title: Psychological distress after cancer cure: a survey of 459 Hodgkin's disease survivors.
abstract: To assess the levels of psychological distress and identify predictors of anxiety/depression caseness after cancer cure, a national population of 557 Hodgkin's disease (HD) survivors was surveyed. The respondents [204 women, 255 men, mean age 44 years (SD = 12)] returned a mailed questionnaire including The Hospital Anxiety and Depression Scale (HADS). Disease and treatment variables were based on the hospital records. A total of 27% had caseness scores (anxiety, 14.5%; depression, 4%; anxiety and depression, 8.5%). In a multiple logistic regression analysis, anxiety caseness was predicted by low educational status [OR (odds ratio) = 2.07, 95% CI = 1.02-4.22], observational period 7 years or longer (7-10 years: OR = 3.07, 95% CI = 1.26-7.47), combined irradiation and chemotherapy treatment (OR = 2.77, 95% CI = 1.17-6.54) and psychiatric symptoms before HD (OR = 2.55, 95% CI = 1.40-4.65) or during treatment (OR = 3.51, 95% CI = 2.08-5.90). Depression caseness was predicted by age (OR = 1.03, 95% CI = 1.00-1.06) and psychiatric symptoms before HD (OR = 5.1, 95% CI = 2.55-10.31) Anxiety cases are more prevalent than in the general Norwegian population, and were found to be most common 7-10 years after treatment. The most intensive treatment was associated with increased risk for anxiety caseness. The subjects experienced distress during treatment precedes difficulties in long-term adjustment. Focusing on these predictors during treatment and follow-up controls may improve long-term outcome.
authors.affiliation: Department of Behavioural Sciences in Medicine, University of Oslo, Norway.
authors.forename: J H
authors.initials: JH
authors.lastname: Loge
authors.forename: A F
authors.initials: AF
authors.lastname: Abrahamsen
authors.forename: O
authors.initials: O
authors.lastname: Ekeberg
authors.forename: E
authors.initials: E
authors.lastname: Hannisdal
authors.forename: S
authors.initials: S
authors.lastname: Kaasa
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology; D003625:Data Collection; D005260:Female; D005500:Follow-Up Studies; D006689:Hodgkin Disease / Q000523:psychology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires