The course of anxiety and depression during the first year after allogeneic or autologous stem cell transplantation

M J Hjermstad, J H Loge, S A Evensen, S O Kvaløy, Peter Fayers, S Kaasa

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Abstract

Psychological distress is frequently reported in transplant survivors. We prospectively assessed anxiety and depression before transplant, in the isolation period and during a follow-up period of 1 year. The Hospital Anxiety and Depression Scale (HADS) was administered to 131 cancer patients treated with high-dose chemotherapy followed by allogeneic (SCT) or autologous (ASCT) stem cell transplantation, and a concurrent group of 123 lymphoma patients receiving standard chemotherapy (CT) who served as a reference group. Relatively low levels of anxiety and depression were found. The level of anxiety slightly declined from baseline during follow-up (mean scores SCT: from 5.3 to 3.6, CT: from 6.0 to 4.2) or remained fairly stable (ASCT: from 5.4 to 4.8). The level of depression peaked when the transplant patients were in protective isolation or shortly thereafter (SCT: 6.1, ASCT: 6.4), but stabilized at baseline levels after 4 months. The highest level of depression in the CT group was reported 4 months after start of chemotherapy (3.4). Elevated levels of anxiety and depression at baseline predicted more anxiety and depression at the later assessments (P values <0.0001). The ASCT group had higher levels of anxiety after 1 year (mean 4.8) than those found in the other two groups (SCT: 3.6, CT: 4.2), although they were not statistically significant. This study revealed lower than expected levels of anxiety and depression after intensive chemotherapy followed by SCT or ASCT. There was a decline in psychological distress during the 1-year follow-up period.
Original languageEnglish
Pages (from-to)1219-1228
Number of pages10
JournalBone Marrow Transplantation
Volume24
Issue number11
DOIs
Publication statusPublished - Dec 1999

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Keywords

  • Adolescent
  • Adult
  • Antineoplastic Combined Chemotherapy Protocols
  • Anxiety
  • Depression
  • Fatigue
  • Female
  • Hematopoietic Stem Cell Transplantation
  • Humans
  • Leukemia
  • Lymphoma
  • Male
  • Middle Aged
  • Prospective Studies
  • Questionnaires
  • Regression Analysis
  • Time Factors
  • Transplantation, Autologous
  • Transplantation, Homologous
  • anxiety
  • depression
  • HADS
  • high-dose chemotherapy
  • prospective study

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