Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Digestive Diseases and Sciences
Published in: Digestive Diseases and Sciences 1/2016

01-01-2016 | Original Article

Sense of Coherence and Defense Style Predict Sleep Difficulties in Early Non-metastatic Colorectal Cancer

Authors: Thomas Hyphantis, Panagiota Goulia, Ioannis Zerdes, Solomis Solomou, Elias Andreoulakis, André F. Carvalho, Nicholas Pavlidis

Published in: Digestive Diseases and Sciences | Issue 1/2016

Login to get access

Abstract

Background

Sleep disturbances are common in cancer patients, but little is known about the complex interplay between the background psychological profile, coping with health stressors capacities and psychological distress in the formation of sleep difficulties in colorectal cancer.

Aims

To study the course and to identify psychological predictors of sleep difficulties in early non-metastatic colorectal cancer patients over a one-year period.

Methods

In this 1-year prospective study, we assessed in 84 early non-metastatic colorectal cancer patients the association of psychological distress (SCL-90-R), sense of coherence (SOC-29), and defense styles (Defense Style Questionnaire) with sleep difficulties (SCL-90-R) in multiple regression models. Eighty-two patients with breast cancer and 50 patients with cancer of unknown primary site served as disease controls, and 84 matched for age and sex alleged healthy individuals served as healthy controls.

Results

Colorectal cancer patients presented more sleep difficulties compared to healthy participants but fewer than patients with breast cancer and cancer of unknown primary site. Colorectal cancer patients’ trouble falling asleep (p = 0.033) and wakening up early in the morning (p < 0.001) deteriorated over time. Sleep that was restless or disturbed was independently associated with low SOC (p = 0.046) and maladaptive defenses (p = 0.008). Anxiety symptoms (p < 0.001) predicted deterioration in trouble falling asleep, while depressive symptoms (p = 0.022) and self-sacrificing defense style (p = 0.049) predicted deterioration in wakening up early in the morning.

Conclusions

Psychological parameters and coping with health stressors capacities are independently associated with sleep difficulties in colorectal cancer patients, indicating the need for psychological interventions aiming at improving adjustment to the disease.
Literature
1.
2.
Garland SN, Johnson JA, Savard J, et al. Sleeping well with cancer: a systematic review of cognitive behavioral therapy for insomnia in cancer patients. Neuropsychiatr Dis Treatment. 2014;10:1113–1124. doi:10.​2147/​NDT.​S47790.
3.
4.
5.
Clevenger L, Schrepf A, Degeest K, et al. Sleep disturbance, distress, and quality of life in ovarian cancer patients during the first year after diagnosis. Cancer. 2013;1(119):3234–3241. doi:10.​1002/​cncr.CrossRef
6.
7.
8.
Davidson JR, MacLean AW, Brundage MD, et al. Sleep disturbance in cancer patients. Soc Sci Med. 2002;54:1309–1321.PubMedCrossRef
9.
Flynn KE, Shelby RA, Mitchell SA, et al. Sleep-wake functioning along the cancer continuum: focus group results from the Patient-Reported Outcomes Measurement Information System (PROMIS(®)). Psychooncology. 2010;19:1086–1093. doi:10.​1002/​pon.​1664.PubMedCrossRefPubMedCentral
10.
Antonovsky A. Unraveling the Mystery of Health. How People Manage Stress and Stay Well. 1st Ed. San Francisco: Jossey-Bass Inc, 1987.
11.
Eriksson M, Lindström B. Antonovsky’s sense of coherence scale and its relation with quality of life: a systematic review. J Epidemiol Commun Health. 2007;61:938–944.CrossRef
12.
American Psychiatric Association Diagnostic and Statistical. Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Press; 2004.
13.
Malone JC, Cohen S, Liu SR, et al. Adaptive midlife defense mechanisms and late-life health. Personal Individ Differ. 2013;55:85–89.CrossRef
14.
Beresford TP, Alfers J, Mangum L, et al. Cancer survival probability as a function of ego defense (adaptive) mechanisms versus depressive symptoms. Psychosomatics.. 2006;47:247–253.PubMedCrossRef
15.
American Joint Committee on Cancer. Colon and Rectum. In Greene FL, Page DL, Fleming ID, Fritz A, Balch CM, Haller DG, Morrow M, eds. 6th Ed. American Joint Committee on Cancer: AJCC Staging Manual Philadelphia: Lippincott- Raven Publishers, 2002.
16.
Hyphantis T, Almyroudi A, Paika V, et al. Anxiety, depression and defense mechanisms associated with treatment decisional preferences and quality of life in non-metastatic breast cancer: a 1-year prospective study. Psychooncology.. 2013;22(11):2470–2477.PubMedCrossRef
17.
Hyphantis T, Papadimitriou I, Petrakis D, et al. Psychiatric manifestations, personality traits and health-related quality of life in cancer of unknown primary site. Psychooncology.. 2013;22(9):2009–2015.PubMedCrossRef
18.
19.
Donias S, Karastergiou A, Manos N. Standardization of the symptom checklist-90-Rating scale in a Greek population (in Greek with English abstract). Psychiatrike.. 1991;2:42–48.
20.
Derogatis LR, Morrow GR, Fetting J, et al. The prevalence of psychiatric disorders among cancer patients. JAMA. 1983;249:751–757.PubMedCrossRef
21.
Bond M. An empirical study of defense styles: the defense style questionnaire. Ego mechanisms of defense: a guide for clinicians and researchers. In Vaillant GE, ed. Washington DC: American Psychiatric 1992; p. 137.
22.
Karalis I, Langius A, Tsirogianni M, et al. The translation-validation of the sense of coherence scale into Greek and its use in primary health care. Arch Hell Med.. 2004;21:195–203.
23.
Miles J, Shevlin M. Applying Regression and Correlation. London: Sage Publications; 2003:126–132.
24.
Little RJ, Rubin DB. Statistical Analysis with Missing Data. New York: Wiley Interscience Pub; 1987.
25.
Hyphantis T, Paika V, Almyroudi A, et al. Personality variables as predictors of early non-metastatic colorectal cancer patients’ psychological distress and health-related quality of life: a one-year prospective study. J Psychosom Res. 2011;70(5):411–421. doi:10.​1016/​j.​jpsychores.​2010.​09.​011.PubMedCrossRef
26.
Lemasters T, Madhavan S, Sambamoorthi U, et al. A population-based study comparing HRQoL among breast, prostate, and colorectal cancer survivors to propensity score matched controls, by cancer type, and gender. Psychooncology. 2013. doi:10.​1002/​pon.​3288.PubMed
27.
Katz DA, McHorney CA. Clinical correlates of insomnia in patients with chronic illness. Arch Intern Med. 1998;158(10):1099–1107.PubMedCrossRef
28.
29.
30.
31.
Kaneita Y, Ohida T, Uchiyama M, et al. The relationship between depression and sleep disturbances: a Japanese nationwide general population survey. J Clin Psychiatry. 2006;67:196–203.PubMedCrossRef
32.
Caap-Ahlgren M, Dehlin O. Sense of coherence is a sensitive measure for changes in subjects with Parkinson’s disease during 1 year. Scand J Caring Sci. 2004;18:154–159.PubMedCrossRef
33.
Bäärnhielm S. Restructuring illness meaning through the clinical encounter: a process of disruption and coherence. Cult Med Psychiatry. 2004;28:41–65.PubMedCrossRef
34.
35.
Bond M, Perry JC. Long-term changes in defense styles with psychodynamic psychotherapy for depressive, anxiety, and personality disorders. Am J Psychiatry. 2004;161:1665–1671.PubMedCrossRef
36.
Perry JC, Bond M. Change in defense mechanisms during long-term dynamic psychotherapy and five-year outcome. Am J Psychiatry. 2012;169:916–925.PubMedCrossRef
37.
38.
Edinger JD, Stout AL, Hoelscher TJ. Cluster analysis of insomniacs’ MMPI profiles: relation of subtypes to sleep history and treatment outcome. Psychosom Med. 1988;50:77–87.PubMedCrossRef
39.
Horowitz LM, Alden LE, Wiggins JS, et al. The inventory of interpersonal problems (IIP). San Antonio, TX: Psychological Corporation; 2000.
40.
Repetti RL, Taylor SE, Seeman TE. Risky families: family social environments and the mental and physical health of offspring. Psychol Bull. 2002;128:230–266.CrossRef
41.
Lane JD, McCaskill CC, Williams PG, et al. Personality correlates of glycemic control in type 2 diabetes. Diabetes Care. 2000;23:1321–1325.PubMedCrossRef
42.
Manber R, Blasey C, Arnow B. Assessing insomnia severity in depression: comparison of depression rating scales and sleeps diaries. J Psychiatr Res. 2005;39(5):481–488.PubMedCrossRef
43.
Boelen PA, Lancee J. Sleep difficulties are correlated with emotional problems following loss and residual symptoms of effective prolonged grief disorder treatment. Depress Res Treat. 2013;2013:739804.PubMedPubMedCentral
Metadata
Title
Sense of Coherence and Defense Style Predict Sleep Difficulties in Early Non-metastatic Colorectal Cancer
Authors
Thomas Hyphantis
Panagiota Goulia
Ioannis Zerdes
Solomis Solomou
Elias Andreoulakis
André F. Carvalho
Nicholas Pavlidis
Publication date
01-01-2016
Publisher
Springer US
Published in
Digestive Diseases and Sciences / Issue 1/2016
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-015-3843-1

Other articles of this Issue 1/2016

Digestive Diseases and Sciences 1/2016 Go to the issue

Original Article

Outcomes of Next-Day Versus Non-next-Day Colonoscopy After an Initial Inadequate Bowel Preparation

Editorial

Prevention of NSAID-Enteropathy: A Soluble Problem?

Editorial

Microwave Ablation for the Treatment of Hypersplenism: Short Waves, Low Cost, Big Results

Original Article

Cortactin Mediates Apoptosis of Gastric Epithelial Cells Induced by VacA Protein of Helicobacter pylori

UNM Clinical Case Conferences

Obscure Occult GI Bleeding: An Iatrogenic Tale?

Original Article

An Increased Serum N-Terminal Telopeptide of Type I Collagen, a Biochemical Marker of Increased Bone Resorption, Is Associated with Infliximab Therapy in Patients with Crohn’s Disease
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits