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. 2020 Nov;29(11):1864-1873.
doi: 10.1002/pon.5514. Epub 2020 Aug 25.

Predictors of long-term anxiety and depression in uveal melanoma survivors: A cross-lagged five-year analysis

Stephen L Brown  1 , Peter L Fisher  1   2 , Laura Hope-Stone  1   2   3 , Rumana N Hussain  3 , Heinrich Heimann  3 , Bertil Damato  3 , M Gemma Cherry  1   2
Affiliations

Predictors of long-term anxiety and depression in uveal melanoma survivors: A cross-lagged five-year analysis

Stephen L Brown et al. Psychooncology. 2020 Nov.

Abstract

Objective: Cancer survivors commonly experience long-term anxiety and depression. Anxiety and depression might result from problems emerging during survivorship rather than illness and treatment. This study tested three potential causal paths: (a) concerns about physical symptoms and functional problems and fear of cancer recurrence (FCR) arising during survivorship directly cause anxiety and depression, (b) an indirect path whereby FCR mediates effects of concerns about physical symptoms and functional problems on anxiety and depression, and (c) a reciprocal path whereby anxiety and depression cause concerns about physical symptoms and functional problems and FCR, which exacerbate later anxiety and depression.

Methods: Sample of 453 uveal melanoma survivors who completed observations 6-, 12-, 24-, 36-, 48- and 60-months post-diagnosis and did not miss two consecutive observations. Cross-lagged analyses were conducted to predict Hospital Anxiety and Depression Scale subscale scores. Symptoms and functional problems were measured using the EORTC OPT 30 scale, and FCR operationalised by the EORTC OPT 30 worry about recurrence scale. Covariates were age, gender, treatment modality, and visual acuity of the fellow eye and chromosome-3 status (which accurately predicts 10-year survival), worry and anxiety or depression.

Results: All paths received some support, although the indirect path emerged only for anxiety in females. Concerns about physical symptoms, functional problems, and FCR originated in survivorship and appeared to both influence and be influenced by anxiety and depression.

Conclusions: Findings emphasise the importance of actively monitoring survivors to prevent, detect, and intervene in the development of anxiety and depression during survivorship.

Keywords: anxiety; cancer; cross-lagged analysis; depression; psycho-oncology; uveal melanoma.

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References

REFERENCES

    1. Burgess C, Cornelius V, Love S, Graham J, Richards M, Ramirez A. Depression and anxiety in women with early breast cancer: five year observational cohort study. BMJ. 2005;330:702. https://doi.org/10.1136/bmj.38343.670868.d3.
    1. Hoffman KE, McCarthy EP, Recklitis CJ, Ng AK. Psychological distress in long-term survivors of adult-onset cancer: results from a national survey. Arch Int Med. 2009;169:1274-1281. https://doi.org/10.1001/archinternmed.2009.179.
    1. Hope-Stone L, Brown SL, Heimann H, Damato B, Salmon P. Two-year patient-reported outcomes following treatment for uveal melanoma. Eye. 2016;30:1598-1605. https://doi.org/10.1038/eye.2016.188.
    1. Sharpley C, Christie D, Bitsika V. Variability in anxiety and depression over time following diagnosis in patients with prostate cancer. J Psychosoc Oncol. 2010;28:644-652. https://doi.org/10.1080/07347332.2010.516810.
    1. Philip E, Merluzzi T, Zhang Z, Heitzmann C. Depression and cancer survivorship: importance of coping self-efficacy in post-treatment survivors. Psycho-Oncol. 2013;22:987-994. https://doi.org/10.1002/pon.3088.

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