title: Characterizing the psychological distress response before and after a cancer diagnosis.
abstract: Psychological distress among cancer survivors is common. It is unknown if symptoms predate diagnosis or differ from patients without cancer because studies are limited to patient follow-up. Linked cohort (Wisconsin Longitudinal Study) and tumor registry records were used to assess the psychological distress response pre- to post-cancer diagnosis. Adjusted predicted probabilities of being in one of five categories of change for three psychological distress measures (depression, anxiety, well-being) were compared for participants diagnosed with cancer between 1993-1994 and 2004-2005 and participants without cancer (N = 5,162). Cancer survivors were more likely to experience clinically significant increases (≥0.8 standard deviation) in depression (15, 95 % CI = 12-18 %) and anxiety (19 %, CI = 16-22 %) compared to their no-cancer counterparts (10 %, CI = 10-11 %; 11 %, CI = 11-12 %). Cancer survivors <5 years from diagnosis were more likely to experience worsening depression. Survivors ≥5 years were more likely to experience worsening anxiety. No significant results were found for well-being. Characterizing the psychological distress response is a prerequisite for identifying at-risk patients and communicating expected symptoms, allowing for proactive resource provision.
authors.affiliation: Department of Health Services Research, Management and Policy, University of Florida, P.O. Box 100195, Gainesville, FL, 32610-0195, USA, jschumacher@phhp.ufl.edu.
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Schumacher
authors.forename: Mari
authors.initials: M
authors.lastname: Palta
authors.forename: Noelle K
authors.initials: NK
authors.lastname: Loconte
authors.forename: Amy
authors.initials: A
authors.lastname: Trentham-Dietz
authors.forename: Whitney P
authors.initials: WP
authors.lastname: Witt
authors.forename: Susan M
authors.initials: SM
authors.lastname: Heidrich
authors.forename: Maureen A
authors.initials: MA
authors.lastname: Smith
mesh_terms: D001007:Anxiety / Q000175:diagnosis / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D013315:Stress, Psychological / Q000175:diagnosis / Q000523:psychology*; D017741:Survivors / Q000523:psychology