Depressive Symptoms In Cancer Patients Research Articles

Factors associated with depressive symptoms among cancer patients: a nationwide cross-sectional study

ObjectiveResearch on factors contributing to depressive symptoms in cancer patients at a national level, encompassing a comprehensive set of variables was limited. This study aimed to address this gap by identifying the factors associated with depressive symptoms among cancer patients through a nationwide cross-sectional analysis.MethodsVarious factors, including demographic, socioeconomic, behavioral patterns, general and self-rated health status, chronic conditions, dietary habits, and cancer-related factors, were examined. Data was from the National Health and Nutrition Examination Survey. Univariate and multivariate logistic regression analyses were performed to identify associated factors. The receiver-operating characteristic (ROC) curve was used to evaluate the performance of the logistic model.ResultsThe findings showed that five sociodemographic factors, two behavioral styles, self-rated health status, comorbid arthritis, two dietary factors and two cancer-related factors were strongly associated with depressive symptoms. Compared with those aged 20–39 years, cancer individuals aged 40–59 years (OR = 0.48, P < 0.05) and those 60 years or older (OR = 0.18, P < 0.05) had lower odds of depression. Positive factors included being never married (OR = 1.98, P < 0.05), widowed, divorced or separated (OR = 1.75, P < 0.05), unemployment (OR = 1.87, P < 0.05), current smoking (OR = 1.84, P < 0.05), inadequate sleep (OR = 1.96, P < 0.05), comorbid arthritis (OR = 1.79, P < 0.05), and poor self-rated health status (OR = 3.53, P < 0.05). No significant association was identified between the Healthy Eating Index 2015 and the Dietary Inflammatory Index with depression (P > 0.05). Shorter cancer diagnosis duration was associated with reduced odds of depression (P < 0.05). The logistic model had an area under the curve of 0.870 (95% CI: 0.846–0.894, P < 0.05).ConclusionsCancer patients should receive enhanced family and social support while cultivating a healthy lifestyle and diet. Incorporating plenty of fruits, greens, and beans is highly recommended, along with establishing a comprehensive health management framework.

Assessment of depression symptoms among cancer patients: a cross-sectional study from a developing country

Cancer patients experience psychological symptoms such as depression during the cancer treatment period, which increases the burden of symptoms. Depression severity can be assessed using the beck depression inventory (BDI II). The purpose of the study was to use BDI-II scores to measure depression symptoms in cancer patients at a large tertiary hospital in Palestine. A convenience sample of 271 cancer patients was used for a cross-sectional survey. There are descriptions of demographic, clinical, and lifestyle aspects. In addition, the BDI-II is a tool for determining the severity of depression. Two hundred seventy-one patients participated in the survey, for a 95% response rate. Patients ranged in age from 18 to 84 years, with an average age of 47 years. The male-to-female ratio was approximately 1:1, and 59.4% of the patients were outpatients, 153 (56.5%) of whom had hematologic malignancies. Most cancer patients (n = 104, 38.4%) had minimal depression, while 22.5%, 22.1%, and 17.0% had mild, moderate, and severe depression, respectively. Education level, economic status, smoking status, and age were significantly associated with depression. The BDI-II is a useful instrument for monitoring depressive symptoms. The findings support the practice of routinely testing cancer patients for depressive symptoms as part of standard care and referring patients who are at a higher risk of developing psychological morbidity to specialists for treatment as needed.

Leisure-time physical activity is associated with depressive symptoms in cancer patients: Data from the NHANES 2007–2018

BackgroundCancer patients have a higher risk of depression and are associated with severe adverse prognosis. The relationship between leisure-time physical activity (LTPA) and depressive symptoms in cancer patients is currently unclear. Therefore, our study mainly explores the potential association between LTPA and the weekly cumulative time of LTPA with depressive symptoms in cancer patients. MethodsWe included and analyzed 3368 cancer patients (aged >20 years) from the National Health and Nutrition Examination Survey (NHANES) of the United States from 1999 to 2018. The LTPA score was evaluated through a self-report questionnaire, while depressive symptoms were evaluated through the Health Questionnaire-9 (PHQ-9). Multiple logistic regression analysis was used to explore the relationship between LTPA duration and the occurrence of cancer-related depressiive symptoms. Linear correlation was studied using the restricted cubic spline method. ResultsAccording to a fully adjusted multivariate logistic regression model with confounding variables, the odds ratio (OR) between LTPA and depressive symptoms in cancer patients in this study was 0.59 (95 % confidence interval = 0.39, 0.92; P = 0.02). When the LTPA level was ≥300 min/week, the incidence of depressive symptoms was reduced by 59 % (OR = 0.41, 95 % CI = 0.21, 0.83). In addition, the cubic spline method was used to obtain a linear negative correlation between LTPA duration and tumor depressive symptoms. ConclusionLTPA was negatively correlated with cancer-related depressive symptoms, and the cumulative time of LTPA/week was linearly correlated with depressive symptoms. The slope of the benefit curve changed significantly when the cumulative time of LTPA reached 600 min per week, suggesting that appropriately increasing LTPA had significant benefits on mental health of cancer patients.

Anxiety and depression disorders in oncological patients under palliative care at a hospital service: a cross-sectional study

BackgroundThis study aimed to evaluate the risk and protective factors associated with anxiety and depression symptoms in cancer patients at an advanced stage of cancer.MethodsA cross-sectional study was conducted on patients with advanced cancer who were receiving palliative care. Cancer patients aged 18 years or older, with preserved cognitive function who completed the questionnaires were eligible. The questionnaires of Hospital Anxiety and Depression Scale (HADS) and health related of quality of life questionnaire; the European Organization for Research and Treatment of Cancer (EORTC-C30) were applied. Outcome variables were the depression and anxiety symptoms of cancer patients under palliative care, according to the answers to the 14 items that make up the HADS Scale. The analysis used the R software, version 4.2.0.ResultsSeventy cancer patients with advanced cancer were included. The colon was the most common neoplastic diagnostic (20%), followed by breast (12.9%) and lung (10%). The prevalence of depression was 44.3%, 25.7% anxiety and 52.9% had both symptoms. Patients with a high level of functionality had a lower chance of anxiety (OR = 0.80;p = 0.025), depression (OR = 0.82; p = 0.007), and anxiety and depression (OR = 0.82p = 0.008). We observed a lower chance of depression and depression/anxiety who showed a high level of Overall Performance. Three symptoms increased the chance of depression/anxiety: nausea/vomiting (p = 0.019), fatigue (0.031), loss of appetite (0.048).ConclusionThis study found high prevalence of anxiety and depression.Better quality of life and functionality were negatively associated with these outcomes. Examining the patient’s functions will assist the clinician in alleviating symptoms of anxiety and depression, giving cancer patients in palliative care more dignity.Trial registrationNot applicable.

Impact of Exercise Training on Depressive Symptoms in Cancer Patients: A Critical Analysis.

Simple SummaryCancer patients need to overcome several issues, leaving them more vulnerable to depressive symptoms. Exercise is recognised as a practice that helps to deal with depressive symptoms. This study is an umbrella review of meta-analyses about the effect of exercise on depressive symptoms among cancer patients. Six studies were included. A significant reduction in depressive symptoms was observed because of exercise. However, the studies varied in methodological terms, making a broad generalisation difficult. We can conclude that exercise is a good alternative to deal with depressive symptoms among cancer patients. Still, more studies are needed to clarify some aspects that are not answered yet.Background: Cancer patients must deal with several health challenges, including emotional distress and depressive symptoms. This study aimed to evaluate evidence from published systematic reviews and meta-analyses about the efficacy of exercise on depressive symptoms in cancer patients. Methods: We searched for previous meta-analyses of randomised controlled trials on PubMed, Web of Science and Scopus, with data inception to 30 December 2021. Two independent researchers assessed the methodological quality using the Assessment of Multiple Systematic Reviews 2 (AMSTAR2) instrument. Six meta-analyses were integrated. All included middle-aged and older adults. Five presented moderate quality, and one presented low quality. Results: Overall, a significant reduction in depressive symptoms was observed among the included studies. However, the heterogeneity between studies was high, and high-quality evidence for the efficacy of exercise on depressive symptoms was limited. Conclusions: Exercise could be a possibility in the treatment of depressive symptoms in cancer patients, especially when supervised and outside the home. The better dose of exercise needs to be clarified. More high-quality evidence is needed to better prescribe exercise to this vulnerable population.

Cancer-related inflammation and depressive symptoms: Systematic review and meta-analysis.

Depressive symptoms in patients with cancer are associated with poor quality of life and decreased survival. Although inflammation is reliably associated with depression in otherwise healthy individuals, the association in patients with cancer remains unclear. Given the high prevalence of cancer-related inflammation, the authors aimed to establish the relationship between inflammation and depression in cancer patients based on extant literature. A systematic review and meta-analysis was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and registered under Prospero ID CRD42021226743. Three databases were searched including PubMed, the Cochrane Library, and PsycINFO using the following criteria for inclusion: 1) measurement of a peripheral inflammatory marker, 2) use of a validated tool/scale to measure depression, and 3) a cancer diagnosis. Risk of publication bias was assessed by Funnel plot and Egger test. Seventy-three studies were included in the systematic review and 54 studies (n=5017) were included in meta-analyses. Associations with depressive symptoms were significant for peripheral blood interleukin (IL)-6 (standardized mean difference [SMD] = 0.59; 95% confidence interval [CI], 0.35-0.82), I2 =57.9%; tumor necrosis factor (TNF) (SMD=0.73; 95% CI, 0.35-1.11), I2 =74.1%; and C-reactive protein (CRP) (SMD=0.57; 95% CI, 0.27-0.87), I2 =0%. IL-5, IL-13, albumin, and neutrophil-to-lymphocyte ratio were associated with depressive symptoms but based on fewer studies. Most cancer settings were represented; the number of studies per inflammatory marker varied from 1 to 52. Although peripheral inflammatory markers were unevenly studied, the most studied markers (IL-6, TNF, and CRP) were associated with depressive symptoms in cancer patients and may be useful for management of depressive symptoms in the cancer setting. Peripheral blood inflammatory markers (IL-6, TNF, and CRP) were associated with depressive symptoms in various cancer settings. Although further studies are warranted, these findings may help identify and manage depressive symptoms in patients with cancer.

The Potential Role of Peer Support Interventions in Treating Depressive Symptoms in Cancer Patients.

Depressive symptoms are prevalent in cancer patients and are one of the most distressing symptoms in this population. Although mental health professionals such as psychiatrists and psychologists are now engaged in cancer care, the management of depressive symptoms in cancer patients needs further improvement. Peer support interventions (PSIs) in cancer care have attracted substantial attention and have several advantages over support by medical professionals, potentially improving depressive symptoms in cancer patients. However, there may be some potential risks. Several strategies using PSIs have been developed to improve depressive symptoms and have been evaluated in randomized controlled trials. The strategies include education on stress management skills, promoting emotional support, counseling on specific topics that are difficult to discuss with others, helping patients navigate the use of resources, and promoting health-related behaviors to decrease depressive symptoms. In this paper, we present recent findings on PSIs in cancer, focusing on randomized controlled trials.

Are cancer patients with high depressive symptom levels able to manage these symptoms without professional care? The role of coping and social support.

ObjectiveAround 25% of cancer patients experiences depressive symptoms. However, the majority does not receive formal psychological care because patients often prefer managing symptoms alone or with informal social support. Previous research has shown that adaptive coping and social support can indeed be effective in managing relatively mild depressive symptoms. However, higher depressive symptom levels rarely improve without psychological treatment. This longitudinal study examined how and to what extent coping and social support are related to reductions in depressive symptoms in cancer patients with moderate to severe depressive symptoms.MethodsRespondents were diagnosed with cancer in the past five years, experienced high depressive symptom levels (PHQ‐9 ≥ 10) and were not receiving psychological care at baseline. We collected data with self‐report questionnaires (including PHQ‐9, brief COPE and Social Support List) at two assessments, taken three months apart.ResultsAlthough depressive symptoms decreased significantly between baseline and follow‐up, the average level at follow‐up was still moderate to severe. Patients using less avoidant coping, specifically less substance use, were more likely to report a reduction of depressive symptoms. We found no significant beneficial effects of approach coping and social support (coping) on the course of depressive symptoms.ConclusionsA significant group of cancer patients with high levels of depressive symptoms do not seem able to effectively manage depressive symptoms by themselves, especially those more likely to avoid dealing with their symptoms. Cancer patients can be educated about avoidant coping and its possible detrimental effects, as well as being informed about possibilities of psychosocial services.

The influence of olfactory dysfunction on risk of malnutrition is mediated by depressive symptoms in cancer patients undergoing chemotherapy.

Malnutrition is common and detrimental in cancer patients undergoing chemotherapy. There are close associations between olfactory dysfunction, depression, and malnutrition, but how they correlate in cancer patients undergoing chemotherapy remains unclear. Two hundred and one cancer patients undergoing chemotherapy were recruited to this study. Their risk of malnutrition was assessed using the Simplified Nutritional Appetite Questionnaire (SNAQ); odor identification was assessed by Sniffin' Sticks test; self-measurement of olfaction was assessed by Self-reported Mini Olfactory Questionnaire (Self-MOQ); and depressive symptoms were assessed using the Beck Depression Inventory (BDI). Correlation analyses and mediation analyses were used to explore the relationships between olfaction, depression, and risk of malnutrition. The SNAQ score was negatively correlated with the Self-MOQ score and BDI score, and positively correlated with body mass index (BMI) scores and odor identification. The Self-MOQ score was negatively correlated with odor identification and positively correlated with BDI scores, and the duration of chemotherapy was negatively correlated with odor identification. Mediation analyses suggested that BDI scores exhibited a partial mediation effect on the relationship between Self-MOQ score and SNAQ scores. The influence of olfactory dysfunction on risk of malnutrition is mediated by depressive symptoms in cancer patients undergoing chemotherapy. Early intervention of olfactory dysfunction and depressive symptoms may be helpful in reducing the risk malnutrition in cancer patients undergoing chemotherapy.

Increased Levels of Serum Glycosylated Hemoglobin are Associated with Depressive Symptoms in a Population with Cancer (≥49 Years): An Antidepressant-Stratified Analysis.

PurposePatients with cancer tend to have a high prevalence of depressive symptoms. The direct relationship between serum glycosylated hemoglobin (GHb) levels and depressive symptoms in cancer patients is still uncertain. We aimed to evaluate the association with serum GHb levels with depressive symptoms in the population (aged ≥49 years) with cancer.Patients and MethodsLongitudinal data in 204 participants with cancer obtained from The Irish LongituDinal Study on Ageing (TILDA) were used to investigate the association of serum GHb levels with depressive symptoms.ResultsOur results suggested a positive and significant association between serum GHb levels and depression score, independent of age, gender, body mass index (BMI), currently married, education, smoking status, drink alcohol, systolic and diastolic blood pressure (BP), physical activity, self-reported cardiovascular diseases and laboratory measurement in participants with cancer (coefficient =0.141, P<0.001; Model 2) at baseline (wave 1). Higher GHb levels did associate with higher prevalence of depressive symptoms in participants with cancer (OR=2.100, 95% CI 1.105–5.036, P=0.004; Model 2) after adjustment for these same confounding factors in wave 1 was made. Stratified analysis further showed that these significant associations were interfered by antidepressants. Sensitivity analysis showed that higher serum GHb levels in subjects with cancer were linked to higher prevalence of depression events during a follow-up of 4 years.ConclusionOur results found a significant association between elevated serum GHb levels and increased risk of depressive symptoms in the population aged ≥49 years with cancer after confounding factors were adjusted.

Nonesterified Fatty Acids and Depression in Cancer Patients and Caregivers.

ABSTRACTBackgroundNonesterified fatty acids (NEFAs) are known to have inflammatory effects. The inflammatory hypothesis of depression suggests that omega-3 (ω-3) and omega-6 (ω-6) fatty acids might be negatively and positively correlated with depression, respectively.ObjectiveAn exploratory study was conducted to determine the association between dietary free fatty acids and depressive symptoms in cancer patients and caregivers.MethodsAssociations between depression and the NEFA pool were investigated in 56 cancer patients and 23 caregivers using a combination of nonparametric tests and regularized regression. Plasma NEFAs were measured using thin layer and gas chromatography with flame ionization detection. Depression was characterized both as a continuous severity score using the GRID-Hamilton Depression Rating Scale (GRID Ham-D), and as a categorical diagnosis of major depression by structured clinical interview.ResultsInitial hypotheses regarding the relation between depression and omega-3 or omega-6 fatty acids were not well supported. However, elaidic acid, a trans-unsaturated fatty acid found in hydrogenated vegetable oils, was found to be negatively correlated with continuous depression scores in cancer patients. No significant associations were found in caregivers.ConclusionsAn unexpected negative association between elaidic acid and depression was identified, supporting recent literature on the role of G protein–coupled receptors in depression. Further research is needed to confirm this result and to evaluate the potential role of G protein agonists as therapeutic agents for depression in cancer patients.

Effects of a Mind Map-Based Life Review Program on Anxiety and Depressive Symptoms on Cancer Patients Undergoing Chemotherapy: A Randomized Controlled Trial.

Cancer patients undergoing chemotherapy often experience psychological distress. The mind map-based life review program (MBLRP) offers the potential to reduce patients' negative emotions. However, its effects remain unknown. The objective of this study is to determine the effects of the MBLRP on anxiety and depressive symptoms in cancer patients undergoing chemotherapy. A randomized controlled trial with repeated measures was adopted. Eighty-four cancer patients undergoing chemotherapy were recruited from a general hospital in Fujian, China. Participants were randomly assigned to an experimental group (n = 40) or a control group (n = 44). The participants in the experimental group received the MBLRP plus routine care. The participants in the control group received routine care. Outcomes were measured at baseline, on the second day, and at 4 weeks after the MBLRP. In terms of anxiety, multivariate test statistics showed significant differences in within-group (F = 11.343, P < .001), between-group (F = 8.873, P = .004), and interaction effects (group × time) (F = 19.595, P < .001). For the depressive symptoms, the results showed that the within-group effect (F = 12.385, P < .001), group effect (F = 18.000, P < .001), and group × time effect (F = 26.544, P < .001) were statistically significant, favoring the MBLRP experimental group. The MBLRP has the potential to reduce anxiety and depressive symptoms in cancer patients undergoing chemotherapy. Further research is needed within larger more representative samples. The MBLRP is a nurse-led, nonpharmacological program that could be recommended for cancer patients undergoing chemotherapy and integrated into clinical practice.

The value of distinct depressive symptoms (PHQ-9) to differentiate depression severity in cancer survivors: An item response approach.

The value of distinct depressive symptoms (PHQ-9) to differentiate depression severity in cancer survivors: An item response approach.

Protective factors of depressive symptoms in adult cancer patients: The role of sense of coherence and posttraumatic growth in different time spans since diagnosis

Purpose: The purpose of this study was to investigate the impact of posttraumatic growth (PTG) and sense of coherence (SOC) as protective factors on depressive symptoms at different time spans after cancer diagnosis.Design: In a cross-sectional study, adult cancer patients were recruited from the tumor clinics of the University Hospital in Erlangen (Germany) and from peer-support groups for cancer survivors.Sample: Participants included 157 adult patients with primary cancer or in remission (53.5% female; mean age: 58.0 ± 14.1 years; mean time since diagnosis: 46.7 ± 72.8 months) with various forms of cancer.Methods: Multiple linear regression analyses were conducted. The patients were divided into two groups (≤1 year and >1 year since diagnosis) to test the impact of PTG and SOC on depressive symptoms at different time intervals after diagnosis. The Posttraumatic Growth Inventory (PTGI), Sense of Coherence Scale (SOC-13), and Hospital Anxiety and Depression Scale (HADS) were applied.Findings: After controlling for major demographic and clinical variables, SOC (β = –.489, p < .001) was found to be the only significant predictor for depressive symptoms ≤ 1 year after diagnosis; >1 year after diagnosis, SOC (β = –.571, p < .001), PTG (β = –.318, p = .002), and metastatic cancer (β = .231, p = .023) were significant predictors of depressive symptoms (high levels of SOC as well as PTG, and having no metastatic cancer were associated with low manifestations of depressive symptoms).Conclusions: These findings suggest that SOC may be a protective factor against depressive symptoms in both the short as well as in the long term after cancer diagnosis, but PTG only in the long term.Implications for psychosocial providers or policy: To prevent the development of depressive symptoms in cancer patients, individuals with a low SOC should be detected and should receive psychological assistance.

Coping strategies and depressive symptoms in cancer patients

Depression in cancer patients is prevalent and negatively impacts their quality of life. Likewise, it correlates with lower overall survival. The aim of this work is to analyze whether different coping strategies, as well as sociodemographic and clinical factors are associated with the presence of depressive symptoms in individuals with a resected, non-metastatic neoplasm about to initiate adjuvant chemotherapy. NEOcoping is a cross-sectional, prospective, observational, multicenter study. Clinical (tumor site and stage, time to diagnosis, risk of recurrence, and type of adjuvant treatment) and sociodemographic characteristics (age, gender, marital status, educational level, occupational sector, and employment status), coping strategies (Mini-MAC scale), and depressive symptoms (BSI scale) were collected. A two-block linear regression model was performed to determine the predictive variables of depressive symptoms. 524 adults with resected, non-metastatic cancer were recruited. Twenty-six percent of patients have clinically significant depressive symptoms. Being female, < 40years of age, having breast and stomach cancer, and > 50% chance of recurrence were associated with increased risk of depression. Likewise, depression was associated with greater helplessness and anxious preoccupation, and less fighting spirit. Age, gender, and risk of recurrence accounted for only 7% of the variance in depressive symptoms. Including coping strategies in the regression analysis significantly increased the variance explained (48.5%). Early psychological intervention in patients with maladaptive coping strategies may modulate the onset of depressive symptoms, especially in those at higher risk for depression.

Twelve Chinese herbal preparations for the treatment of depression or depressive symptoms in cancer patients: a systematic review and meta-analysis of randomized controlled trials

BackgroundPatients with cancer are vulnerable to depression or other depressive conditions. The aim of this paper was to evaluate the efficacy and safety of Chinese herbal medicine (CHM) for the treatment of depression or depressive symptoms in cancer patients.MethodsCENTRAL, MEDLINE, EMBASE, PsycINFO, CNKI, VIP, SinoMed, and online clinical trial registry websites were searched for relevant RCTs until May 2017. The methodological quality of each included study was assessed with the “risk of bias” tool. Review Manager 5.3.5 was used to analyze the data.ResultsWe identified 18 RCTs that included data from 1441 participants. Twelve different types of Chinese herbal preparations were investigated by these studies, and they showed a better therapeutic effect in most comparisons when measured in terms of depression rating scale scores, with SMDs (95% CI) of − 2.30 (− 3.54, − 1.05) (CHM versus no treatment), − 0.61 (− 1.03, − 0.18) (CHM versus antidepressants), and − 0.55 (− 1.07, − 0.02) (CHM plus psychological treatments versus psychological treatments), or when measured in terms of treatment response rate, with RRs (95% CI) of 1.65 (1.19, 2.29) (CHM versus no treatment), 1.15 (1.03, 1.28) (CHM versus psychological treatments), 1.32 (1.07, 1.63) (CHM plus antidepressants versus antidepressants), and 1.70 (1.02, 2.85) (CHM plus psychological treatments versus psychological treatments). Compared with antidepressants, these CHMs showed borderline superiority for improving the response rate, with an RR (95% CI) of 1.08 (0.93, 1.26). Subgroup analysis based on psychiatric diagnosis (depression versus depressive symptoms) did not modify the direction of these estimates and neither could it explain the high level of heterogeneity. Patients in the CHM group experienced fewer adverse events of cardiac toxicity (P = 0.02), functional gastrointestinal disorders (P = 0.008), sleep disturbances (P = 0.02), blurred vision (P = 0.02) and fatigue (P = 0.03) than the patients in the no treatment group or the antidepressants group.ConclusionsAccording to the investigation of the twelve herbal preparations, the CHM intervention appears to alleviate depressive symptoms in cancer patients, either alone or combined with antidepressants or psychological treatments. However, a high risk of bias and high heterogeneity made the mean estimates uncertain. Well-designed trials with comprehensive and transparent reporting are warranted in the future.

Investigation Of The Severity Of Depressive Symptoms In Cancer Patients Receiving Chemotherapy

Investigation Of The Severity Of Depressive Symptoms In Cancer Patients Receiving Chemotherapy

Work-specific cognitive symptoms and the role of work characteristics, fatigue, and depressive symptoms in cancer patients during 18months post return to work.

Cancer patients can experience work-specific cognitive symptoms post return to work. The study aims to (1) describe the course of work-specific cognitive symptoms in the first 18months post return to work and (2) examine the associations of work characteristics, fatigue and depressive symptoms with work-specific cognitive symptoms over time. This study used data from the 18-month longitudinal "Work Life after Cancer" cohort. The Cognitive Symptom Checklist-Work Dutch Version (CSC-W DV) was used to measure work-specific cognitive symptoms. Linear mixed models were performed to examine the course of work-specific cognitive symptoms during 18-month follow-up; linear regression analyses with generalized estimating equations were used to examine associations over time. Working cancer patients examined with different cancer types were included (n=378). Work-specific cognitive symptoms were stable over 18months. At baseline, cancer patients reported more working memory symptoms (M=32.0; CI, 30.0-34.0) compared with executive function symptoms (M=19.3; CI, 17.6-20.9). Cancer patients holding a job with both manual and nonmanual tasks reported less work-specific cognitive symptoms (unstandardized regression coefficient b=-4.80; CI, -7.76 to -1.83) over time, compared with cancer patients with a nonmanual job. Over time, higher depressive symptoms were related to experiencing more overall work-specific cognitive symptoms (b=1.27; CI, 1.00-1.55) and a higher fatigue score was related to more working memory symptoms (b=0.13; CI, 0.04-0.23). Job type should be considered when looking at work-specific cognitive symptoms over time in working cancer patients. To reduce work-specific cognitive symptoms, interventions targeted at fatigue and depressive symptoms might be promising.

Calligraphy Therapy Interventions for Managing Depression in Cancer Patients: A Scoping Study

For the last three decades, scientists have conducted research for medical therapy interventions of Chinese calligraphy handwriting (CCH). Clinical research has found CCH has positive effects on behavioral and psychosomatic disorders: Depressive symptoms in cancer patients, psychiatric and cognitive disorders in elderly people, stress reduction, hyperarousal symptoms after earthquake, changes in theta waves and other diseases such as hypertension and Attention Deficit Hyperactivity. Depression and anxiety are common among people diagnosed with cancer. CCH as a medical intervention was tested in Nasopharyngeal cancer patients (stage II and III). CCH improved certain stress symptoms and mood disturbances. All studies showed a notable paucity for CCH intervention in medical therapy. However, to apply CCH for improving depressive symptoms in cancer patients and to strengthen the evidence, further research is required.

Cytokines and depression in cancer patients and caregivers.

ObjectiveA better understanding of the biobehavioral mechanisms underlying depression in cancer is required to translate biomarker findings into clinical interventions. We tested for associations between cytokines and the somatic and psychological symptoms of depression in cancer patients and their healthy caregivers.Patients and methodsThe GRID Hamilton Rating Scale for Depression (Ham-D) was administered to 61 cancer patients of mixed type and stage, 26 primary caregivers and 38 healthy controls. Concurrently, blood was drawn for multiplexed plasma assays of 15 cytokines. Multiple linear regression, adjusted for biobehavioral variables, identified cytokine associations with the psychological (Ham-Dep) and somatic (Ham-Som) subfactors of the Ham-D.ResultsThe Ham-Dep scores of cancer patients were similar to their caregivers, but their Ham-Som scores were significantly higher (twofold, p=0.016). Ham-Som was positively associated with IL-1ra (coefficient: 1.27, p≤0.001) in cancer patients, and negatively associated with IL-2 (coefficient: −0.68, p=0.018) in caregivers. Ham-Dep was negatively associated with IL-4 (coefficient: −0.67, p=0.004) in cancer patients and negatively associated with IL-17 (coefficient: −1.81, p=0.002) in caregivers.ConclusionThe differential severity of somatic symptoms of depression in cancer patients and caregivers and the unique cytokine associations identified with each group suggests the potential for targeted interventions based on phenomenology and biology. The clinical implication is that depressive symptoms in cancer patients can arise from biological stressors, which is an important message to help destigmatize the development of depression in cancer patients.