title: The course of anxiety and depression during the first year after allogeneic or autologous stem cell transplantation.
abstract: Psychological distress is frequently reported in transplant survivors. We prospectively assessed anxiety and depression before transplant, in the isolation period and during a follow-up period of 1 year. The Hospital Anxiety and Depression Scale (HADS) was administered to 131 cancer patients treated with high-dose chemotherapy followed by allogeneic (SCT) or autologous (ASCT) stem cell transplantation, and a concurrent group of 123 lymphoma patients receiving standard chemotherapy (CT) who served as a reference group. Relatively low levels of anxiety and depression were found. The level of anxiety slightly declined from baseline during follow-up (mean scores SCT: from 5.3 to 3.6, CT: from 6.0 to 4.2) or remained fairly stable (ASCT: from 5.4 to 4.8). The level of depression peaked when the transplant patients were in protective isolation or shortly thereafter (SCT: 6.1, ASCT: 6.4), but stabilized at baseline levels after 4 months. The highest level of depression in the CT group was reported 4 months after start of chemotherapy (3.4). Elevated levels of anxiety and depression at baseline predicted more anxiety and depression at the later assessments (P values < 0.0001). The ASCT group had higher levels of anxiety after 1 year (mean 4.8) than those found in the other two groups (SCT: 3.6, CT: 4.2), although they were not statistically significant. This study revealed lower than expected levels of anxiety and depression after intensive chemotherapy followed by SCT or ASCT. There was a decline in psychological distress during the 1-year follow-up period.
authors.affiliation: Norwegian Cancer Society, Oslo, Norway.
authors.forename: M J
authors.initials: MJ
authors.lastname: Hjermstad
authors.forename: J H
authors.initials: JH
authors.lastname: Loge
authors.forename: S A
authors.initials: SA
authors.lastname: Evensen
authors.forename: S O
authors.initials: SO
authors.lastname: Kvaløy
authors.forename: P M
authors.initials: PM
authors.lastname: Fayers
authors.forename: S
authors.initials: S
authors.lastname: Kaasa
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects; D001007:Anxiety / Q000209:etiology*; D003863:Depression / Q000209:etiology*; D005221:Fatigue / Q000209:etiology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000523:psychology*; D006801:Humans; D007938:Leukemia / Q000523:psychology / Q000628:therapy; D008223:Lymphoma / Q000523:psychology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D013997:Time Factors; D014182:Transplantation, Autologous / Q000523:psychology; D014184:Transplantation, Homologous / Q000523:psychology