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COVID-19 or Cancer Stress? Anxiety and Depressive Symptoms in Patients with Advanced Lung Cancer

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Abstract

Background

Of all cancer patients, those with lung cancer are among the highest risk for infection, pneumonia, hospitalization, and early death from COVID-19. As cancer stress is ubiquitous, this exploratory study examines patients’ COVID-19 stress and cancer stress in relation to their depressive and anxiety symptoms.

Method

Newly diagnosed advanced lung cancer patients (N = 76) completed measures of cancer stress, COVID-19 illness perceptions and stress, and depressive and anxiety symptoms at a single monthly follow-up early in the pandemic (May 2020 to July 2020; Clinicaltrials.gov #NCT03199651). Hierarchical linear multiple regression analysis was used to identify the relationship of stressor variables to depressive and anxiety symptoms in this cross-sectional study.

Results

Hierarchical linear models revealed cancer stress was a significant predictor of both depressive symptoms (F(14,30) = 5.327, p < 0.001, R2 = 0.71, adjusted R2 = 0.58) and anxiety symptoms (F(14,30) = 4.513, p < 0.001, R2 = 0.68, adjusted R2 = 0.53) for patients at the start of the COVID-19 pandemic. By contrast, COVID-19 stress was not a significant predictor of depressive (F(13,31) = 1.415 p = .21, R2 = .37, adjusted R2 = .11) or anxiety symptoms (F(13,31) = 1.23, p = .30, R2 = .34, adjusted R2 = − .07).

Conclusions

Advanced lung cancer patients during the early phase of the COVID-19 pandemic reported cancer stress as more important than COVID-19 stress in relation to their mental health. Empirically supported biobehavioral and cognitive behavioral treatments remain important to reducing psychological symptoms and enhancing patients’ quality of life.

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References

  1. Salari N, Khazaie H, Hosseinian-Far A, Khaledi-Paveh B, Kazeminia M, Mohammadi M, et al. The prevalence of stress, anxiety and depression within front-line healthcare workers caring for COVID-19 patients: a systematic review and meta-regression. Hum Resour Health. 2020;18:1–14.

    Article  Google Scholar 

  2. Lou E, Teoh D, Brown K, Blaes A, Holtan SG, Jewett P, et al. Perspectives of cancer patients and their health during the COVID-19 pandemic. PLoS ONE. 2020;15:e0241741.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Cooke JE, Eirich R, Racine N, Madigan S. Prevalence of posttraumatic and general psychological stress during COVID-19: a rapid review and meta-analysis. Psychiatry Res. 2020;292:113347.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Calles A, Aparicio MI, Alva M, Bringas M, Gutierrez N, Soto J, et al. Outcomes of COVID-19 in patients with lung cancer treated in a tertiary hospital in Madrid. Front Oncol. 2020;10:1777.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Lei H, Yang Y, Zhou W, Zhang M, Shen Y, Tao D, et al. Higher mortality in lung cancer patients with COVID-19? A systematic review and meta-analysis. Lung Cancer. 2021;157:60–5.

    Article  CAS  PubMed  Google Scholar 

  6. Dai M, Liu D, Liu M, Zhou F, Li G, Chen Z, et al. Patients with cancer appear more vulnerable to SARS-CoV-2: a multicenter study during the COVID-19 outbreak. Cancer Discov. 2020;10:783–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Marino P, Touzani R, Pakradouni J, Ben Soussan P, Gravis G. The psychological distress of cancer patients following the COVID-19 pandemic first lockdown: results from a large French survey. Cancers. 2022;14:1794.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. De Jaeghere EA, Kanervo H, Colman R, Schrauwen W, West P, Vandemaele N, et al. Mental health and quality of life among patients with cancer during the SARS-CoV-2 pandemic: results from the longitudinal ONCOVID survey study. Cancers. 2022;14:1093.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Andersen BL, Valentine TR, Lo SB, Carbone DP, Presley CJ, Shields PG. Newly diagnosed patients with advanced non-small cell lung cancer: a clinical description of those with moderate to severe depressive symptoms. Lung Cancer. 2020;145:195–204.

    Article  CAS  PubMed  Google Scholar 

  10. Richardson EM, Schuez N, Sanderson K, Scott JL, Schuez B. Illness representations, coping, and illness outcomes in people with cancer: a systematic review and meta-analysis. Psychooncology. 2017;26:724–37.

    Article  PubMed  Google Scholar 

  11. Hagger MS, Koch S, Chatzisarantis NL, Orbell S. The common sense model of self-regulation: meta-analysis and test of a process model. Psychol Bull. 2017;143:1117.

    Article  PubMed  Google Scholar 

  12. Arrato NA, Lo SB, Coker CA, Covarrubias JJ, Blevins TR, Reisinger SA, et al. Cancer treatment during COVID-19: resilience of individuals with advanced non–small cell lung cancer versus community controls. J Natl Compr Canc Netw. 2022;20:118–25.

    Article  CAS  PubMed  Google Scholar 

  13. Lutgendorf SK, Andersen BL. Biobehavioral approaches to cancer progression and survival: mechanisms and interventions. Am Psychol. 2015;70:186.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006;60:631–7.

    Article  PubMed  Google Scholar 

  15. Weiss D, Marmar C. The Impact of Event Scale—Revised. W: Wilson J., Keane T.(red.). Assessing psychological trauma and PTSD: a handbook for practitioners. Guildford Press, New York; 1997.

  16. Horowitz M, Wilner N, Alvarez W. Impact of event scale: a measure of subjective stress. Psychosom Med. 1979;41:209–18.

    Article  CAS  PubMed  Google Scholar 

  17. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092–7.

    Article  PubMed  Google Scholar 

  19. Bergman B, Aaronson NK, Ahmedzai S, Kaasa S, Sullivan M. The EORTC QLQ-LC13: a modular supplement to the EORTC core quality of life questionnaire (QLQ-C30) for use in lung cancer clinical trials. Eur J Cancer. 1994;30:635–42.

    Article  Google Scholar 

  20. Charlson ME, Pompei P, Ales KL, MacKenzie R. Charlson comorbidity index. J Chronic Dis. 1987;40:373–83.

    Article  CAS  PubMed  Google Scholar 

  21. Pacheco RL, Martimbianco ALC, Roitberg F, Ilbawi A, Riera R. Impact of strategies for mitigating delays and disruptions in cancer care due to COVID-19: systematic review. JCO Glob Oncol. 2021;7:342–52.

    Article  PubMed  Google Scholar 

  22. Hyland KA, Jim HS. Behavioral and psychosocial responses of people receiving treatment for advanced lung cancer during the COVID-19 pandemic: a qualitative analysis. Psycho-Oncol. 2020;29:1387–92.

    Article  Google Scholar 

  23. Massicotte V, Ivers H, Savard J. COVID-19 pandemic stressors and psychological symptoms in breast cancer patients. Curr Oncol. 2021;28:294–300.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Andersen BL, Lacchetti C, Ashing K, Berek JS, Berman BS, Bolte S, et al. Management of anxiety and depression in adult survivors of cancer: ASCO guideline update. J Clin Oncol. 2023;41:3426–53.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Psychology, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA

    Tessa R. Blevins, Stephen B. Lo, Clarence A. Coker, Nicole A. Arrato & Barbara L. Andersen

  2. Comprehensive Cancer Center, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA

    Sarah A. Reisinger & Peter G. Shields

  3. Division of Medical Oncology, Department of Internal Medicine, College of Medicine, The Ohio State University, 1835 Neil Avenue, Columbus, OH, 43210, USA

    Peter G. Shields

Authors
  1. Tessa R. Blevins
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  2. Stephen B. Lo
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  3. Clarence A. Coker
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  4. Nicole A. Arrato
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  5. Sarah A. Reisinger
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  6. Peter G. Shields
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  7. Barbara L. Andersen
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Corresponding author

Correspondence to Barbara L. Andersen.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Blevins, T.R., Lo, S.B., Coker, C.A. et al. COVID-19 or Cancer Stress? Anxiety and Depressive Symptoms in Patients with Advanced Lung Cancer. Int.J. Behav. Med. 31, 325–330 (2024). https://doi.org/10.1007/s12529-023-10206-w

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  • DOI: https://doi.org/10.1007/s12529-023-10206-w

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