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    Anxiety and depression after diagnosis of high-risk primary cutaneous melanoma: a 4-year longitudinal study

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    Authors
    Beesley, VL
    Hughes, MCB
    Smithers, BM
    Khosrotehrani, K
    Malt, MK
    von Schuckmann, LA
    Green, Adèle C
    Affiliation
    Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
    Issue Date
    2020
    
    Metadata
    Show full item record
    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.
    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.
    Journal
    Journal of Cancer Survivorship
    URI
    http://hdl.handle.net/10541/623136
    DOI
    10.1007/s11764-020-00885-9
    PubMed ID
    32519121
    Additional Links
    https://dx.doi.org/10.1007/s11764-020-00885-9
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1007/s11764-020-00885-9
    Scopus Count
    Collections
    All Paterson Institute for Cancer Research

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