Anxiety and depression after diagnosis of high-risk primary cutaneous melanoma: a 4-year longitudinal study
- PDF / 752,136 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 18 Downloads / 211 Views
Anxiety and depression after diagnosis of high-risk primary cutaneous melanoma: a 4-year longitudinal study Vanessa L. Beesley 1 & Maria Celia B. Hughes 1 & B. Mark Smithers 2 & Kiarash Khosrotehrani 3 & Maryrose K. Malt 1 & Lena A. von Schuckmann 1 & Adèle C. Green 1,4 Received: 3 December 2019 / Accepted: 11 April 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To quantify the prevalence of anxiety or depression (overall; melanoma-related) among people with high-risk primary melanoma, their related use of mental health services and medications, and factors associated with persistent new-onset symptoms across 4 years post-diagnosis. Methods A longitudinal study of 675 patients newly diagnosed with tumor-stage 1b–4b melanoma. Participants completed the Hospital Anxiety and Depression Scale and answered questions about fear of cancer recurrence, use of medication, and support, serially over 4 years. We identified anxiety and depression trajectories with group-based trajectories models and factors associated with persistent symptoms with logistic regression. Results At diagnosis, 93 participants (14%) had melanoma-related anxiety or depression, and 136 (20%) were affected by anxiety and/or depression unrelated to melanoma. After 6 months, no more than 27 (5%) reported melanoma-related anxiety or depression at any time, while the point prevalence of anxiety and depression unrelated to melanoma was unchanged (16–21%) among the disease-free. Of 272 participants reporting clinical symptoms of any cause, 34% were taking medication and/or seeing a psychologist or psychiatrist. Of the participants, 11% (n = 59) had new-onset symptoms that persisted; these participants were more likely aged < 70. Conclusions Melanoma-related anxiety or depression quickly resolves in high-risk primary melanoma patients after melanoma excision, while prevalence of anxiety or depression from other sources remains constant among the disease-free. However, onein-ten develop new anxiety or depression symptoms (one-in-twenty melanoma-related) that persist. Implications for Cancer Survivors Chronic stress has been linked to melanoma progression. Survivors with anxiety and depression should be treated early to improve patient and, potentially, disease outcomes. Keywords Melanoma . Anxiety . Depression . Distress . Fear of recurrence
Introduction Diagnosis of invasive melanoma is often perceived as lifethreatening and can trigger psychological distress, even when
the majority of patients today are diagnosed when the primary tumor is localized to the skin and < 1 mm thick [1] with a fiveyear survival rate of greater than 90% [2]. However, the subgroup of patients diagnosed with thicker or ulcerated primary
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11764-020-00885-9) contains supplementary material, which is available to authorized users. * Vanessa L. Beesley [email protected] 1
Population Health Department, QIMR Berghofer Medical Rese
Data Loading...
