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Characterizing the psychological distress response before and after a cancer diagnosis

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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.

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Acknowledgments

This research was supported by the Agency for Healthcare Research and Quality/National Research Service Award T-32 Institutional Training Program (Grant number T32 HS00083); the National Cancer Institute (Grant number R21 CA137288); the National Institute on Aging (Grant number P01 AG021079); and the Community-Academic Partnerships core of the University of Wisconsin Institute for Clinical and Translational Research, National Center for Research Resources, National Institutes of Health (Grant number UL1 RR025011). This project was further supported by the Health Innovation Program. This research uses data from the Wisconsin Longitudinal Study of the University of Wisconsin-Madison. Since 1991, the Wisconsin Longitudinal Study has been supported principally by the National Institute on Aging (Grant numbers R01 AG09775, R01 AG033285), with additional support from the Vilas Estate Trust, the National Science Foundation, the Spencer Foundation, and the Graduate School of the University of Wisconsin-Madison. A public use file of data from the Wisconsin Longitudinal Study is available at http://www.ssc.wisc.edu/wlsresearch/data/. The opinions expressed herein are those of the authors.

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Authors and Affiliations

  1. Department of Health Services Research, Management and Policy, University of Florida, P.O. Box 100195, Gainesville, FL, 32610-0195, USA

    Jessica R. Schumacher

  2. Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA

    Mari Palta, Amy Trentham-Dietz, Whitney P. Witt & Maureen A. Smith

  3. Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, WI, USA

    Mari Palta

  4. Department of Medicine, Section of Hematology/Oncology, University of Wisconsin-Madison, Madison, WI, USA

    Noelle K. LoConte

  5. School of Nursing, University of Wisconsin-Madison, Madison, WI, USA

    Susan M. Heidrich

  6. Department of Family Medicine, University of Wisconsin-Madison, Madison, WI, USA

    Maureen A. Smith

  7. Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA

    Maureen A. Smith

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  1. Jessica R. Schumacher
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  2. Mari Palta
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  4. Amy Trentham-Dietz
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Schumacher, J.R., Palta, M., LoConte, N.K. et al. Characterizing the psychological distress response before and after a cancer diagnosis. J Behav Med 36, 591–600 (2013). https://doi.org/10.1007/s10865-012-9453-x

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  • DOI: https://doi.org/10.1007/s10865-012-9453-x

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