Depression, Anxiety and Quality of Life in Long-Term Survivors of Malignant Melanoma

Depression, Anxiety and Quality of Life in Long-Term Survivors of Malignant Melanoma

shutterstock_98508260In a recent study titled “Depression, Anxiety and Quality of Life in Long-Term Survivors of Malignant Melanoma: A Register-Based Cohort Study, published in the PlosOne journal, a research team from the University Medical Center Mainz, Germany, set out to better understand anxiety, depression, quality of life, and their determinants in long-term survivors of malignant melanoma.

Recent studies have demonstrated that approximately 30% of malignant melanoma survivors suffer from increased distress during the time of diagnosis and throughout treatment. Additionally, between 18 and 44% of patients suffer from anxiety.

Earlier research from these authors had already demonstrated that in a group of 520 melanoma patients, 47% suffered from heightened distress, such as emotional sources of distress, practical and work problems, family, partner, and physical problems.

Even though upon early detection, melanoma survival rates can be very optimistic, survivors of this disease continuously deal with the eminent threat of cancer recurrence and have to adopt increased prevention measures, such as reduced UV exposure, continued self-examination and dermatological controls. Furthermore, malignant melanoma survivors have also reported to suffer from fear or developing a new melanoma.

In this study, the research team contacted several (1,302) malignant melanoma patients, using a state cancer registry. Of these, 52.2% completed the Patient Health Questionnaire with generalized anxiety and depression and the EORTC Quality of Life Questionnaire.

Trough statistical analysis, the team concluded that after an average of 8.4 years post melanoma diagnosis, women suffered from higher levels of distress when compared to men. Furthermore, distress levels increased proportionally to patient’s age (independent of gender). Also, researchers found that malignant melanoma survivors had an increased functional decline and physical symptoms when compared to the general population.

Importantly, the authors observed that distress and reduced quality of life were reliably predicted by the absence of social support, fear of recurrence, pessimism and self-blame. Additionally, patients who had a family history of melanoma, showed an increased distress and further mental and somatic diseases.

The authors state that their results support the implementation of regular psychooncological screening of malignant melanoma survivors, to identify and support patients who have an increased difficulty adapting to their disease. “Screening should include distress and specific aspects of quality of life (functional and symptom scales). The interplay of vulnerability factors (e.g. previous mental disease), confrontation with the threat of cancer (e.g. in the family), appraisal, coping and social support may determine long-term adjustment and indicate specific needs for information and psychooncological support”, they conclude.

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