Hermann Faller1, Elmar Brähler2,3, Martin Härter4, Monika Keller5, Holger Schulz4, Karl Wegscheider6, Joachim Weis7, Anna Boehncke7, Matthias Richard1, Susanne Sehner6, Uwe Koch4, Anja Mehnert2,4. 1. Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany. 2. Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany. 3. Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany. 4. Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 5. Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine, University Hospital Heidelberg, Heidelberg, Germany. 6. Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 7. Department of Psychooncology, Tumor Biology Center, University of Freiburg, Freiburg, Germany.
Abstract
OBJECTIVE: This study aimed to examine whether depressive symptoms and performance status are independent predictors of both the physical and psychological domains of health-related quality of life (HRQoL) in cancer patients. METHODS: A sample of 4020 cancer patients (mean age 58 years, 51% women) was evaluated. Depressive symptoms were measured with the patient health questionnaire and HRQoL with the European Organisation for Research and Treatment of Cancer quality of life questionnaire core 30. The impact of the illness on everyday activities was assessed with physician ratings of both the Karnofsky performance status and the Eastern Cooperative Oncology Group performance status. The simultaneous effects of depression and performance status on quality of life outcomes were estimated using structural equation modeling. RESULTS: Both depressive symptoms and performance status independently predicted the physical and psychological domains of HRQoL. However, the impact of depressive symptoms on the physical HRQoL was stronger than the impact of performance status on the psychological HRQoL. CONCLUSION: Our results suggest that comorbid depressive symptoms are independently associated with both physical and psychological HRQoL in cancer patients after controlling for the physician-rated performance status. Thus, comorbid depression should be taken into account when evaluating reduced HRQoL in cancer patients. To support a causal impact of depression on HRQoL, intervention studies are needed to show that improving depression enhances cancer patients' HRQoL.
OBJECTIVE: This study aimed to examine whether depressive symptoms and performance status are independent predictors of both the physical and psychological domains of health-related quality of life (HRQoL) in cancerpatients. METHODS: A sample of 4020 cancerpatients (mean age 58 years, 51% women) was evaluated. Depressive symptoms were measured with the patient health questionnaire and HRQoL with the European Organisation for Research and Treatment of Cancer quality of life questionnaire core 30. The impact of the illness on everyday activities was assessed with physician ratings of both the Karnofsky performance status and the Eastern Cooperative Oncology Group performance status. The simultaneous effects of depression and performance status on quality of life outcomes were estimated using structural equation modeling. RESULTS: Both depressive symptoms and performance status independently predicted the physical and psychological domains of HRQoL. However, the impact of depressive symptoms on the physical HRQoL was stronger than the impact of performance status on the psychological HRQoL. CONCLUSION: Our results suggest that comorbid depressive symptoms are independently associated with both physical and psychological HRQoL in cancerpatients after controlling for the physician-rated performance status. Thus, comorbid depression should be taken into account when evaluating reduced HRQoL in cancerpatients. To support a causal impact of depression on HRQoL, intervention studies are needed to show that improving depression enhances cancerpatients' HRQoL.
Authors: Raymond W Lam; Diane McIntosh; JianLi Wang; Murray W Enns; Theo Kolivakis; Erin E Michalak; Jitender Sareen; Wei-Yi Song; Sidney H Kennedy; Glenda M MacQueen; Roumen V Milev; Sagar V Parikh; Arun V Ravindran Journal: Can J Psychiatry Date: 2016-08-02 Impact factor: 4.356
Authors: Jonas A de Souza; Bonnie J Yap; Kristen Wroblewski; Victoria Blinder; Fabiana S Araújo; Fay J Hlubocky; Lauren H Nicholas; Jeremy M O'Connor; Bruce Brockstein; Mark J Ratain; Christopher K Daugherty; David Cella Journal: Cancer Date: 2016-10-07 Impact factor: 6.860