title: Age-specific influences of emotional distress on performance status in cancer patients.
abstract: OBJECTIVE
  Improving and maintaining performance status is an important part of cancer treatment because it may predict patients' survival. Several cancer-related medical conditions have been known to influence the functional performance of cancer patients. We here examined whether emotional distress would also contribute to performance decline of cancer patients.
  
  
  METHODS
  With consecutive sampling, a total of 880 patients diagnosed as having cancer were recruited and evaluated on cancer-related variables, emotional distress, and performance status using the standardized instruments.
  
  
  RESULTS
  Approximately 8.9% of participants showed compromised performance rated 2 or more on the Eastern Cooperative Oncology Group performance status scale. Emotional distress was strongly associated with compromised performance after controlling for demographic and cancer-related external risk factors. The effects of emotional distress on performance decline were likely to be remarkably greater in the younger age group (<45 years) than in old-aged cancer patients (≥65 years).
  
  
  CONCLUSIONS
  Our results provide support for the independent effects of emotional distress on having a higher risk for performance decline in cancer patients. These effects seem to be age-dependent suggesting that special clinical attention to emotional distress may be required in younger patients with cancer.
authors.affiliation: Department of Psychiatry, Catholic University of Daegu School of Medicine, Daegu, South Korea.
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Psychiatry, Catholic University of Korea College of Medicine, Seoul, South Korea.|The Brain Institute and Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: Sujung
authors.initials: S
authors.lastname: Yoon
authors.affiliation: Department of Psychiatry, Catholic University of Korea College of Medicine, Seoul, South Korea.
authors.forename: Wang-Youn
authors.initials: WY
authors.lastname: Won
authors.affiliation: Department of Psychiatry, Catholic University of Korea College of Medicine, Seoul, South Korea.
authors.forename: Chul
authors.initials: C
authors.lastname: Lee
authors.affiliation: Department of Psychiatry, Catholic University of Korea College of Medicine, Seoul, South Korea.
authors.forename: Chang-Uk
authors.initials: CU
authors.lastname: Lee
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, Catholic University of Korea College of Medicine, Seoul, South Korea.
authors.forename: Kyo Young
authors.initials: KY
authors.lastname: Song
authors.affiliation: Department of Psychiatry, Catholic University of Korea College of Medicine, Seoul, South Korea.
authors.forename: Jung-Ah
authors.initials: JA
authors.lastname: Min
authors.affiliation: Division of Life and Pharmaceutical Sciences and Ewha Brain Institute, Ewha University, Seoul, South Korea.
authors.forename: In Kyoon
authors.initials: IK
authors.lastname: Lyoo
authors.affiliation: Department of Psychiatry, Catholic University of Korea College of Medicine, Seoul, South Korea.|The Brain Institute and Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA.
authors.forename: Tae-Suk
authors.initials: TS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D012306:Risk; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000523:psychology*
keywords: age; cancer; emotional distress; oncology; performance status