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- Title
CO-OCCURRENCE OF DEPRESSION AND SLEEP DISTURBANCE AND ASSOCIATIONS WITH STRESS IN OUTPATIENTS RECEIVING CHEMOTHERAPY.
- Authors
Calvo-Schimmel, Alejandra; Miaskowski, Christine; Oppegaard, Kate; Cooper, Bruce; Paul, Steven; Joosun Shin; Harris, Carolyn; Kober, Kord
- Abstract
The purpose of this project was to identify subgroups of patients with distinct depression AND sleep disturbance profiles and evaluate for differences in demographic and clinical characteristics and measures of stress and resilience among these subgroups. Depression and sleep disturbance occur in up to 45% and 88% of oncology patients, respectively. While previous research focused on an evaluation of these two symptoms individually, little is known about their co-occurrence and associated risk factors. Outpatients (n=1331) were recruited during their first or second cycle of chemotherapy. Center for Epidemiologic Studies Depression Scale (CES-D) and General Sleep Disturbance Scale (GSDS) assessed depression and sleep disturbance, respectively. Measures were completed six times over two cycles of chemotherapy. Stress and resilience measures were: Perceived Stress Scale (PSS), Impact of Event Scale-Revised (IES-R), Life Stressor Checklist-Revised (LSC-R), and Connor Davidson Resilience Scale (CDRD). Latent profile analysis was used to identify subgroups of patients with distinct depression AND sleep disturbance profiles. Five classes were identified: None (21.4%), No Depression and Moderate sleep disturbance (No DEP+Mod SD (32.3%)), Subsyndromal Depression (SubS DEP)+Very High sleep disturbance (SD) (20.4%), Both Moderate (17.7%), and Both High (8.2%). Compared to the None class, the other four classes were more likely to be female, less likely to be employed, had lower functional status and higher level of comorbidity, and were more likely to self-report a diagnosis of depression. For the total PSS and IES-R scores, significant differences among the five classes followed the expected pattern (i.e., None < No DEP+- Mod SD < SubS DEP+Very High SD < Both Moderate < Both High). Compared to the None and the No DEP+ Mod SD classes, the other three classes reported a higher LSC-R affected sum score. Compared to the None class, patients in the SubS DEP+Very High SD, Both Moderate, and Both High classes reported lower CDRS scores. This study identified five subgroups of patients and risk factors for the co-occurrence of depression AND sleep disturbance. For the Both Moderate and Both High classes CES-D and GSDS scores suggest clinically meaningful levels of both symptoms and IES-R toral scores were suggestive of post-traumatic stress disorder. Clinicians need to assess for the co-occurrence of both symptoms and causes of stress.
- Subjects
CALIFORNIA; CANCER chemotherapy; PATIENTS; CONFERENCES &; conventions; SLEEP disorders; MENTAL depression; COMORBIDITY; PSYCHOLOGICAL stress; PSYCHOLOGICAL resilience
- Publication
Oncology Nursing Forum, 2022, Vol 49, Issue 2, pE149
- ISSN
0190-535X
- Publication type
Article
- DOI
10.1188/22.ONF.E2