The use of antidepressants for physical and psychological symptoms in cancer

Cancer patients are commonly associated with various physical and psychological symptoms. In palliative setting, the aims are to relieve those symptoms, improve quality of life, and increase medication adherence among cancer patients. Antidepressants are generally accepted for the treatment of depression among patients with or without cancer. Some other potential benefits of the antidepressants have been reported in cancer patients. Objective: This study aims to review the use of antidepressants for physical and psychological symptoms in cancer patients. Results: Our findings showed the mixed result of positive and negative findings in various symptoms associated with cancer patients. These studies are categorised according to the hierarchy of evidence from high to low level, namely randomised controlled trials, cohort studies, case-control studies, case series, case reports, as well as other type of publications. The majority of antidepressants used in cancer patients seem to be beneficial for the treatment of depression, anxiety, hot flashes and other symptoms such as sexual dysfunction, fatigue, nicotine dependence, vasomotor symptoms, executive functions, sleep problems, pruritus, as well as for hypochondriasis. While fluoxetine was found to be associated with the reduction of antiemetic property in ondansetron, mirtazapine was identified to be a good alternative in treating nausea and cachexia among cancer patients. Conclusion: More research studies with adequate statistical power are warranted to validate the use of antidepressants among cancer patients in treating these physical and psychological symptoms

Hand properties of woven fabric treated with commercial softeners / Nor Kamalia Othman Adli... [et al.]

This study was carried out to determine the hand properties of cotton woven fabric treated with three different brands of commercial softeners and to identify the stiffness relationship between objective and subjective assessment. The hand properties refer to the impression feels when the fabric is touched, squeezed, rubbed or otherwise handled. The cotton woven fabric was categorized into light to medium weight and medium to heavy weight type. Three different brands of softener; Brand A, Brand B and Brand C were used, and the fabric samples were washed by using top load home washing machine for 48 minutes in each cycle with the detergent and softener added into the washing machine dispenser drawer following the instruction label on the softener’s bottle. After washing process was done, the samples were evaluated objectively by their stiffness and panel experts did subjective assessment on the samples by investigating three attributes namely stiffness, softness, smoothness. The results obtained from objective and subjective evaluation were then analysed using Two-way ANOVA and Kruskal Wallis test respectively

A 6-Month Open-Label Study of Vortioxetine among Cancer Patients with Major Depressive Disorder (MDD)

Objective: Vortioxetine is a monoaminergic drug with a novel multimodal mechanism of action. We investigated its efficacy on depressive symptoms, cognitive function, and quality of life among cancer patients.Methods: In this multicenter, open-label, single-arm, observational study, patients received flexible doses of Vortioxetine for a period of six months. All participants were assessed at baseline and scheduled for monitoring at weeks 2, 4, 8, 12, 16, 20, and 24. Depression severity was assessed using Montgomery-Asberg Depression Rating Scale (MADRS) and the Clinical Global Impression (CGI) scale. The Perceived Deficiency Questionnaire (PDQ-5) assessed the perceived cognitive difficulties in concentration, executive functioning, and memory. The European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC) was used to assess the patients’ quality of life. Side effects of vortioxetine were monitored using the Antidepressant Side-Effect Checklist (ASEC). Results: Patients experienced a reduction in MADRS scores from 29.89 ± 5.997 at baseline to 11.59 ± 4.629 by Week 24. The PDQ-5 scores showed significant change from Week-4, whereas the EORTC role, emotional, and cognitive functioning scores showed a significant change from Week 2 onwards. CGI-Severity scores decreased from a baseline of 4.39 ± 0.746 to 2.41 ± 1.085 by Week 24. During the 24-Weeks of therapy, around three-quarters of the patients (73.3%) had one or more adverse events reported on the ASEC. The most frequently reported TEAEs were dry mouth, insomnia, somnolence, and headache, with more than a 30% incidence rate. Conclusion: Vortioxetine seems promising in the management of depression and enhancement of cognitive function and quality of life of cancer patients with Major Depressive Disorder

Psychological distress among cancer patients on chemotherapy

Distress has become a major issue in cancer population. Patients may suffer from either physical, psychological distress or both. Cancer patients who are undergoing chemotherapy are more likely to experience psychological distress. This could be due to the negative effects of chemotherapy agents, the uncertainty of post-treatment, and the occurrence of psychosocial problems. As a result, the patient may experience a normal reaction such as sadness or may develop common psychiatric disorders such as depression and anxiety

Psychometric properties of the acceptance and action questionnaire (AAQ II) Malay version in cancer patients

Psychological inflexibility has been found as one of the predictor to psychopathology in cancer patient. Cancer patients tend to experience psychological inflexibility as a reaction to cancer diagnosis, prognosis and treatment. Therefore, there is a need to identify psychological inflexibility due to its impact on quality of life among cancer patients. Objectives Acceptance and action questionnaire (AAQ II) is a scale used to assess psychological inflexibility. The aim of this study is to translate AAQ II into Malay language and evaluate the psychometric properties of AAQ II Malay version. Methods The AAQ II which has been translated into Malay language via back translation procedure was distributed to 101 cancer patients and 100 non-cancer patients. The evaluation of psychometric properties in this study included content validity index, internal consistency, parallel reliability, exploratory factor analysis, concurrent validity, sensitivity and specificity of AAQ II Malay version. Results AAQ II Malay version has established good content validity index, acceptable internal consistency with Cronbach’s alpha value of 0.91, excellent parallel reliability and adequate concurrent validity. Exploratory factor analysis (EFA) results demonstrated AAQ II Malay version is a unidimensional factor instrument. The result of sensitivity and specificity of AAQ II Malay version indicated cancer patients who scored more than 17.5 were having significant psychological inflexibility. Conclusion AAQ II Malay version is a reliable and valid instrument to measure psychological inflexibility among cancer patient in Malaysia. © 2019 Shari et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Cognitive dysfunction in Malaysian patients with major depressive disorder: A subgroup analysis of a multicountry, cross‐sectional study

Introduction: Cognitive dysfunction has been significantly associated with functional impairment in patients with major depressive disorder (MDD). Methods: This is a subgroup analysis of 211 Malaysian patients recruited from the multicountry, multicenter, cross-sectional Cognitive Dysfunction in Asian patients with Depression (CogDAD) study. Depression severity, cognitive dysfunction, and functional disability were assessed and compared with the overall CogDAD study population. Factors associated with functional disability were also evaluated in this Malaysian patient population. Results: Approximately half of the Malaysian patients were in their first depressive episode, with the majority being treated for mild-to-moderate depression. Furthermore, Malaysian patients experienced cognitive dysfunction, with self-reported Perceived Deficits Questionnaire (PDQ-D) scores falling within the third quartile of PDQ-D severity. Malaysian patients also reported functional disability evidenced by a mean total Sheehan Disability Scale (SDS) score of 11.47 ± 6.68, with the highest SDS score reported in the “Social Life/Leisure Activities” domain. Compared with the overall CogDAD study population, the Malaysian patient population had comparable patient demographics in terms of marital and working status; outcome scores for PHQ-9 (9-item Patient Health Questionnaire for self-reported depression severity), PDQ-D and SDS; and worst perceived cognitive dysfunction reported in the “Attention/Concentration” domain. Factors found to be significantly associated with functional disability were PDQ-D score, sick leave taken, and antidepressant treatment (P < 0.05). Discussion: Findings from this subgroup analysis highlight the significance of treating cognitive dysfunction in patients with MDD and its correlation to functional disability

The associated factors of depression and quality of life in patients with diabetic foot ulcer in Hospital Tengku Ampuan Afzan

Introduction: Diabetic foot complications are one of the common causes of lower extremity amputations. Furthermore, diabetic patients with foot ulcer have high hospitalization rates as compared with those without foot complications. Diabetic foot ulcer patients with comorbid depression have high morbidity and mortality as well as poor quality of life. However, there is limited study available in Malaysia. Objective: The primary aim was to determine the prevalence of depression in patients with diabetic foot ulcer in Hospital Tengku Ampuan Afzan and to determine the sociodemographic and clinical factors associated with depression in diabetic foot ulcer patients. The study was also to determine the quality of life and social support among diabetic foot ulcer patients and compared between the depressed and non depressed diabetic foot patients. Method: This was a cross sectional study where a total of 150 diabetic foot ulcer patients were recruited. Sociodemographic data and clinical variables were determined in diabetic foot ulcer patients. The prevalence of major depressive disorder among the diabetic foot ulcer patients was determined using Mini International Neuropsychiatry Interview (M.I.N.I) and Hospital Anxiety and Depression Scale (HADS). The study also investigated the association between major depressive disorder with clinical and sociodemographic factors of diabetic foot ulcer patients. The Quality of life was assessed using the WHOQOL-BREF and social support was evaluated using Multidimensional Scale of Perceived Social Support (MSPSS). Result: The prevalence of depression in diabetic foot ulcer patients using M.I.N.I was 20.7% and prevalence of depression based on HADS-D with cut off point of ≥8 was 24%. Major depressive disorder was found to be significantly associated with the family history of depression (p=0.015, OR=8.667 ), another chronic medical illnesses (1-2 chronic illnesses p=0.033, OR=5.093; ≥3 chronic medical illnesses p=0.009, OR=13.200), three and more diabetes complication( p=0.025, OR=5.564). In this study, quality of life of diabetic foot ulcer patients with comorbid depression was found lower compared to those without depression. The mean total score for WHOQOL-BREF was 76.6 (SD=8.8) for diabetic foot ulcer patients with depression and 89.2 (SD=10.9) for non depressed group. In this study, the diabetic foot ulcer patients with comorbid depression had perceived overall good social support with mean total score 5.5 (SD=0.98). Conclusion: This study found a high prevalence of depression among the patients with diabetic foot ulcer. The diabetic foot ulcer with comorbid depression had significantly poorer quality of life compared to non depressed group. Medical practitioners should regularly screen high risk group for early detection of depression and improve the quality of life

Kazakh version of the beck depression inventory: Validation study in female cancer patients

This study aimed to evaluate the validity of the Beck Depression Inventory (BDI-II) as a screening tool for depression among Kazakh-speaking female cancer patients. A cross-sectional study design with random sampling was used to collect and analyze data from 115 female cancer patients. Means, sensitivity, specificity, and positive and negative predictive values were calculated. An analysis of receiver operating characteristic (ROC) curves was conducted to determine the optimal cut-off score for the BDI-II in this population as a screening tool for depression. Test-retest reliability and internal consistency were also tested. Results showed that using a BDI-II cut score of 15 retained high sensitivity (82.7%), increased specificity (75.0%), and improved positive (86.1%) and negative predictive values (69.8%) of the BDI-II compared to a cut score of 14. Kazakh BDI-II indicated excellent consistency (Cronbach's alpha of 0.86) and reliability (intraclass correlation coefficient (ICC) of 0.92 (95% CI [0.89–0.94])). The use of this valid screening tool can facilitate the diagnosis of depression in female cancer patients

Effects of Self-Care Education Intervention Program (SCEIP) on Activation Level, Psychological Distress, and Treatment-Related Information

Self-care education can direct patients to manage their side effects during treatment, reduce psychological distress, and improve self-care information. In this study, the effectiveness of the Self-Care Education Intervention Program (SCEIP) on patient activation levels, psychological distress, and treatment-related concerns in women with breast cancer was assessed by adopting a longitudinal quasi-experimental pre-test and post-test design. The data for 246 women with breast cancer undergoing adjuvant chemotherapy were collected. Pre- and post-interventional assessments were conducted at baseline (T1) and the second (T2), fourth (T3), and sixth (T4) cycles using the 13-item Patient Activation Measure, 14-item Hospital Anxiety and Depression Scale, and 25-item Cancer Treatment Survey. It was found that the SCEIP significantly improved the activation level (p ≤ 0.001), psychological distress (anxiety level (p ≤ 0.001), the depression level (p ≤ 0.001)), and treatment-related concerns (sensory/psychological concerns (p = 0.05); procedural concerns (p ≤ 0.001)). Therefore, the SCEIP could potentially improve patients’ activation level, psychological distress, and treatment-related concerns regarding symptom management during chemotherapy, specifically for Malaysian women with breast cancer