Volume 33, Issue 2 pp. 153-161

Research Article

STRESSORS, SYMPTOM PROFILE, AND PREDICTORS OF ADJUSTMENT DISORDER IN CANCER PATIENTS. RESULTS FROM AN EPIDEMIOLOGICAL STUDY WITH THE COMPOSITE INTERNATIONAL DIAGNOSTIC INTERVIEW, ADAPTATION FOR ONCOLOGY (CIDI-O)

Bianca Hund,

Bianca Hund

diploma psychologist

Rhein-Jura-Klinik, Bad Säckingen, Germany

Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany

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Katrin Reuter Ph.D.,

Katrin Reuter Ph.D.

Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany

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Martin Härter M.D., Ph.D.,

Martin Härter M.D., Ph.D.

Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

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Elmar Brähler Ph.D.,

Elmar Brähler Ph.D.

Department of Medical Psychology and Medical Sociology, Division of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany

Department of Psychosomatic Medicine and Psychotherapy, Universal Medical Center Mainz, Mainz, Germany

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Hermann Faller M.D., Ph.D.,

Hermann Faller M.D., Ph.D.

Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany

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Monika Keller M.D.,

Monika Keller M.D.

Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine, University Hospital Heidelberg, Heidelberg, Germany

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Holger Schulz Ph.D.,

Holger Schulz Ph.D.

Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

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Karl Wegscheider Ph.D.,

Karl Wegscheider Ph.D.

Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

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Joachim Weis Ph.D.,

Joachim Weis Ph.D.

Department of Psychooncology, Tumor Biology Center, University of Freiburg, Freiburg, Germany

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Hans-Ulrich Wittchen Ph.D.,

Hans-Ulrich Wittchen Ph.D.

Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technical University Dresden, Dresden, Germany

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Uwe Koch M.D., Ph.D.,

Uwe Koch M.D., Ph.D.

Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

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Michael Friedrich M.A.,

Michael Friedrich M.A.

Department of Medical Psychology and Medical Sociology, Division of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany

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Anja Mehnert Ph.D.,

Corresponding Author

Anja Mehnert Ph.D.

Department of Medical Psychology and Medical Sociology, Division of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany

Correspondence to: Anja Mehnert, Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, 04103 Leipzig, Germany. E-mail: [email protected]Search for more papers by this author

Bianca Hund,

Bianca Hund

diploma psychologist

Rhein-Jura-Klinik, Bad Säckingen, Germany

Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany

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Katrin Reuter Ph.D.,

Katrin Reuter Ph.D.

Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany

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Martin Härter M.D., Ph.D.,

Martin Härter M.D., Ph.D.

Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

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Elmar Brähler Ph.D.,

Elmar Brähler Ph.D.

Department of Medical Psychology and Medical Sociology, Division of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany

Department of Psychosomatic Medicine and Psychotherapy, Universal Medical Center Mainz, Mainz, Germany

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Hermann Faller M.D., Ph.D.,

Hermann Faller M.D., Ph.D.

Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany

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Monika Keller M.D.,

Monika Keller M.D.

Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine, University Hospital Heidelberg, Heidelberg, Germany

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Holger Schulz Ph.D.,

Holger Schulz Ph.D.

Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

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Karl Wegscheider Ph.D.,

Karl Wegscheider Ph.D.

Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

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Joachim Weis Ph.D.,

Joachim Weis Ph.D.

Department of Psychooncology, Tumor Biology Center, University of Freiburg, Freiburg, Germany

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Hans-Ulrich Wittchen Ph.D.,

Hans-Ulrich Wittchen Ph.D.

Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technical University Dresden, Dresden, Germany

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Uwe Koch M.D., Ph.D.,

Uwe Koch M.D., Ph.D.

Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

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Michael Friedrich M.A.,

Michael Friedrich M.A.

Department of Medical Psychology and Medical Sociology, Division of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany

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Anja Mehnert Ph.D.,

Corresponding Author

Anja Mehnert Ph.D.

Department of Medical Psychology and Medical Sociology, Division of Psychosocial Oncology, University Medical Center Leipzig, Leipzig, Germany

First published: 16 October 2015

https://doi.org/10.1002/da.22441

Citations: 43

The authors declare that there are no conflicts of interest or financial disclosures related to this work.

Contract grant sponsor: Deutsche Krebshilfe (DKH); contract grant number: 107465.

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Abstract

Background

We aimed to investigate type and frequency of stressors, predominant symptom profiles, and predictors of adjustment disorders (AD) in cancer patients across major tumor entities.

Methods

In this epidemiological study, we examined 2,141 cancer patients out of 4,020 screened with the Composite International Diagnostic Interview, adaptation for oncology (CIDI-O). AD were operationalized as subthreshold disorders according to DSM-IV criteria.

Results

In our sample, 265 out of 2,141 patients (12.4%) met all criteria for AD (unweighted 4-week prevalence). The disclosure of the cancer diagnosis, relapse or metastases, and cancer treatments were most frequently described as stressors associated with depressive or anxious symptoms. With regard to AD symptom profiles, patients showed high prevalence rates of affective symptoms according to the DSM-IV criteria of Major Depression: The highest prevalence rates were found for cognitive disturbances (concentration and memory problems) (88%), sleeping disturbances (86%), and depressive mood (83%). We found sex, education, and metastasis as significant predictors for AD. Higher education was the most influential predictor. Men were half as likely to report symptoms fulfilling the AD criteria as women. Patients with metastasized tumors had a more than 80% higher risk of AD than those without metastasis. However, the explained variance of our model is very small (Nagelkerke's R² = 0.08).

Conclusions

Patients with AD can be identified using a standardized instrument and deserve clinical attention, as they often show severe clinical symptoms and impairments. Improving the clinical conceptualization of AD by the adding-on of potential stress-response-symptoms is necessary to identify severe psychological strain.

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STRESSORS, SYMPTOM PROFILE, AND PREDICTORS OF ADJUSTMENT DISORDER IN CANCER PATIENTS. RESULTS FROM AN EPIDEMIOLOGICAL STUDY WITH THE COMPOSITE INTERNATIONAL DIAGNOSTIC INTERVIEW, ADAPTATION FOR ONCOLOGY (CIDI-O)

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STRESSORS, SYMPTOM PROFILE, AND PREDICTORS OF ADJUSTMENT DISORDER IN CANCER PATIENTS. RESULTS FROM AN EPIDEMIOLOGICAL STUDY WITH THE COMPOSITE INTERNATIONAL DIAGNOSTIC INTERVIEW, ADAPTATION FOR ONCOLOGY (CIDI-O)

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Conclusions

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