-IV mood disorder field trial and issue overview. Psychiatr Clin North Am 19:1–28PubMed
29.
Kessler RC, McGonagle KA, Zhao S, Nelson CB, Hughes M, et al (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Arch Gen Psychiatry 51:8–19PubMed
30.
Klecka WR (1993) Discriminant analysis. Sage, Newbury Park
31.
Koenig HG, George LK, Peterson BL, Pieper CF (1997) Depression in medically ill hospitalized older adults: prevalence, characteristics, and course of symptoms according to six diagnostic schemes. Am J Psychiatry 154:1376–1383PubMed
32.
Koenig HG, Cohen HJ, Blazer DG, Krishnan KRR, Sibert TE (1993) Profile of depressive symptoms in younger and older medical inpatients with major depression. J Am Geriatr Soc 41:1169–1176PubMed
33.
Massie MJ, Holland JC (1989) Overview of normal reactions and prevalence of psychiatric disorders. In: Holland JC, Rowland JH (eds) Handbook of psycho-oncology: Psychological care of the patient with cancer. Oxford University Press, New York, pp 273–282
34.
McDaniel S, Musselmann DL, Porter MP, Reed DA, Nemeroff CB (1995) Depression in patients with cancer: diagnosis, biology, and treatment. Arch Gen Psychiatry 52:89–99PubMed
35.
Moffic HS, Paykel ES (1975) Depression in medical in-patients. Brit J Psychiatry 126:346–353
36.
Noyes R, Holt CS, Massie MJ (1998) Anxiety disorders. In: Holland JC (ed) Psycho-oncology. New York University Press, New York, pp 548–563
37.
Plumb MM, Holland JC (1977) Comparative studies of psychological function in patients with advanced cancer: I. self-reported depressive symptoms. Psychosom Med 39:264–276PubMed
38.
Raison CL, Miller AH (2003) Depression in cancer: new developments regarding diagnosis and treatment. Biol Psychiatry 54:283–94CrossRefPubMed
39.
Rapp SR, Vrana S (1989) Substituting nonsomatic for somatic symptoms in the diagnosis of depression in elderly male medical patients. Am J Psychiatry 146:1197–1200PubMed
40.
Reuter K, Härter M (2001) Screening for mental disorders in cancer patients—discriminant validity of HADS and GHQ-12 assessed by standardized clinical interview. Int J Meth Psych Res 10:86–96
41.
Reuter K, Woll S, Stadelmann S, Bengel J, Härter M (2002) Recognition and treatment of psychological burden and mental disorders in the orthopedic rehabilitation. (German: “Erkennen und Behandeln psychischer Belastungen und Störungen in der orthopädischen Rehabilitation”). Z Klin Psychol Psychother 3:313–327
42.
Sellick SM, Crooks DL (1999) Depression and cancer: an appraisal of the literature for prevalence, detection, and practice guideline development for psychological interventions. Psychooncology 8:315–333CrossRefPubMed
43.
Sharpe M, Strong V, Allen K, Rush R, Postma K, et al (2004) Major depression in outpatients attending a regional cancer centre: screening and unmet treatment needs. Br J Cancer 90(2):314–320CrossRefPubMed
44.
Silverstone PH (1996) Prevalence of psychiatric disorders in medical inpatients. J Nerv Ment Dis 184:43–51CrossRefPubMed
45.
Spiegel D (1996) Cancer and depression. Br J Psychiatry 168:109–116
46.
Spiegel D, Giese-Davis J (2003) Depression and Cancer: Mechanisms and Disease progression. Biol Psychiatry 54:269–282CrossRefPubMed
47.
Stiefel L, Di Trill M, Berney A, Nunez Olarte JM, Razavi D (2001) Depression in palliative care: a pragmatic report from the expert working group of the European Association for Palliative Care. Support Care Cancer 9:477–488CrossRefPubMed
48.
Swanwick GR, Wrigley M (1998) Screening for depression in elderly patients (comment). Am J Psych 155(7):994–995
49.
Van Hemert AM, Hawton K, Bolk JH, Fagg J (1993) Key symptoms in the detection of affective disorders in medical patients. J Psychosom Res 37:397–404CrossRefPubMed
50.
Van’t Spijker A, Trijsberg RW, Duivenvoorden HJ (1997) Psychological sequelae of cancer diagnosis: a meta-analytical review of 59 Studies after 1980. Psychosom Med 59:280–293PubMed
51.
Wilson KG, Mikail SF, D’Eon SF, Minns JE (2001) Alternative diagnostic criteria for major depressive disorder in patients with chronic pain. Pain 91:227–234CrossRefPubMed
52.
Wittchen HU (1994) Reliability and validity studies of the WHO-Composite International Diagnostic Interview (CIDI): a critical review. J Psychiatr Res 28:57–84CrossRefPubMed
53.
Wittchen HU, Weigel A, Pfister H, Perkonnig A (1997) DIA-X-Interview. Swets Test Services Deutschland, Frankfurt
54.
Wittchen HU, Lachner G, Wunderlich U, Pfister H (1998) Test-retest reliability of the computerized DSM-IV version of the Munich-Composite International Diagnostic Interview (M-CIDI). Soc Psychiatry Psychiatr Epidemiol 33:568–578CrossRefPubMed
Metadata
Title
Depressive symptom patterns and their consequences for diagnosis of affective disorders in cancer patients
Authors
Katrin Reuter
Simone Raugust
Jürgen Bengel
Martin Härter
Publication date
01-12-2004
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 12/2004
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-004-0694-2

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