Depression Treatment: Unmet Needs and Their Relationship With Quality of Life Among Women With Recurrent Breast Cancer.

Unmet Needs and Their Relationship with Quality of Life among Women with Recurrent Breast Cancer.

Filed under: Depression Treatment

J Breast Cancer. 2012 Dec; 15(4): 454-61
Park BW, Hwang SY

This study aimed to evaluate the prevalence and the effects of unmet needs on quality of life (QOL) among recurrent breast cancer survivors.Completed questionnaires were collected from 52 women with recurrent breast cancer. Clinical and socio-demographic characteristics were reviewed, and the Supportive Care Needs Survey, Functional Assessment of Cancer Therapy-Breast Cancer Instrument, and Beck Depression Inventory (BDI) were administered. The frequency of unmet needs and the mean differences by patient characteristics and BDI scores were analyzed. The predictive value of unmet needs on QOL, controlling for socio-demographic variables and then for clinical variables, was analyzed in hierarchical regression models.The most common unmet needs belonged to the health system and information domain. The depressive group had greater unmet needs in the psychological domain (p<0.001), physical and daily living domain (p=0.001), and health and information domain (p=0.002). Patients with lower education attainment and those with lower performance status had greater unmet needs in the psychological needs (p=0.002) and in the physical and daily living needs domain (p=0.002), respectively. Unmet needs in the psychological domain (p=0.008), physical and daily living domain (p=0.022), and sexuality domain (p=0.040) strongly predicted QOL of women with recurrent breast cancer.Unmet needs were strong predictors for QOL among recurrent breast cancer patients. This suggests that QOL of women with recurrent breast cancer is possibly more affected by unmet needs than by patient's socio-demographic or clinical characteristics. Intervention strategies could be developed based on the identified needs of women with recurrent breast cancer in order to improve their QOL. Further longitudinal and prospective studies will be necessary to confirm the independent impact of unmet needs on QOL. HubMed – depression

Translation and validation of the korean version of the 39-item Parkinson’s disease questionnaire.

Filed under: Depression Treatment

J Clin Neurol. 2013 Jan; 9(1): 26-31
Kwon DY, Kim JW, Ma HI, Ahn TB, Cho J, Lee PH, Chung SJ, Kim JS, Baik JS, Koh SB

The importance of health-related quality of life (HrQoL) has been increasingly emphasized when assessing and providing treatment to patients with chronic, progressive, degenerative disorders. The 39-item Parkinson’s disease questionnaire (PDQ-39) is the most widely used patient-reporting scale to assess HrQoL in Parkinson’s disease (PD). This study evaluated the validity and reliability of the translated Korean version of the PDQ-39 (K-PDQ-39).One hundred and two participants with PD from 10 movement disorder clinics at university-affiliated hospitals in South Korea completed the K-PDQ-39. All of the participants were also tested using the Unified Parkinson’s Disease Rating Scale (UPDRS), Korean version of the Mini-Mental State Examination (K-MMSE), Korean version of the Montgomery-Asberg Depression Scale (K-MADS), Epworth Sleepiness Scale (ESS) and non-motor symptoms scale (NMSS). Retests of the K-PDQ-39 were performed over time intervals from 10 to 14 days in order to assess test-retest reliability.Each K-PDQ-39 domain showed correlations with the summary index scores (rS=0.559-0.793, p<0.001). Six out of eight domains met the acceptable standard of reliability (Cronbach's ? coefficient ?0.70). The Guttman split-half coefficient value of the K-PDQ-39 summary index, which is an indicator of test-retest reliability, was 0.919 (p<0.001). All of the clinical variables examined except for age, comprising disease duration, levodopa equivalent dose, modified Hoehn and Yahr stage (H&Y stage), UPDRS part I, II and III, mood status (K-MADS), cognition (K-MMSE), daytime sleepiness (ESS) and (NMSS) showed strong correlations with the K-PDQ-39 summary index (p<0.01).The K-PDQ-39 has been validated for use in the Korean-speaking PD population. The questionnaire is a valid and reliable assessment tool for assessing the HrQoL of Korean PD patients. HubMed – depression

Road traffic accidents: more than just whiplash?

Filed under: Depression Treatment

BMJ Case Rep. 2013; 2013:
Counsell H, Johnson S

Following a minor road traffic accident (RTA) a 55-year-old woman developed a new onset of whole body tremor and abnormal gait. This was in the context of significant previous depressive episodes and a traumatic background relating to RTAs. After extensive investigation, no organic causes were identified. The patient was subsequently referred to psychiatry and diagnosed with conversion disorder. Subsequently, various treatments including mirtazepine, venlafaxine, clonazepam, diazepam and lithium have been tried. Currently, the patient remains on mirtazepine 15 mg nocte, diazepam 2 mg twice daily, venlafaxine 225 mg and recently has been started on lithium 400 mg nocte. The patient has also been seen regularly by a psychologist for mindfulness therapy. There has been a significant improvement after seven sessions of mindfulness therapy and the patient has long periods without a tremor and is now able to walk normally. In addition, this case highlights the importance of communication skills with our patients in diagnostic uncertainty.
HubMed – depression

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