Predictors of anxiety and depression in hematopoietic stem cell transplant patients during protective isolation

Psychooncology. 2013 Aug;22(8):1790-7. doi: 10.1002/pon.3215. Epub 2012 Nov 7.

Abstract

Objective: To examine in a sample of hematopoietic stem cell transplant patients assessed throughout protective isolation (i) levels of anxiety and depression and (ii) pre-isolation factors (socio-demographics, biomedical variables and personality traits), which might predict higher levels of anxiety and depression during isolation.

Methods: The study used a longitudinal prospective design. Anxiety and depression were assessed in 107 participants by the State-Trait Anxiety Inventory and Self-rating Depression Scale at admission and weekly at fixed time points throughout isolation. Among pre-isolation factors, patients' psychological status was evaluated by the Cognitive Behavioral Assessment (2.0). Predictors were explored by random-effects models.

Results: One-tenth of the patients suffered from clinically significant anxiety and depressive symptoms at admission. Although the percentage of depressed patients increased more than twofold after 2 weeks of isolation, that of anxious patients did not significantly change over time. Female gender, higher anxiety and obsessive-compulsive symptoms, intratensive personality traits and lower performance status predicted higher depression during isolation.

Conclusions: Anxiety and depression represent a relevant problem for hematopoietic stem cell transplant patients during isolation. Early detection of predictors, such as anxiety levels, obsessive-compulsive symptoms and performance status, could help prevent depression via targeted psychological intervention.

Keywords: anxiety; cancer; depression; hematopoietic stem cell transplant; isolation; oncology.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anxiety / diagnosis*
  • Anxiety / etiology
  • Anxiety / psychology
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / psychology
  • Depression / diagnosis*
  • Depression / etiology
  • Depression / psychology
  • Depressive Disorder
  • Female
  • Follow-Up Studies
  • Hematologic Neoplasms / psychology*
  • Hematologic Neoplasms / therapy
  • Hematopoietic Stem Cell Transplantation / psychology*
  • Humans
  • Italy
  • Male
  • Middle Aged
  • Patient Isolation / psychology*
  • Personality Inventory
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Self Report
  • Socioeconomic Factors
  • Stress, Psychological / psychology
  • Young Adult