Longitudinal relationships between fatigue and depression in cancer patients with depression and/or pain.

Objective: Fatigue is one of the most common and debilitating symptoms reported by cancer patients, yet relatively little is understood about its etiology. Recently, as researchers have begun to focus attention on cancer-related fatigue (CRF), depression has emerged as its strongest correlate. Few longitudinal studies, however, have examined directionality of the relationship between the two symptoms.

Longitudinal comparison of three depression measures in adult cancer patients.

Context: Although a number of depression measures have been used with cancer patients, longitudinal comparisons of several measures in the same patient population have been infrequently reported.

Objectives: To compare the Hopkins Symptom Checklist 20-item depression scale, Short-Form 36 Mental Health Inventory five-item distress scale, and Patient Health Questionnaire nine-item depression scale in adults with cancer.

Methods: Of the 309 cancer patients enrolled in a telecare management trial for depression, 247 completed the three depression measures at both baseline and at three months and a retrospective assessment of global rating of change in depression at three months.

Comparison of SF-36 vitality scale and Fatigue Symptom Inventory in assessing cancer-related fatigue.

Purpose: Cancer-related fatigue (CRF) is an important symptom in clinical practice and research. The best way to measure it, however, remains unsettled. The SF-36 vitality scale, a general measure of energy/fatigue, is a frequently cited measure.

Telecare management of pain and depression in patients with cancer: patient satisfaction and predictors of use.

Pain and depression are 2 of the most common and disabling cancer-related symptoms. In the Indiana Cancer Pain and Depression trial, 202 cancer patients with pain and/or depression were randomized to the intervention group and received centralized telecare management augmented by automated symptom monitoring (ASM). Over the 12-month trial, the average patient completed 2 ASM reports and 1 nurse call per month.

The association of depression and anxiety with health-related quality of life in cancer patients with depression and/or pain.

Objectives: Depression is known to be a major problem in cancer patients, and evidence is emerging about the importance of anxiety. Because the disorders are highly comorbid, we examined the relationship of anxiety and depression with health-related quality of life (HRQL) in cancer patients.

Methods: Sample included 405 adult oncology patients participating in a randomized controlled trial of telecare management for pain and depression.

An open label pilot study of citalopram for depression and boredom in ambulatory cancer patients.

Objective: Significant levels of depressive symptoms are an impediment to adjustment and affect greater than one-third of people with cancer. The clinical diagnosis of major depression is estimated to occur in 25%. Depression is dramatically underrecognized by oncologists and oncology nurses, and as a result, often undertreated.

A chart review, pilot study of two single-item screens to detect cancer patients at risk for cachexia.

Objective: Cachexia is a problematic wasting syndrome experienced by some cancer patients that can lead to early death in these patients. The purpose of the present study was to examine the criterion validity and sensitivity and specificity of two single items from a depression scale to rapidly screen patients in ambulatory oncology clinics for cancer-related nutritional risk and cachexia.

Methods: A chart review was conducted of 50 randomly selected patient profiles.

Access to communication technologies in a sample of cancer patients: an urban and rural survey.

Background: There is a growing awareness among providers of the symptom burden experienced by cancer patients. Systematic symptom screening is difficult. Our plan was to evaluate a technology-based symptom screening process using touch-tone telephone and Internet in our rural outreach cancer program in Indiana.

Cancer pain, fatigue, distress, and insomnia in cancer patients.

Insomnia is common among cancer patients, occurring in approximately 30% to 50% of the cancer population. The interactions between cancer pain, insomnia, fatigue, and depression/anxiety are complex, warranting treatment plans that focus not only on the relief of specific symptoms to improve quality of life but also on the impact of treatment on other related symptoms. Pain is one of the most common symptoms experienced by cancer patients and is one of the primary factors that precipitate insomnia in this population.

Pain clinicians' rankings of aberrant drug-taking behaviors.

A pilot study was conducted to examine experienced pain physicians' perceptions of aberrant drug taking behaviors. One hundred pain physicians attending a meeting on pain management were asked to rank order (from most aberrant = 1 to least aberrant = 13) a list of aberrant drug-taking behaviors. The sample was comprised mainly of anesthesiologists (50%) and half of the group had 10 or more years of pain management experience.

A retrospective chart review of the use of olanzapine for the prevention of delayed emesis in cancer patients.

Chemotherapy-induced delayed emesis (DE) affects approximately 50-70% of patients receiving moderately and highly emetogenic chemotherapy. DE most commonly occurs within the first 24-48 hours of chemotherapy administration and can persist for 2-5 days. Olanzapine, which has been used anecdotally for chronic nausea in advanced cancer patients, might be a useful treatment for the prevention of delayed emesis in chemotherapy patients.

An unsuccessful attempt to develop a single-item screen for insomnia in cancer patients.

The focus of this pilot study was to examine issues of criterion validity and detection of insomnia utilizing a single item from the Zung Self-Rating Depression Scale (ZSDS) as a means to rapidly screen cancer patients in ambulatory oncology clinics. In our previous work, we have demonstrated the usefulness of other single items for screening purposes, such as for fatigue. The sleep item reads "I have trouble sleeping through the night" and is rated on a 4-point Likert scale ranging from "none or little of the time" to "most or all of the time.

An open-label, crossover trial of mirtazapine (15 and 30 mg) in cancer patients with pain and other distressing symptoms.

We performed a pilot open-label, crossover trial of mirtazapine (15 and 30 mg at night) in advanced cancer patients with pain and other distressing symptoms. Twenty patients completed the trial and sixteen dropped out. Following a baseline assessment, patients completed a one-week observation period and were then randomized to a starting dose of either 15 mg or 30 mg of mirtazapine given at bedtime.