Dynamic of time estimation and its relation with levels of distress.

Abstract

e19091 Background: Our previous study showed a potential relationship between perception of time and level of distress in cancer patients prior to starting chemotherapy. In this study we explored the dynamics of time estimation and the level of distress in cancer patients. Methods: Time estimation and distress were assessed in 262 chemonaïve patients with solid tumors by evaluating each subject’s prospective estimation of how fast one minute passed compared to the actual amount of time passed. The National Comprehensive Cancer Network Distress Thermometer was used at the beginning of the treatment to evaluate the levels of distress. Patients scoring 4 or above were regarded as having high levels of distress. The median value of time estimation was used to stratify the patients into two categories of fast and slow time estimation. After 3 months of treatment time estimation and levels of distress were reevaluated. Results: In total, 125 (response rate 47.7%) patients wanted to be reassessed for the distress level and time estimation. After 3 months of treatment 84 (67.2%) of the patients had not changed their levels of distress, 24 (19.2%) of the patients had low levels of distress, while 17 (13.6%) had high levels distressed. Wilcoxon test did not show a significant change of time estimation and levels of distress before and after 3 months of treatment. We observed a negative weak but significant correlation between the change of distress and change of time estimation (rho = -0.186; p = 0.038). The pattern of the change of time estimation distributions significantly changed according to the reported distress levels at 3rd month. Patients with a fast time estimation at 3rd month had significantly higher levels of distress (4.2±2.6) than patients with a slow time estimation (2.8±2.6). ROC analysis revealed that at the optimal cut-off value of time estimation at 3rd month, high levels of distress can be discriminated with an AUC = 0.64 (95% CI: 0.54-0.73, p = 0.008), a sensitivity of 63.1% and a specificity of 60.1%. Conclusions: Time estimation and its dynamic is a novel potent indicator for high distress in cancer patients.