Anette Brechtel

Depression, anxiety and disease-related distress in couples affected by advanced lung cancer.

OBJECTIVES Lung cancer patients and their partners are prone to high levels of depression and anxiety or severe distress related to the poor prognosis of the illness. However, there remain doubts regarding the extent to which this distress exceeds levels in the general population. This study explored levels of depression and generalized anxiety for comparison with matched data of a representative sample from the general population. Additionally, covariance of distress between the two partners, together with disease-specific components and differences were investigated. MATERIALS AND METHODS In a cross-sectional survey, 54 pairs of lung cancer patients and their partners (n=108) were assessed for depression and anxiety, cancer-related distress, unmet needs and disclosure in communication. Comparisons between distress levels of participating couples and matched community-comparisons (n=162) were conducted. Additionally, multilevel analysis for estimating intra-dyadic associations of anxiety and depression was computed. Components of distress, needs and aspects of communication were explored via item mean values. RESULTS Lung cancer patients as well as their partners exhibited significantly higher levels of depression and anxiety when compared to community-based comparison subjects (patients: mean difference of 1.01 for depression with a relative risk (RR) of 4.5 and 0.84 for anxiety with RR=6.1; partners: 1.17 for depression with RR=4.6 and 1.59 for anxiety with RR=7.6). Partial intraclass correlations between patients and partners were weak (PIC=.29 for depression; PIC=.21 for anxiety). Fear of progression emerged as main component of distress for both patients and partners, although differing stressors were described. CONCLUSION Lung cancer-affected couples exhibit levels of depression and anxiety far exceeding those of the general community. In clinical practice, patients and partners should be assessed separately for distress against the background of weak intra-dyadic associations. In cases of significant depression or anxiety, referral for psychosocial treatment is indicated and has been shown to improve quality of life.

Psychosocial support in patients with multiple myeloma at time of diagnosis: who wants what?

The aim of this study was to examine interest in psychosocial interventions among patients with multiple myeloma at time of diagnosis as well as associated factors.

Quality of life after restorative proctocolectomy and ileal pouch–anal anastomosis in patients with familial adenomatous polyposis: a matter of adjustment

Aim  Favourable outcomes for health‐related quality of life (HRQL) have been reported in patients with familial adenomatous polyposis (FAP) after restorative proctocolectomy and ileal pouch–anal anastomosis (RPC). However, less is known about patients’ subjective experience and adjustment to postoperative impairment. Using a multidimensional psychometric assessment, we investigated patient‐reported HRQL to determine the impact of the patient’s subjective experience together with medical, functional and psychosocial factors on HRQL.