Staging of psychiatric disorders in patients with limited and advanced/metastatic solid cancer: A pilot study.

Abstract

e22545 Background: 38% of cancer patients (pts) receive diagnosis of major depressive disorder. According with the clinimetric approach of the staging of psychiatric disease, the 5-step model of unipolar depression allows for the evaluation of the extent of the disorder, its severity, and characteristics at a specific time in the course of the disease. This study was aimed: a) to assess mental health and quality of life of cancer patients with limited (LS) and advanced/metastatic (AS) solid cancer through the join evaluation of the staging of psychiatric disorders; b) to explore the potential role of severity of oncological disease in anxious/depressive disease development. Methods: A cross-sectional study was conducted at the Oncology Unit of Luigi Sacco Hospital of Milan during the first session of a psychological support path. Patients’ cancer diagnosis and stage, as well as regular engagement in work, leisure and social activities were explored. Hospital and Depression Anxiety Scale (HADS), the Revised Illness Perception Questionnaire (IPQ-R) and Mental Health Continuum Short-Form (MHC-SF) were also administered. Results: 104 pts were included: F 86, M 18, median age 57,5 (27-84), 30% AS, and 70% LS. Pts’ anxious/depressive symptoms were assessed by HADS scoring and they were divided into 3 groups according to the model of unipolar depression: Group 1a (prodromal phase – no symptoms), Group 1b (prodromal phase – mood symptoms) and Group 2 (anxious/depressive disorder). Pts in group 2 were significantly more frequently AS pts, while in group 1a pts in LS stage (χ² = 7.78, p < .05). Based on MHC-SF scores, flourishing and languishing were significantly more frequently reported by pts in group 1a (55,5% and 46% of pts, respectively), and moderate mental health in group 2 (45,9% of pts, χ² = 18.1, p < .001). Regression analysis highlighted non-hobbyist vs. hobbyists, AS vs. LS cancer pts, asthenic vs. non asthenic pts, and moderate vs flourishing metal health were more likely to receive a provisional anxious depressive disorder diagnosis (Stage 2). No association emerged for other physical symptoms, work, and socialization. Conclusions: AS pts with asthenia, no engagement in structured activities and moderate mental health had a higher risk of developing anxious/depressive disorders. Screening psychiatric disorders in cancer pts may improve the physician's ability to recognize earlier phase of psychopathological disease and guide pts to tailored treatment. These may prevent progression of psychiatric disease and promote mental health and positive quality of life.