Depression, anxiety and quality of life in patients with melanoma

  • Aleksandra R Vojvodić Department of Dermatology and Venerology, Military Medical Academy, Belgrade, Serbia
  • Gordana Dedić Clinic for Psychiatry, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defense, Belgrade, Serbia
Keywords: melanoma;, quality of life;, depression;, anxiety;, surveys and questionnaires

Abstract


Background/Aim. Recent investigations have established a significant correlation between melanoma and quality of life, as well as anxiety and depression in these patients. In prognosis of melanoma, the most important is the stage in which it is diagnosed. The objective of the study was to analyze the quality of life, anxiety and depression in patients with a diagnosis of melanoma at different stages of the disease. Methods. In our cross-sectional study, 40 consecutive patients with melanoma, diagnosed and treated at the Department of Dermatology and Venerology, Military Medical Academy in Belgrade during the period from October to November 2015, were included. Twenty respondents were in stages I and II (localized disease) and 20 respondents in the stage IV (distant metastases). We used European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (EORTC QLQ 30), Beck anxiety inventory (BAI) and Beck depression inventory (BDI). The statistical analysis included parametric and non-parametric descriptive statistics. Results. In patients with stages I and II of the disease, anxiety scores were higher in comparison to those in patients with the stage IV (37.5 vs. 14.5, respectively; p < 0.05), but depression was more pronounced (6 vs. 2.5, respectively; p < 0.05) in patients with the IV stage of the disease. There were statistically significant differences in all segments of quality of life between patients with stages I and II and those with the stage IV of the disease. The global quality of life was significantly worse in patients with the IV stage (33.5 vs. 83), the symptomatology was more pronounced (78.5 vs. 0) and the functioning was significantly worse (31 vs. 85) in relation to patients with stages I and II (p < 0.01) for all segments of quality of life. Conclusion. Anxiety and quality of life decrease, while depression increases with melanoma stages. The need for adequate social and family support as well as psychological assistance in order to achieve better coping with the illness are necessary in patients with melanoma. Further studies are needed for monitoring of anxiety, depression and quality of life from the moment of diagnosis of the disease over time, as well as the impact of new treatment modalities on these parameters.

 

 

References

Tran AD, Fogarty G, Nowak AK, Espinoza D, Rowbotham N, Stockler MR, et al. A systematic review and meta-analysis of utility estimates in melanoma. Br J Dermatol 2018; 178(2): 384‒93.

Malkhasyan KA, Zakharia Y, Milhem M. Quality of life out-comes in patients with advanced melanoma: a review of the literature. Pigment Cell Melanoma Res 2017; 30(6): 511‒20.

Garbe C, Peris K, Hauschild A, Saiag P, Middleton M, Bastholt L, et al. European Dermatology Forum (EDF); European Asso-ciation of Dermato-Oncology (EADO); European Organisa-tion for Research and Treatment of Cancer (EORTC). Diag-nosis and treatment of melanoma. European consensus-based interdisciplinary guideline - Update 2016. Eur J Cancer 2016; 63: 201‒17.

Arnold M, Holterhues C, Hollestein LM, Coebergh JW, Nijsten T, Pukkala E, et al. Trends in incidence and prediction of cuta-neous melanoma across Europe up to 2015. J Eur Acad Der-matol Venereol 2014; 28(9): 1170‒8.

Rodríguez-Cerdeira C, Molares-Vila A, Carnero-Gregorio M, Cor-balán-Rivas A. Recent advances in melanoma research via "omics" platforms. J Proteomics 2018; 188: 152‒66.

Rat C, Hild S, Gaultier A, Khammari A, Bonnaud-Antignac A, Quereux G, et al. Anxiety, locus of control and sociodemo-graphic factors associated with adherence to an annual clinical skin monitoring: a cross sectional survey among 1000 high- risk French patients involvedin a pilot-targeted screening pro-gramme for melanoma. BMJ Open 2017; 7(10): e016071.

Hamama-Raz Y. Does psychological adjustment of melanoma survivors differs between genders? Psychooncology 2012; 21(3): 255–63.

Schuermeyer I, Maican A, Sharp R, Bena J, Triozzi PL, Singh AD. Depression, anxiety, and regret before and after testing to es-timate uveal melanoma prognosis. JAMA Ophthalmol 2016; 134(1): 51‒6.

Fischbeck S, Imruck BH, Blettner M, Weyer V, Binder H, Zeissig SR, et al. Psychosocial care needs of melanoma survivors: are they being met? PLoS One 2015; 10(8): e0132754.

Beutel ME, Fischbeck S, Binder H, Blettner M, Brähler E, Emrich K, et al. Depression, anxiety and quality of life in long-term survivors of malignant melanoma: a register-based cohort study. PLoS One 2015; 10(1): e0116440.

Fayers PM, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bot-tomley A. The EORTC QLQ-C30 scoring manual. 3rd ed. Bel-gium, Brussels: European Organization for Research and Treatment of Cancer; 2001.

Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988; 56(6): 893‒7.

Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inven-tory for measuring depression. Arch. Gen. Psychiatry 1961; 4: 561–7.

Beck AT, Steer RA, Garbin MG. Psychometric properties of the Beck Depression Inventory Twenty-five years of evalua-tion. Clin Psychol Rev 1988; 8(1): 77–100.

Pflugfelder A, Kochs C, Blum A, Capellaro M, Czeschik C, Detten-born T, et al. German Dermatological Society; Dermatologic Cooperative Oncology Group. Malignant melanoma S3-guideline "diagnosis, therapy and follow-up of melanoma". J Dtsch Dermatol Ges 2013; 11(Suppl 6): 1‒116, 1‒126. (Eng-lish, German)

Mayer S, Teufel M, Schaeffeler N, Keim U, Garbe C, Eigentler TK, et al. The need for psycho-oncological support for melanoma patients: Central role of patients' self-evaluation. Medicine (Baltimore) 2017; 96(37): e7987.

Bonnaud-Antignac A, Bourdon M, Dréno B, Quéreux G. Coping strategies at the time of diagnosis and quality of life 2 years later: a study in primary cutaneous melanoma patients. Cancer Nurs 2017; 40(1): E45‒E53.

Holterhues C, Cornish D, van de Poll-Franse LV, Krekels G, Koedijk F, Kuijpers D, et al. Impact of melanoma on patients’ lives among 562 survivors: a Dutch population-based study. Arch Dermatol 2011; 147(2): 177–85.

Hamama-Raz Y, Solomon Z, Schachter J, Azizi E. Objective and subjective stressors and the psychological adjustment of mela-noma survivors. Psychooncology 2007; 16(4): 287–94.

Mendis S, Davis S, Norrving B. Organizational update: the world health organization global status report on noncom-municable diseases 2014; one more landmark step in the com-bat against stroke and vascular disease. Stroke 2015; 46(5): e121‒2.

Albrecht K, Droll H, Giesler JM, Nashan D, Meiss F, Reuter K. Self-efficacy for coping with cancer in melanoma patients: its association with physical fatigue and depression. Psychooncol-ogy 2013; 22(9): 1972–8.

Vogel RI, Strayer LG, Ahmed RL, Blaes A, Lazovich D. A Qual-itative Study of Quality of Life Concerns following a Mela-noma Diagnosis. J Skin Cancer 2017; 2017: 2041872.

Dubravcić ID, Brozić JM, Aljinović A, Sindik J. Quality of life in Croatian metastatic melanoma patients. Coll Antropol 2014; 38(1): 69‒74.

Nowe E, Stöbel-Richter Y, Sender A, Leuteritz K, Friedrich M, Geue K. Review article: cancer-related fatigue in adolescents and young adults: a systematic review of the literature. Crit Rev Oncol Hematol 2017; 118: 63‒9.

Hinz A, Singer S, Brähler E. European reference values for the quality of life questionnaire EORTC QLQ-C30: Results of a German investigation and a summarizing analysis of six Euro-pean general population normative studies. Acta Oncol 2014; 53(7): 958–65.

Hamel JF, Pe M, Coens C, Martinelli F, Eggermont AM, Brand-berg Y, Bottomley A. A systematic review examining factors in-fluencing health related quality of life among melanomacancer survivors. Eur J Cancer 2016; 69: 189‒98.

Fischbeck S, Imruck BH, Blettner M, Weyer V, Binder H, Zeissig SR, at al. Psychosocial care needs of melanoma survivors: are they being met? PLoS One 2015; 10(8): e0132754.

Palesh O, Aldridge-Gerry A, Bugos K, Pickham D, Chen JJ, Greco R, et al. Health behaviors and needs of melanoma survivors. Support Care Cancer 2014; 22(11): 2973‒80.

Mehnert A, Koch U. Psychological comorbidity and health-related quality of life and its association with awareness, utili-zation, and need for psychosocial support in a cancer register-based sample of long-term breast cancer survivors. J Psycho-som Res 2008; 64(4): 383–91.

Tas F, Karabulut S, Guveli H, Kurul S, Erturk K, Guveli M, et al. Assessment of anxiety and depression status in Turkish cuta-neous melanoma patients. Asian Pac J Cancer Prev 2017; 18(2): 369‒73.

Tesio V, Ribero S, Castelli L, Bassino S, Leombruni P, Caliendo V, et al. Psychological characteristics of early-stage melanoma patients: a cross-sectional study on 204 patients. Melanoma Res 2017; 27(3): 277‒80.

Pereira MG, Ponte M, Ferreira G, Machado JC. Quality of life in patients with skin tumors: the mediator role of body image and social support. Psychooncology 2017; 26(6): 815‒21.

Published
2021/01/15
Section
Original Paper