These findings may help explain previous research that cancer patients are not significantly more anxious and are only slightly more depressed than the general population.
“Few studies have investigated the relatively low levels of anxiety and depression experienced by this patient group in spite of the potential severity of their disease,” says lead study author Karin Nordin, Ph.D., of Uppsala University in Sweden.
Nordin and colleagues analyzed three groups of study participants. The first consisted of 52 gastrointestinal cancer patients who were considered potentially cured, since all known tumor tissue was removed during surgery; the second consisted of 33 patients suffering from advanced gastrointestinal cancer; the third group consisted of 26 spouses of the patients with advanced disease.
In questionnaires both immediately after diagnosis and a month or more afterward, the study participants were asked to rate the importance of life values and their level of attainment of these values which included serenity, positive relationships, independence, involvement in hobbies or community activities, ability to communicate, financial security, religion and health. Anxiety and depression levels of participants were also measured.
The study results are published in the current issue of the journal Psycho-Oncology.
Anxiety and depression decreased over time for the two patient groups, the researchers found. Why this occurred may relate to another study finding: the gap between patients' values and their perceived achievement level of those values also shrank. In other words, patients tended to lower their expectations to match reality.
“Large discrepancies between the perceived attainment and importance of life values are associated with high anxiety and depression,” Nordin says. “Patients may strive to reduce such discrepancies as part of their adjustment to serious diseases such as cancer.”
For spouses, the gap between life values and the achievement of these values did not decrease, and anxiety and depression increased. These findings are in line with several previous studies that found that spouses experience more psychological distress than the cancer patients themselves.
Unlike the cancer patients, spouses are physically capable of continuing to strive for their goals, so they are not forced by circumstances to lower their expectations. But their care-taking responsibilities may lessen the time they have to pursue life goals, according to the study. “Spouses often report a disruption in their lives and a concomitant need to maintain a cheerful demeanor,” Nordin says.
Both patient groups rated communication as the most important life value, while the spouses rated positive relationships as the most important. “The higher levels of anxiety and depression among spouses, and therefore the greater need for support, may explain the higher importance of positive relations for spouses,” Nordin says.
This research was funded by a grant from the Swedish Cancer Society.
Psycho-Oncology is a bimonthly international journal devoted to the psychological, social and behavioral dimensions of cancer. Published by John Wiley, it is the official journal of the American, British and International Psycho-Oncology Societies. Contact Jimmie Holland, M.D., Co-Editor, at (212) 739-7051 for information.
Journal
Psycho-Oncology