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Predictors of long‐term anxiety and depression in uveal melanoma survivors: A cross‐lagged five‐year analysis
Author(s) -
Brown Stephen L.,
Fisher Peter L.,
HopeStone Laura,
Hussain Ruma.,
Heimann Heinrich,
Damato Bertil,
Cherry M. Gemma
Publication year - 2020
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.5514
Subject(s) - worry , anxiety , depression (economics) , survivorship curve , psychology , hospital anxiety and depression scale , clinical psychology , psychiatry , medicine , cancer , economics , macroeconomics
Objective Cancer survivors commonly experience long‐term anxiety and depression. Anxiety and depression might result from problems emerging during survivorship rather than illness and treatment. This study tested three potential causal paths: (a) concerns about physical symptoms and functional problems and fear of cancer recurrence (FCR) arising during survivorship directly cause anxiety and depression, (b) an indirect path whereby FCR mediates effects of concerns about physical symptoms and functional problems on anxiety and depression, and (c) a reciprocal path whereby anxiety and depression cause concerns about physical symptoms and functional problems and FCR, which exacerbate later anxiety and depression. Methods Sample of 453 uveal melanoma survivors who completed observations 6‐, 12‐, 24‐, 36‐, 48‐ and 60‐months post‐diagnosis and did not miss two consecutive observations. Cross‐lagged analyses were conducted to predict Hospital Anxiety and Depression Scale subscale scores. Symptoms and functional problems were measured using the EORTC OPT 30 scale, and FCR operationalised by the EORTC OPT 30 worry about recurrence scale. Covariates were age, gender, treatment modality, and visual acuity of the fellow eye and chromosome‐3 status (which accurately predicts 10‐year survival), worry and anxiety or depression. Results All paths received some support, although the indirect path emerged only for anxiety in females. Concerns about physical symptoms, functional problems, and FCR originated in survivorship and appeared to both influence and be influenced by anxiety and depression. Conclusions Findings emphasise the importance of actively monitoring survivors to prevent, detect, and intervene in the development of anxiety and depression during survivorship.