Predictors of anxiety and depression in hematopoietic stem cell transplant patients during protective isolation

Abstract

Objective: To examine in a sample of hematopoietic stem cell transplant patients assessed throughout protective isolation (i) levels of anxiety and depression and (ii) pre-isolation factors (socio-demographics, biomedical variables and personality traits), which might predict higher levels of anxiety and depression during isolation.

Methods: The study used a longitudinal prospective design. Anxiety and depression were assessed in 107 participants by the State-Trait Anxiety Inventory and Self-rating Depression Scale at admission and weekly at fixed time points throughout isolation. Among pre-isolation factors, patients' psychological status was evaluated by the Cognitive Behavioral Assessment (2.0). Predictors were explored by random-effects models.

Results: One-tenth of the patients suffered from clinically significant anxiety and depressive symptoms at admission. Although the percentage of depressed patients increased more than twofold after 2 weeks of isolation, that of anxious patients did not significantly change over time. Female gender, higher anxiety and obsessive-compulsive symptoms, intratensive personality traits and lower performance status predicted higher depression during isolation.

Conclusions: Anxiety and depression represent a relevant problem for hematopoietic stem cell transplant patients during isolation. Early detection of predictors, such as anxiety levels, obsessive-compulsive symptoms and performance status, could help prevent depression via targeted psychological intervention.

Keywords: anxiety; cancer; depression; hematopoietic stem cell transplant; isolation; oncology.