Stressors, symptom profile, and predictors of adjustment disorder in cancer patients. Results from an epidemiological study with the composite international diagnostic interview, adaptation for oncology (CIDI-O)

TY - JOUR

T1 - Stressors, symptom profile, and predictors of adjustment disorder in cancer patients. Results from an epidemiological study with the composite international diagnostic interview, adaptation for oncology (CIDI-O)

AU - Hund, Bianca

AU - Reuter, Katrin

AU - Härter, Martin

AU - Brähler, Elmar

AU - Faller, Hermann

AU - Keller, Monika

AU - Schulz, Holger

AU - Wegscheider, Karl

AU - Weis, Joachim

AU - Wittchen, Hans-Ulrich

AU - Koch, Uwe

AU - Friedrich, Michael

AU - Mehnert, Anja

N1 - © 2015 Wiley Periodicals, Inc.

PY - 2016/2

Y1 - 2016/2

N2 - BACKGROUND: We aimed to investigate type and frequency of stressors, predominant symptom profiles, and predictors of adjustment disorders (AD) in cancer patients across major tumor entities.METHODS: In this epidemiological study, we examined 2,141 cancer patients out of 4,020 screened with the Composite International Diagnostic Interview, adaptation for oncology (CIDI-O). AD were operationalized as subthreshold disorders according to DSM-IV criteria.RESULTS: In our sample, 265 out of 2,141 patients (12.4%) met all criteria for AD (unweighted 4-week prevalence). The disclosure of the cancer diagnosis, relapse or metastases, and cancer treatments were most frequently described as stressors associated with depressive or anxious symptoms. With regard to AD symptom profiles, patients showed high prevalence rates of affective symptoms according to the DSM-IV criteria of Major Depression: The highest prevalence rates were found for cognitive disturbances (concentration and memory problems) (88%), sleeping disturbances (86%), and depressive mood (83%). We found sex, education, and metastasis as significant predictors for AD. Higher education was the most influential predictor. Men were half as likely to report symptoms fulfilling the AD criteria as women. Patients with metastasized tumors had a more than 80% higher risk of AD than those without metastasis. However, the explained variance of our model is very small (Nagelkerke's R² = 0.08).CONCLUSIONS: Patients with AD can be identified using a standardized instrument and deserve clinical attention, as they often show severe clinical symptoms and impairments. Improving the clinical conceptualization of AD by the adding-on of potential stress-response-symptoms is necessary to identify severe psychological strain.

AB - BACKGROUND: We aimed to investigate type and frequency of stressors, predominant symptom profiles, and predictors of adjustment disorders (AD) in cancer patients across major tumor entities.METHODS: In this epidemiological study, we examined 2,141 cancer patients out of 4,020 screened with the Composite International Diagnostic Interview, adaptation for oncology (CIDI-O). AD were operationalized as subthreshold disorders according to DSM-IV criteria.RESULTS: In our sample, 265 out of 2,141 patients (12.4%) met all criteria for AD (unweighted 4-week prevalence). The disclosure of the cancer diagnosis, relapse or metastases, and cancer treatments were most frequently described as stressors associated with depressive or anxious symptoms. With regard to AD symptom profiles, patients showed high prevalence rates of affective symptoms according to the DSM-IV criteria of Major Depression: The highest prevalence rates were found for cognitive disturbances (concentration and memory problems) (88%), sleeping disturbances (86%), and depressive mood (83%). We found sex, education, and metastasis as significant predictors for AD. Higher education was the most influential predictor. Men were half as likely to report symptoms fulfilling the AD criteria as women. Patients with metastasized tumors had a more than 80% higher risk of AD than those without metastasis. However, the explained variance of our model is very small (Nagelkerke's R² = 0.08).CONCLUSIONS: Patients with AD can be identified using a standardized instrument and deserve clinical attention, as they often show severe clinical symptoms and impairments. Improving the clinical conceptualization of AD by the adding-on of potential stress-response-symptoms is necessary to identify severe psychological strain.

UR - http://onlinelibrary.wiley.com/doi/10.1002/da.22441/epdf

U2 - 10.1002/da.22441

DO - 10.1002/da.22441

M3 - SCORING: Journal article

C2 - 26474266

VL - 33

SP - 153

EP - 161

JO - DEPRESS ANXIETY

JF - DEPRESS ANXIETY

SN - 1091-4269

IS - 2

ER -