Cognitive function in long-term lymphoma survivors: relationship between subjective reports and objective assessments and with quality of life.

Cognitive functioning plays a fundamental role in people's life and quality of life (QoL), and anti-cancer chemotherapy may provoke long-lasting cognitive problems. This study investigated the subjective perception of cognitive functioning in long-term lynfoma survivors and its associations with objectively assessed cognitive functioning and QoL. 198 long-term lynfoma survivors were administered the Cognitive Functioning Self-Assessment Scale (CFSS), the Esame Neuropsicologico Breve 2 (ENB2) and the Short Form 36 Health Survey Questionnaire (SF-36). Subjectively reported cognitive functioning was worse than the norm for the general population (p<0.001). Difficulty in recalling recent information (22%), using of periphrases or generic terms (16.7%) and tip-of-the-tongue phenomena (14.7%) were the cognitive difficulties most frequently reported. CFSS overall score correlated positively with the number of impaired performances (p<0.001) and borderline performances (p=0.014) on the ENB2. Both subjectively and objectively assessed cognitive measures correlated negatively with most assessed QoL domains, indicating that QoL is worse when cognitive functioning is poor. Subjective concerns about one's own cognitive functioning are a reality for long-term lynphoma survivors, who experience these worries more than the general population does. Since improving QoL is a priority in oncology, this study supports the use of interventions to improve cognitive functioning in cancer survivors.

Quality of life and psychological distress during cancer: a prospective observational study involving young breast cancer female patients.

BACKGROUND: Despite the possible traumatic significance of cancer and of the incidence, prevalence, and survival of young women with breast cancer, these patients are underrepresented in multidimensional research. In the present survey, QoL and psychological distress were studied in a sample of young female breast cancer patients during the first year of their disease. More in detail, the study was firstly aimed to assess if QoL of 18-45 years old female breast cancer patients was different from QoL of women from the general population and if it changed over time. Secondly, it described the psychological distress and its change over time. Finally, it assessed if QoL registered 1 year post-surgery may be explained by QoL and/or psychological distress registered during the hospitalization. METHODS: One hundred six, consecutive 18-45 years old, female primary breast cancer patients undergoing anticancer surgery filled out the Short Form 36 Health Survey Questionnaire, the Hospital Anxiety and Depression Scale and a socio-demographic and clinical form during hospitalization to receive surgery (T0), and again at 12 months post-surgery (T1). RESULTS: At T0, participants showed a better physical functioning (p = 0.001) than the female normative sample, whereas their mental functioning was worse (p < 0.001). In this time, mental functioning within our sample was weaker than physical functioning (p < 0.001). Over time, physical functioning decreased (p < 0.001), whereas mental functioning increased (p < 0.001). Both at T0 and T1, anxiety was higher than depression (p < 0.05). Both distress dimensions decreased over time (p < 0.001). Nevertheless, at T0 the 25.5 and 26.4% of the sample were respectively possible and probable cases of anxiety, whereas the 17.9 and 9.4% were possible and probable cases of depression. At T1, the percentages were 17.9 and 18.9% for anxiety, and 8.5 and 6.6% for depression. In both considered times, a better QoL corresponded to less psychological distress. However, QoL and psychological distress assessed at T0 did not predict the QoL at T1. CONCLUSIONS: This study documented as QoL and psychological distress may change during the first year after surgery for a primary breast cancer in young women; therefore, they should be monitored over time to detect and treat women with alarming levels on them.

Hospital Anxiety and Depression Scale (HADS) accuracy in cancer patients.

PURPOSE: The Hospital Anxiety and Depression Scale (HADS) is a self-report questionnaire designed to screen anxious and depressive states in patients in non-psychiatric settings. In spite of its large use, no agreement exists in literature on HADS accuracy in case finding. The present research addresses the issue of HADS accuracy in cancer patients, comparing its two subscales (HADS-A and HADS-D) against tools not in use in psychiatry, which are able to detect prolonged negative emotional states. METHODS: 2121 consecutive adult cancer inpatients were administered the HADS together with the State Anxiety subscale of State-Trait Anxiety Inventory and the Center for Epidemiologic Studies Scale on Depression. Receiver operating characteristic (ROC) curves were computed to identify a cut-off for anxious and depressive states in cancer patients. All indicators were computed together with their corresponding 95% confidence interval (95% CI). RESULTS: Data of 1628 and 1035 participants were used to assess the accuracy in case finding of HADS-A and HADS-D, respectively. According to the ROC analysis, the optimal cut-off was > 9 units for the HADS-A and > 7 units for the HADS-D. The area under the ROC curve was 0.90 for HADS-A (95% CI 0.88-0.91) and 0.84 for HADS-D (95% CI 0.81-0.86). CONCLUSIONS: This study suggested that risk scores of anxious and depressive states above specific HADS cut-offs are useful in identifying anxious and depressive states in cancer patients, and they may thus be applicable in clinical practice.

A contribution to the validation of the Italian version of the Body Image Scale (BIS).

BACKGROUND: The Body Image Scale (BIS) is a 10-item mono-factorial scale, designed to capture distress and symptoms related to body image in cancer patients. This paper describes the conversion and psychometric evaluation of an Italian BIS version. METHODS: After the back-translation procedure, the Italian version of the BIS, together with the Hospital Anxiety and Depression Scale and the Short Form 36 Health Survey Questionnaire, have been administered to a sample of Italian adult females, surgically treated for a breast cancer at least one year before. RESULTS: Data on 109 participants were analyzed. The response rate was 92.5%. Response prevalence was adequate for 9 out of 10 items. Principal component analysis showed a one-factor structure. Internal consistency (Cronbach's alpha =0.924) was good. The BIS correlated with the theoretically pertinent subscales of the other administered tools and was able to discriminate participants (discriminant validity) according to the undertaken surgical treatment (p = 0.031). CONCLUSIONS: This study supports the valid and reliable use also of the Italian version of the BIS.

Intensity and Prevalence of Psychological Distress in Cancer Inpatients: Cross-Sectional Study Using New Case-Finding Criteria for the Hospital Anxiety and Depression Scale.

Psychological distress includes all negative subjective experiences elicited by a disease and its treatments. Since psychological distress in oncology is associated with negative outcomes, its detection and description are helpful for designing tailored supportive interventions. This study used the Hospital Anxiety and Depression Scale (HADS) to assess the intensity and prevalence of psychological distress (i.e., anxiety and depression) in cancer inpatients and examined the relationships between these variables and sociodemographic and clinical factors. An existing dataset of HADS results, from 2021 consecutive adult cancer inpatients at a single hospital, was analyzed. Only those questionnaires with complete responses were used. The intensity of anxiety and depression was determined from HADS sub-scores. The prevalence of anxiety and depression was calculated using, as case-finding criteria, cut-offs of ≥ 10 and ≥ 8, respectively. The mean HADS scores describing intensity were 7.3 for anxiety (n = 1,990) and 5.8 (n = 1,970) for depression. The prevalence rates for anxiety and depression were 26.6 and 28.6%, respectively. Among the 1,916 patients who completed both subscales, 17.2% had both anxiety and depression, 21.0% had either anxiety or depression, and 61.7% had neither. Gender, age, occupational status, and cancer diagnosis were associated with anxiety intensity or prevalence, while age, occupational status, and cancer diagnosis were associated with depression intensity or prevalence. Anxiety intensity was affected by the interaction effect between gender and diagnosis. Our study showed anxiety and depression being distinct entities, with more intense anxiety overall. From a research perspective, it reaffirms the usefulness for assessing both intensity and prevalence concurrently to gain a more detailed description of anxiety and depression.