title: Depression and hopelessness in patients with acute leukemia: the psychological impact of an acute and life-threatening disorder.
abstract: Acute leukemia (AL) is a life-threatening cancer associated with substantial morbidity and mortality, particularly in older adults. Given that there has been little research on the psychological impact of such malignancies with acute onset, we assessed the prevalence and correlates of depression and hopelessness in patients with AL.
  
  
  
  Three hundred forty-one participants were recruited within 1 month of diagnosis or relapse and completed the Beck Depression Inventory-II (BDI-II), Beck Hopelessness Scale (BHS), Memorial Symptom Assessment Scale, and other psychosocial measures. Multivariate regression analyses identified correlates of depression and hopelessness.
  
  
  
  17.8% reported clinically significant depressive symptoms (BDI-II ≥ 15), 40.4% of which were in the moderate-severe range (BDI-II ≥ 20). 8.5% reported significant symptoms of hopelessness (BHS ≥ 8). Depression was associated with greater physical symptom burden (adjusted R(2)  = 48.4%), while hopelessness was associated with older age and lower self-esteem (adjusted R(2)  = 45.4%). Both were associated with poorer spiritual well-being.
  
  
  
  Clinically significant depressive symptoms were common early in the course of AL and related to physical symptom burden. Hopelessness was less common and associated with older age and lower self-esteem. The results suggest that whereas depression in AL may be related to disease burden, the preservation of hope may be linked to individual resilience, life stage, and realistic prognosis.Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Faculty of Arts & Science, University of Toronto, Toronto, Canada.
authors.forename: Galina
authors.initials: G
authors.lastname: Gheihman
authors.affiliation: Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.|Campbell Family Cancer Research Institute, Ontario Cancer Institute, University Health Network, Toronto, Canada.|Department of Medicine, University of Toronto, Toronto, Canada.
authors.forename: Camilla
authors.initials: C
authors.lastname: Zimmermann
authors.affiliation: Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
authors.forename: Amy
authors.initials: A
authors.lastname: Deckert
authors.affiliation: Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.|Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Fitzgerald
authors.affiliation: Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
authors.forename: Ashley
authors.initials: A
authors.lastname: Mischitelle
authors.affiliation: Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.
authors.forename: Anne
authors.initials: A
authors.lastname: Rydall
authors.affiliation: Campbell Family Cancer Research Institute, Ontario Cancer Institute, University Health Network, Toronto, Canada.|Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.|Department of Medical Biophysics, University of Toronto, Toronto, Canada.
authors.forename: Aaron
authors.initials: A
authors.lastname: Schimmer
authors.affiliation: Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.|Campbell Family Cancer Research Institute, Ontario Cancer Institute, University Health Network, Toronto, Canada.|Department of Psychiatry, University of Toronto, Toronto, Canada.|School of Kinesiology and Health Science, York University, Toronto, Canada.|Department of Anesthesia, University of Toronto, Toronto, Canada.|Department of Anesthesia, University Health Network, Toronto, Canada.
authors.forename: Lucia
authors.initials: L
authors.lastname: Gagliese
authors.affiliation: Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.|Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Chris
authors.initials: C
authors.lastname: Lo
authors.affiliation: Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada.|Campbell Family Cancer Research Institute, Ontario Cancer Institute, University Health Network, Toronto, Canada.|Department of Psychiatry, University of Toronto, Toronto, Canada.
authors.forename: Gary
authors.initials: G
authors.lastname: Rodin
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003863:Depression / Q000209:etiology / Q000523:psychology*; D005260:Female; D065026:Hope; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000523:psychology*; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012649:Self Concept