Influence of Coping Strategy on Perception of Anxiety and Depression in Patients with Non-small Cell Lung Cancer.

Abstract

The purpose of this study was to evaluate the influence of cognitive adjustment to cancer, assessed on the mini-Mental Adjustment to Cancer (mini-MAC) scale, on perception of anxiety and depression, assessed with the Hospital Anxiety and Depression Scale, in patients with non-small cell lung carcinoma (NSCLC). There were 185 patients, grouped according to the score of mini-MAC into constructive coping strategies, balanced coping strategies, and destructive coping strategies. We found that patients with predominantly destructive coping strategies had a higher level of anxiety than those with balanced or constructive strategies (10.9 vs. 9.3 vs. 6.3 points, respectively; p<0.001). Likewise, symptoms of depression were more pronounced in patients having destructive coping strategies than in those with balanced or constructive strategies (11.9 vs. 8.8 vs. 5.8 points, respectively; p<0.001). We further found that constructive coping strategy was a significant independent predictor of lower levels of anxiety and depressive symptoms. Other predictors included symptomatic treatment and a good nutritional status, while pain, chemotherapy, and poor performance status exacerbated the negative emotions. We conclude that cognitive adjustments to having cancer outstandingly modify the development of anxiety and depression in NSCLC patients, which also influences the choice of treatment and the treatment process itself. Thus, psychological assessment is essential in clinical practice and care for patients with lung cancer.