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The association between treatment‐specific optimism and depressive symptomatology in patients enrolled in a Phase I cancer clinical trial
Author(s) -
Cohen Lorenzo,
de Moor Carl,
Amato Robert J.
Publication year - 2001
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(20010515)91:10<1949::aid-cncr1218>3.0.co;2-a
Subject(s) - optimism , medicine , depression (economics) , mood , distress , cancer , clinical trial , psychiatry , clinical psychology , psychology , psychotherapist , economics , macroeconomics
BACKGROUND Previous research has found that cancer patients often overestimate the likelihood that they will achieve a positive response in Phase I trials. However, maintaining optimistic expectations may help patients cope with a poor prognosis and uncertain outcome. The authors prospectively examined the association between treatment‐specific optimism and mental health among patients participating in a Phase I/b trial. METHODS Twenty‐four patients with metastatic renal cell carcinoma and 22 patients with metastatic melanoma completed an assessment battery at the beginning of treatment and 3 weeks later, on the final day of treatment. Patients completed measures of treatment‐specific optimism (e.g., beliefs regarding the treatment working), depressive symptomatology, mood disturbance, and overall distress. RESULTS The majority of patients believed that the treatment would either cure them (87%) or stop cancer progression (85%). Regression analyses revealed that the level of treatment‐specific optimism (e.g., “The treatment I am receiving may cure me”) was associated negatively with baseline measures of depressive symptoms ( P < 0.006), mood disturbance ( P < 0.001), and symptoms of distress ( P < 0.0001) after controlling for age, number of metastases, and time since diagnosis. Patients with symptoms of clinical depression at baseline reported significantly lower levels of treatment‐specific optimism than patients without symptoms ( P < 0.03). Treatment‐specific optimism also was associated negatively with symptoms of depression at the end of treatment ( P < 0.003), controlling for symptoms of depression at the beginning of treatment. CONCLUSIONS The results of the current study suggest that high levels of treatment‐specific optimism are associated with better mental health outcomes at both the beginning and end of treatment. Cancer 2001;91:1949–55. © 2001 American Cancer Society.