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

Research output: Contribution to journalArticle

54 Citations (Scopus)

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

Fingerprint

Stem Cell Transplantation
Anxiety
Depression
Drug Therapy
Transplants
Psychology
Survivors
Lymphoma

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

Cite this

The course of anxiety and depression during the first year after allogeneic or autologous stem cell transplantation. / Hjermstad, M J; Loge, J H; Evensen, S A; Kvaløy, S O; Fayers, Peter; Kaasa, S.

In: Bone Marrow Transplantation, Vol. 24, No. 11, 12.1999, p. 1219-1228.

Research output: Contribution to journalArticle

Hjermstad, M J ; Loge, J H ; Evensen, S A ; Kvaløy, S O ; Fayers, Peter ; Kaasa, S. / The course of anxiety and depression during the first year after allogeneic or autologous stem cell transplantation. In: Bone Marrow Transplantation. 1999 ; Vol. 24, No. 11. pp. 1219-1228.
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T1 - The course of anxiety and depression during the first year after allogeneic or autologous stem cell transplantation

AU - Hjermstad, M J

AU - Loge, J H

AU - Evensen, S A

AU - Kvaløy, S O

AU - Fayers, Peter

AU - Kaasa, S

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N2 - 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.

AB - 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.

KW - Adolescent

KW - Adult

KW - Antineoplastic Combined Chemotherapy Protocols

KW - Anxiety

KW - Depression

KW - Fatigue

KW - Female

KW - Hematopoietic Stem Cell Transplantation

KW - Humans

KW - Leukemia

KW - Lymphoma

KW - Male

KW - Middle Aged

KW - Prospective Studies

KW - Questionnaires

KW - Regression Analysis

KW - Time Factors

KW - Transplantation, Autologous

KW - Transplantation, Homologous

KW - anxiety

KW - depression

KW - HADS

KW - high-dose chemotherapy

KW - prospective study

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DO - 10.1038/sj.bmt.1702046

M3 - Article

C2 - 10642812

VL - 24

SP - 1219

EP - 1228

JO - Bone Marrow Transplantation

JF - Bone Marrow Transplantation

SN - 0268-3369

IS - 11

ER -