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Depressed patients with incurable cancer: which depressive symptoms do they experience?
Norwegian Univ Sci & Technol, European Palliat Care Res Ctr, Fac Med, N-7006 Trondheim, Norway.
Norwegian Univ Sci & Technol, European Palliat Care Res Ctr, Fac Med, N-7006 Trondheim, Norway.
Norwegian Univ Sci & Technol, European Palliat Care Res Ctr, Fac Med, N-7006 Trondheim, Norway.
Med Univ Graz, Div Palliat Med, Dept Internal Med, Graz, Austria.
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2013 (English)In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 11, no 6, 491-501 p.Article, review/survey (Refereed) Published
Abstract [en]

OBJECTIVE: Diagnosing depressive disorders in palliative care is challenging because of the overlap between some depressive symptoms and cancer-related symptoms, such as loss of appetite and fatigue. In order to improve future assessment of depression in palliative care, depressive symptoms experienced by patients receiving pharmacological treatment for depression were assessed and compared to the American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria for major depressive disorder.

METHOD: Thirty Norwegian (n = 20) and Austrian (n = 10) patients with advanced cancer were included. Semistructured interviews on symptom experiences were conducted and transcribed verbatim. By the phenomenographic method, patients' symptom experiences were extracted and sorted by headings, first individually and then across patients. The patients subsequently rated 24 symptoms numerically including the DSM-IV depression criteria.

RESULTS: Lowered mood and a diminished motivational drive were prominent and reflected the two main DSM-IV symptom criteria. A relentless focus on their actual situation, restlessness, disrupted sleep, feelings of worthlessness, feelings of guilt, and thoughts of death as a solution were variably experienced. Appetite and weight changes, fatigue and psychomotor retardation were indistinguishable from cancer symptoms. All these symptoms reflected DSM-IV symptom criteria. Some major symptoms occurred that are not present in the DSM-IV symptom criteria: despair, anxiety, and social withdrawal. The numerical ratings of symptoms were mainly in accordance with the findings from the qualitative analysis.

SIGNIFICANCE OF RESULTS: Despair, anxiety, and social withdrawal are common symptoms in depressed patients with incurable cancer, and, therefore, hypothesized as candidate symptom criteria. Other symptom criteria might need adjustment for improvement of relevance in this group of patients.

Place, publisher, year, edition, pages
2013. Vol. 11, no 6, 491-501 p.
Keyword [en]
Cancer, Depression, Major Depressive Disorder, Palliative Care, Classification
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:miun:diva-22961DOI: 10.1017/S1478951512000909ISI: 000339610800006PubMedID: 23388067Scopus ID: 2-s2.0-84908698794OAI: oai:DiVA.org:miun-22961DiVA: diva2:746441
Available from: 2014-09-12 Created: 2014-09-12 Last updated: 2014-12-19Bibliographically approved

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