Depression and Psychological Distress in Patients During the Year After Curative Resection of Non–Small-Cell Lung Cancer

• Published in: Journal of clinical oncology Vol. 21; no. 1; pp. 69 - 77
• Main Authors: UCHITOMI, Yosuke, MIKAMI, Ichiro, NAGAI, Kanji, NISHIWAKI, Yutaka, AKECHI, Tatsuo, OKAMURA, Hitoshi
• Format: Journal Article
• Language: English
• Published: Baltimore, MD American Society of Clinical Oncology 01.01.2003; Lippincott Williams & Wilkins
• Subjects: Adult; Adult and adolescent clinical studies; Aged; Aged, 80 and over; Analysis of Variance; Biological and medical sciences; Carcinoma, Non-Small-Cell Lung - psychology; Carcinoma, Non-Small-Cell Lung - surgery; Depression; Depressive Disorder - epidemiology; Female; Humans; Japan - epidemiology; Lung Neoplasms - psychology; Lung Neoplasms - surgery; Male; Medical sciences; Middle Aged; Mood disorders; Postoperative Complications - epidemiology; Prospective Studies; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Quality of Life; Regression Analysis; Risk Factors; Stress, Psychological - epidemiology; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the respiratory system; Japan; Mood disorder; Human; Lung disease; Socioeconomic status; Respiratory disease; Depression; Surgical resection; Malignant tumor; Bronchopulmonary; Treatment; Surgery; Bronchus disease; Non small cell carcinoma
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/JCO.2003.12.139

There have been few psychosocial studies of patients after curative resection of non-small-cell lung cancer (NSCLC). The purpose of this study was to clarify the clinical course of depression and psychological distress of such patients during the year after surgery and to identify predictors of their long-term outcome. A total of 212 patients completed assessments during a 12-month follow-up period after curative resection of NSCLC. Psychological measurements at 1, 3, and 12 months after surgery were conducted using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (ed 3), Revised, and the Profiles of Mood States (POMS) scale. Univariate and multivariate analyses were used to identify predictors of psychological outcome according to these two methods of assessment. The prevalence of depression did not change during the year after curative resection (range, 4.7% to 8.0%). The total POMS score was also unaltered during the year after surgery: the anger-hostility (P <.001) and tension-anxiety subscale scores (P <.026) had increased at 12 months, but the vigor-activity subscale score had also increased (P <.001). All predictors of psychological outcome at 12 months included a depression episode after the diagnosis of lung cancer or at 1 month after surgery. Less-educated status was also a significant predictor of depression at 12 months. These results suggest the need for psychosocial support even after curative resection of NSCLC and indicate that an approach that includes repetitive perioperative assessment of depression and careful attention to less-educated patients might be of benefit to patients in ameliorating depression and psychological distress during the year after curative resection.