Poster Presentation COSA 2015 ASM

Does the prevalence of anxiety and depression for diffuse large B-cell lymphoma cancer survivors change over time: a prospective study (#384)

Devesh V Oberoi 1 , Vicki White 1 , Michael Jefford 2 , John F Seymour 2 , Miles Prince 2 , Simon Harrison 2 , Nicole Wong Doo 3 , Jeremy Millar 4 , Ingrid Winship 5 , Damien Bolton 6 , Ian D Davis 7 , Graham G Giles 1
  1. Cancer Council Vicotria, Melbourne, VIC, Australia
  2. Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  3. Concord Repatriation and General Hospital, Sydney, NSW, Australia
  4. Alfred Health, Melbourne, Victoria, Australia
  5. Royal Melbourne Hospital, Melbourne, Victoria, Australia
  6. Austin Health, Melbourne, Victoria, Australia
  7. Monash University and Eastern Health, Melbourne, Victoria, Australia

Does the prevalence of anxiety and depression among diffuse large B-cell lymphoma (DLBCL) survivors change over time? Findings from a prospective study

Objective:  To prospectively examine the prevalence of anxiety and depression among survivors of DLBCL.

Methods: Patients with a primary diagnosis of DLBCL (n=354) recruited through Victorian Cancer Registry (response rate 32%) completed telephone interviews on average 6.5 months post-diagnosis (SD: 1.96, range: 2.4-11.8) (T1), with 259 (response rate 74%) completing a second interview on average 8.4 months later (SD: 0.75, range 7-12) (T2). Hospital Anxiety and Depression Scale (HADS) and Supportive Care Needs Survey (SCNS-SF34) were completed at both times. Primary outcomes were elevated levels (scores 8+) of HADS anxiety and depression. McNemar tests examined change in prevalence of anxiety and depression.

Results: We analysed data from 259 patients participating in both interviews. The prevalence of elevated anxiety increased (T1=13% vs. T2=23%, p=0.005), while that of elevated depression remained stable (T1=15% vs. T2=16%, p=0.87). In multivariate logistic regression analysis, elevated anxiety at T1 was positively associated with baseline (T1) unmet psychological needs (OR 1.32, 95%CI 1.12-1.57), and T1 unmet sexuality needs (OR 1.65, 95%CI 1.10-2.45) and was inversely associated with perceived quality of care at T1 (OR 0.55,95%CI 0.37-0.77). T2 anxiety was associated with T1 unmet physical and daily living needs (OR 1.37, 95%CI 1.07-1.74, p<0.05), and unmet psychological needs (OR 1.16, 95%CI 1.01-1.34).  Participants aged under 60 (OR 3.13, 95%CI 1.23-7.63) were more likely to have elevated anxiety at T1 but not T2. T1 Depression (OR 4.83, 95%CI 1.69-13.79) was associated with perceived poorer health at T1. T2 depression was positively associated with baseline unmet psychological needs (OR 1.21, 95%CI 1.03-1.43) and perceived poorer health at T1 (OR 4.41, 95%CI 1.36-14.29).  

Conclusions: A substantial increase in the prevalence of elevated anxiety in DLBCL survivors in the first two years post-diagnosis was observed, although depression remained constant. Identifying effective strategies to address unmet psychological, physical and sexual needs are warranted.