TY - JOUR
T1 - Evaluating time-limited and persistent symptoms of adjustment disorder in cancer patients after a colorectal cancer diagnosis
T2 - a longitudinal observational study
AU - Wijnhoven, Lonneke M. A.
AU - Kwakkenbos, Linda
AU - Verdonck-de Leeuw, Irma M.
AU - Prins, Judith B.
AU - Custers, José A. E.
N1 - Funding Information: This work was supported by the Dutch foundation Fonds NutsOhra under Grant 1003-033. Publisher Copyright: Copyright © 2023 The Authors. Published by Wolters Kluwer Health Inc., on behalf of the International Psycho-Oncology Society.
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Background: Patients with colorectal cancer (CRC) may experience symptoms of adjustment disorder (AD) after cancer diagnosis and treatment. Time-limited symptoms of AD may become persistent if the stressor or its consequences have not disappeared after 6 months, but evidence on the course of AD symptoms is scarce. This longitudinal observational study investigates the proportion of patients with CRC with time-limited and persistent AD symptoms within the first year after diagnosis, in relation to demographic, clinical, and psychological factors and health-related quality of life (HRQoL). Methods: Informed consent was retrieved from 232 participants, and 194 participants completed questionnaires at baseline, 3, 6, and 12 months postdiagnosis. Hospital Anxiety and Depression Scale total scores (HADS-T) were categorized as indication for no symptoms of a mental disorder (MD) (HADS-T ≤10), AD symptoms (HADS-T 11–14), and other MD symptoms (HADS-T ≥15). Symptom subgroups over time were a priori defined: no MD, time-limited AD, persistent AD, other MD, and fluctuating symptoms. Results: Complete data were available for 81 participants (41.4%). Over time, 38.3% had no MD symptoms, 8.6% had time-limited AD symptoms, 1.2% had persistent AD symptoms, 4.9% had other MD symptoms, and 46.9% had fluctuating symptoms. Participants with AD and fluctuating symptoms reported higher fear of cancer recurrence, lower HRQoL, and higher cancer-specific distress than participants without MD symptoms (P, .5). Conclusions: During the first year after CRC diagnosis, only a small proportion of the patients showed time-limited and persistent AD symptoms and most showed fluctuating symptoms. More prospective research is needed to determine how repeated assessments for elevated AD symptoms relate to an AD diagnosis established with a diagnostic interview.
AB - Background: Patients with colorectal cancer (CRC) may experience symptoms of adjustment disorder (AD) after cancer diagnosis and treatment. Time-limited symptoms of AD may become persistent if the stressor or its consequences have not disappeared after 6 months, but evidence on the course of AD symptoms is scarce. This longitudinal observational study investigates the proportion of patients with CRC with time-limited and persistent AD symptoms within the first year after diagnosis, in relation to demographic, clinical, and psychological factors and health-related quality of life (HRQoL). Methods: Informed consent was retrieved from 232 participants, and 194 participants completed questionnaires at baseline, 3, 6, and 12 months postdiagnosis. Hospital Anxiety and Depression Scale total scores (HADS-T) were categorized as indication for no symptoms of a mental disorder (MD) (HADS-T ≤10), AD symptoms (HADS-T 11–14), and other MD symptoms (HADS-T ≥15). Symptom subgroups over time were a priori defined: no MD, time-limited AD, persistent AD, other MD, and fluctuating symptoms. Results: Complete data were available for 81 participants (41.4%). Over time, 38.3% had no MD symptoms, 8.6% had time-limited AD symptoms, 1.2% had persistent AD symptoms, 4.9% had other MD symptoms, and 46.9% had fluctuating symptoms. Participants with AD and fluctuating symptoms reported higher fear of cancer recurrence, lower HRQoL, and higher cancer-specific distress than participants without MD symptoms (P, .5). Conclusions: During the first year after CRC diagnosis, only a small proportion of the patients showed time-limited and persistent AD symptoms and most showed fluctuating symptoms. More prospective research is needed to determine how repeated assessments for elevated AD symptoms relate to an AD diagnosis established with a diagnostic interview.
KW - adjustment disorder
KW - colorectal cancer
KW - longitudinal study
KW - oncology
KW - psychology
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U2 - https://doi.org/10.1097/OR9.0000000000000105
DO - https://doi.org/10.1097/OR9.0000000000000105
M3 - Article
SN - 2637-5974
VL - 5
SP - 1
EP - 7
JO - Journal of Psychosocial Oncology Research and Practice
JF - Journal of Psychosocial Oncology Research and Practice
IS - 3
M1 - 105
ER -