Anxiety and depression after diagnosis of high-risk primary cutaneous melanoma: a 4-year longitudinal study
Beesley, VL Hughes, MCB Smithers, BM Khosrotehrani, K Malt, MK von Schuckmann, LA Green, Adèle C
Beesley, VL
Hughes, MCB
Smithers, BM
Khosrotehrani, K
Malt, MK
von Schuckmann, LA
Green, Adèle C
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Abstract
Purpose: To quantify the prevalence of anxiety or depression (overall; melanoma-related) among people with high-risk primary melanoma, their related use of mental health services and medications, and factors associated with persistent new-onset symptoms across 4 years post-diagnosis.
Methods: A longitudinal study of 675 patients newly diagnosed with tumor-stage 1b-4b melanoma. Participants completed the Hospital Anxiety and Depression Scale and answered questions about fear of cancer recurrence, use of medication, and support, serially over 4 years. We identified anxiety and depression trajectories with group-based trajectories models and factors associated with persistent symptoms with logistic regression.
Results: At diagnosis, 93 participants (14%) had melanoma-related anxiety or depression, and 136 (20%) were affected by anxiety and/or depression unrelated to melanoma. After 6 months, no more than 27 (5%) reported melanoma-related anxiety or depression at any time, while the point prevalence of anxiety and depression unrelated to melanoma was unchanged (16-21%) among the disease-free. Of 272 participants reporting clinical symptoms of any cause, 34% were taking medication and/or seeing a psychologist or psychiatrist. Of the participants, 11% (n = 59) had new-onset symptoms that persisted; these participants were more likely aged < 70.
Conclusions: Melanoma-related anxiety or depression quickly resolves in high-risk primary melanoma patients after melanoma excision, while prevalence of anxiety or depression from other sources remains constant among the disease-free. However, one-in-ten develop new anxiety or depression symptoms (one-in-twenty melanoma-related) that persist.
Implications for cancer survivors: Chronic stress has been linked to melanoma progression. Survivors with anxiety and depression should be treated early to improve patient and, potentially, disease outcomes.
Keywords: Anxiety; Depression; Distress; Fear of recurrence; Melanoma.
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Date
2020
Publisher
Collections
Keywords
Type
Article
Citation
Beesley VL, Hughes MCB, Smithers BM, Khosrotehrani K, Malt MK, von Schuckmann LA, et al. Anxiety and depression after diagnosis of high-risk primary cutaneous melanoma: a 4-year longitudinal study. J Cancer Surviv. 2020.