| 1. |
- Hardardottir, Hronn, et al.
(författare)
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Optimal communication associated with lower risk of acute traumatic stress after lung cancer diagnosis
- 2022
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Ingår i: Supportive Care in Cancer. - : Springer. - 0941-4355 .- 1433-7339. ; 30:1, s. 259-269
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim of this study was to assess the role of the patient's background and perceived healthcare-related factors in symptoms of acute stress after lung cancer diagnosis.Methods: The study population consisted of 89 individuals referred for diagnostic work-up at Landspitali National University Hospital in Iceland and subsequently diagnosed with lung cancer. Before diagnosis, the patients completed questionnaires on sociodemographic characteristics, pre-diagnostic distress (Hospital Anxiety and Depression Scale), social support, and resilience. At a median of 16 days after diagnosis, the patients reported symptoms of acute stress on the Impact of Event Scale-Revised (IES-R) and experience of communication and support from healthcare professionals and family during the diagnostic period.Results: Patients were on average 68 years and 52% reported high levels of post-diagnostic acute stress (IES-R > 23) while 24% reported symptoms suggestive of clinical significance (IES-R > 32). Prior history of cancer (beta = 6.7, 95% CI: 0.1 to 13.3) and pre-diagnostic distress were associated with higher levels of post-diagnostic acute stress (beta = 8.8, 95% CI: 2.7 to 14.9), while high educational level (beta = - 7.9, 95% CI: - 14.8 to - 1.1) was associated with lower levels. Controlling for the abovementioned factors, the patients' perception of optimal doctor-patient (beta = - 9.1, 95% CI: - 14.9 to - 3.3) and family communication (beta = - 8.6, 95% CI: - 14.3 to - 2.9) was inversely associated with levels of post-diagnostic acute stress after lung cancer diagnosis.Conclusions: A high proportion of patients with newly diagnosed lung cancer experience high levels of acute traumatic stress of potential clinical significance. Efforts to improve doctor-patient and family communication may mitigate the risk of these adverse symptoms.
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| 2. |
- Zhu, Jianwei, et al.
(författare)
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First-onset mental disorders after cancer diagnosis and cancer-specific mortality : a nationwide cohort study
- 2017
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Ingår i: Annals of Oncology. - : Oxford University Press. - 0923-7534 .- 1569-8041. ; 28:8, s. 1964-1969
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Tidskriftsartikel (refereegranskat)abstract
- Background: The diagnosis of cancer is strongly associated with the risk of mental disorders even in patients with no previous history of mental disorders. Accumulating data suggest that mental distress may accelerate tumor progression. We hypothesized therefore that mental disorders after a cancer diagnosis may increase the risk of cancer-specific mortality.Patients and methods: We conducted a nationwide cohort study including 244 261 cancer patients diagnosed in Sweden during 2004-2009 and followed them through 2010. Through the Swedish Patient Register, we obtained clinical diagnoses of all mental disorders and focused on mood-, anxiety-, and substance abuse disorders (ICD10: F10-F16, F18-F19, F32-F33, F40-F41, and F43-45) that are commonly diagnosed among patients with cancer. We further classified the studied mental disorders into first-onset or recurrent mental disorders. We used Cox regression to estimate multivariable hazard ratios (HRs) with 95% confidence intervals (CIs) as a measure of the association between mental disorders after cancer diagnosis and cancer-specific mortality, adjusting for age, sex, calendar period, educational level, cancer stage, and cancer type at diagnosis.Results: After cancer diagnosis, 11 457 patients were diagnosed with mood-, anxiety-, and substance abuse disorders; of which 7236 were first-onset mental disorders. Patients with a first-onset mental disorder were at increased risk of cancer-specific mortality (HR: 1.82, 95% CI: 1.71-1.92) while patients with a recurrent mental disorder had much lower risk elevation (HR: 1.14, 95% CI: 1.05-1.24). The increased cancer-specific mortality by first-onset mental disorders was observed for almost all cancer sites/groups and the association was stronger for localized cancers (HR: 2.00, 95% CI: 1.73-2.31) than for advanced cancers (HR: 1.49, 95% CI: 1.32-1.69).Conclusions: Patients with a first-onset common mood-, anxiety-, or substance abuse disorder after cancer diagnosis may be at increased risk of cancer-specific death.
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| 3. |
- Zhu, Jianwei, et al.
(författare)
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Is a cancer diagnosis associated with subsequent risk of transient global amnesia?
- 2015
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Ingår i: PLOS ONE. - San Fransisco, USA : Public Library of Science. - 1932-6203. ; 10:4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Psychological stress has been associated with transient global amnesia (TGA). Whether a cancer diagnosis, a severely stressful life event, is associated with subsequent risk of TGA has not been studied.Methods: Based on the Swedish Cancer Register and Patient Register, we conducted a prospective cohort study including 5,365,608 Swedes at age 30 and above during 2001-2009 to examine the relative risk of TGA among cancer patients, as compared to cancer-free individuals. Incidence rate ratios (IRRs) and their 95% confidence intervals (CIs) derived from Poisson regression were used as estimates of the association between cancer diagnosis and the risk of TGA.Results: During the study 322,558 individuals (6.01%) received a first diagnosis of cancer. We identified 210 cases of TGA among the cancer patients (incidence rate, 0.22 per 1000 person-years) and 4,887 TGA cases among the cancer-free individuals (incidence rate, 0.12 per 1000 person-years). Overall, after adjustment for age, sex, calendar year, socioeconomic status, education and civil status, cancer patients had no increased risk of TGA than the cancer-free individuals (IRR, 0.99; 95% CI, 0.86-1.13). The IRRs did not differ over time since cancer diagnosis or across individual cancer types. The null association was neither modified by sex, calendar period or age.Conclusion: Our study did not provide support for the hypothesis that patients with a new diagnosis of cancer display a higher risk of TGA than cancer-free individuals.
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| 4. |
- Zhu, Jianwei, et al.
(författare)
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Mental disorders around cancer diagnosis and increased hospital admission rate : a nationwide cohort study of Swedish cancer patients
- 2018
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Ingår i: BMC Cancer. - : BioMed Central. - 1471-2407. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Whether the emotional distress around cancer diagnosis is associated with the long-term outcomes and care utilization is unknown. We aimed to examine the association of mental disorders around cancer diagnosis with the hospital admission rates of cancer patients thereafter.METHODS: We conducted a nationwide cohort study including 218,508 cancer patients diagnosed in Sweden during 2004-2009 and followed them from 90 days after cancer through 2010. We used a clinical diagnosis of stress-related mental disorders from 90 days before to 90 days after cancer diagnosis as the exposure. We studied first all hospital admissions and then separately three common admissions, including external injuries, infections, and cardiovascular diseases. The Cox model was used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs).RESULTS: Four thousand one hundred five patients received a diagnosis of stress-related mental disorders around the cancer diagnosis, and experienced a 35% increased rate of any hospital admission during follow-up (HR: 1.35, 95%CI: 1.28-1.41) as well as hospital admissions for external injuries (HR: 1.89, 95%CI: 1.67-2.14), infections (HR: 1.28, 95%CI: 1.08-1.52), and cardiovascular diseases (HR: 1.16, 95%CI: 1.03-1.30). Similar association was noted for most common cancer types.CONCLUSIONS: These data suggest that cancer patients diagnosed with a stress-related mental disorder immediately before or after cancer diagnosis are subsequently at increased risk of hospital admissions for major comorbidities of cancer.
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| 5. |
- Zhu, Jianwei, et al.
(författare)
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Myocardial infarction or mental disorders after cancer diagnosis and cancer-specific survival
- 2015
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Ingår i: Psychoneuroendocrinology. - : Elsevier BV. - 0306-4530 .- 1873-3360. ; 61, s. 23-23
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background: Receiving a cancer diagnosis has been associated with immediate risks of mental disorders and cardiovascular disease which may reflect a severe stress-response to the diagnosis. We aimed to explore the association of myocardial infarction or mental disorders shortly after a cancer diagnosis and cancer-specific survival.Methods: We conducted a prospective cohort study based on the Swedish Cancer Register including 227,943 cancer patients diagnosed during 2004-2009. Non-fetal myocardial infarction (MI) and any mental disorders during the first 90 days after cancer diagnosis were identified by record linkage to the Patient Register. We used Cox proportional hazards regression to calculate the hazard ratio (HR) and 95% confidence interval(CI) as an estimate of the association between MI or mental disorder and total cancer- and cancer-site specific survival.Results: During the first 90 days post diagnosis, 724 patients experienced MI and 2,391 were diagnosed with mental disorders. During the average of 3.2 years of follow-up, the rate of any cancer specific-death was increased among patients who experienced MI (HR:1.46, 95%CI:1.27-1.68) with the highest mortality increments observed for lung cancer (HR:1.60, 95%CI:1.21-2.12) and blood cancers (HR:1.83, 95%CI:1.18-2.84). Similarly, patients diagnosed with mental disorder had higher total cancer-specific mortality rates (HR:1.25, 95%CI:1.15-1.37) with the highest mortality increments observed for breast cancer (HR:1.56, 95%CI:1.14-2.14), lung cancer (HR:1.34, 95%CI:1.10-1.63) and blood cancer (HR:1.61, 95%CI:1.21-2.15).Conclusion: MI or mental disorder shortly after a cancer diagnosis may decrease cancer-specific survival, especially in breast-, lung-, and blood cancers (Funded by Swedish Cancer Society, Swedish Research Council for Health, Working Life and Welfare, and others).
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