title: Course of distress, anxiety, and depression in hematological cancer patients: Association between gender and grade of neoplasm.
abstract: OBJECTIVE
  The aim of our study was to explore the impact of gender and hematological cancer grade on distress, anxiety, and depression in patients receiving chemotherapy.
  
  
  METHODS
  A prospective study was done in a cohort of 104 patients with hematological cancer. We employed the (1) Distress Thermometer (DT) and the Problem List (PL) and (2) the Hospital Anxiety and Depression Scale (HADS) for assessments at baseline (T1), the halfway timepoint (T2), and completion of chemotherapy (T3).
  
  
  RESULTS
  The proportion of patients experiencing significant distress (DT ≥ 4) decreased from the first to the last timepoint; the proportion experiencing anxiety and depression (as assessed by HADS) also decreased. Specifically, 50% of participants reported significant distress levels, 47.1% anxiety, and 26% depression at T1. At T2, the proportion of patients experiencing distress was reduced by 60.8%, by 76% for anxiety, and by 48.5% for depression; at T3, the reduction was close to 80% for all assessments compared with T1. Emotional and physical problems were most commonly reported. Significant reductions were discovered for distress and problem-related distress levels over time, and a significant interaction was found between gender and practical and physical problems (p < 0.05).
  
  
  CONCLUSIONS
  Our findings suggest that female patients reported more distress, anxiety, and depression than male patients. Gender differences were related to problem-related distress but not to grade of neoplasm. We observed that, over the course of chemotherapy, the distress levels of patients with hematological cancer decrease over time.
authors.affiliation: Psycho-Oncology Services, Centro de Câncer de Brasília, Brasília,Brazil.
authors.forename: Cristiane Decat
authors.initials: CD
authors.lastname: Bergerot
authors.affiliation: Department of Supportive Care Medicine, City of Hope, Duarte, California.
authors.forename: Karen Lynn
authors.initials: KL
authors.lastname: Clark
authors.affiliation: Medical Onco-Hematology Services, Centro de Câncer de Brasília, Brasília,Brazil.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Nonino
authors.affiliation: Department of Medical Oncology, City of Hope, Duarte, California.
authors.forename: Sarah
authors.initials: S
authors.lastname: Waliany
authors.affiliation: Medical Oncology Services, Centro de Câncer de Brasília, Brasília,Brazil.
authors.forename: Marco Murilo
authors.initials: MM
authors.lastname: Buso
authors.affiliation: Department of Supportive Care Medicine, City of Hope, Duarte, California.
authors.forename: Matthew
authors.initials: M
authors.lastname: Loscalzo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D019337:Hematologic Neoplasms / Q000473:pathology* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011446:Prospective Studies; D012737:Sex Factors; D013315:Stress, Psychological / Q000523:psychology*
keywords: Supportive care