The association between treatment-specific optimism and depressive symptomatology in patients enrolled in a Phase I cancer clinical trial.
BACKGROUND
Previous research has found that cancer patients often overestimate the likelihood that they will achieve a positive response in Phase I trials. However, maintaining optimistic expectations may help patients cope with a poor prognosis and uncertain outcome. The authors prospectively examined the association between treatment-specific optimism and mental health among patients participating in a Phase I/b trial.


METHODS
Twenty-four patients with metastatic renal cell carcinoma and 22 patients with metastatic melanoma completed an assessment battery at the beginning of treatment and 3 weeks later, on the final day of treatment. Patients completed measures of treatment-specific optimism (e.g., beliefs regarding the treatment working), depressive symptomatology, mood disturbance, and overall distress.


RESULTS
The majority of patients believed that the treatment would either cure them (87%) or stop cancer progression (85%). Regression analyses revealed that the level of treatment-specific optimism (e.g., "The treatment I am receiving may cure me") was associated negatively with baseline measures of depressive symptoms (P < 0.006), mood disturbance (P < 0.001), and symptoms of distress (P < 0.0001) after controlling for age, number of metastases, and time since diagnosis. Patients with symptoms of clinical depression at baseline reported significantly lower levels of treatment-specific optimism than patients without symptoms (P < 0.03). Treatment-specific optimism also was associated negatively with symptoms of depression at the end of treatment (P < 0.003), controlling for symptoms of depression at the beginning of treatment.


CONCLUSIONS
The results of the current study suggest that high levels of treatment-specific optimism are associated with better mental health outcomes at both the beginning and end of treatment.
Cohen
L
L
Department of Behavioral Science, The University of Texas M. D. Anderson Cancer Center, Houston 77030, USA. lcohen@notes.mdacc.tmc.edu
de Moor
C
C
Amato
R J
RJ
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000523:psychology* / Q000556:secondary / Q000628:therapy; D003657:Decision Making; D003866:Depressive Disorder / Q000523:psychology*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D008297:Male; D008545:Melanoma / Q000523:psychology* / Q000556:secondary / Q000628:therapy; D008875:Middle Aged; D009042:Motivation; D010358:Patient Participation / Q000523:psychology*; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D013694:Temperament; D013732:Test Anxiety Scale; D013812:Therapeutics