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Title: Comparison of depressive, anxiety and somatization symptoms in patients with chronic myeloproliferative neoplasms treated with interferon alpha and tyrosine kinase inhibitors


Background: Numerous studies confirm that the mental condition among patients suffering from cancer can be worse than in the general population. The specific nature of cancer and its treatment process may lead to unpleasant emotional conditions among the patients. Researchers indicate that cancer diagnosis determines the occurrence of mental disorders in cancer patients. Both the disease and the side effects of treatment may contribute to developing depression and anxiety symptoms. However, the literature on this topic does not provide studies that analyze the coexistence of depressive, anxiety, or somatization symptoms together, as well as such factors as the number of side effects of treatment, age, sex, duration of the disease, and individual side effects of interferon-alpha treatment in patients with chronic myeloproliferative neoplasms (MPN) or side effects of tyrosine kinase inhibitors (TKI) treatment in chronic myeloid leukemia (CML). The studies focused on either the impact of the disease itself (including its symptoms) on the incidence of depression and/or anxiety or the overall side effects of the treatment medicament. The problems presented above have become an inspiration to conduct the research discussed in this doctoral dissertation. Three studies examined the general mental state and the severity of depressive, anxiety, and somatizatio ; n symptoms in patients with MPN and CML. In addition, the assessment of the relationship between age, sex, treatment duration, and the severity of individual factors of mental state in both groups of patients was examined. The predictors of the severity of somatization, depression, and anxiety symptoms were analyzed. The above results inspired the development of further analyses of the individual side effects of treatment with interferon-alpha and tyrosine kinase inhibitors, as well as their possible impact on the intensity of depressive, anxiety, or somatization symptoms. The thesis consists of three research articles: 1. Assessment of factors affecting the mental condition of patients with chronic myeloid leukemia treated with tyrosine kinase inhibitors. 2. Side effects of treatment with tyrosine kinase inhibitors in patients with chronic myeloid leukemia and the occurrence of anxiety symptoms. 3. Comparison of depressive, anxiety, and somatization symptoms in patients with Philadelphia negative chronic myeloproliferative neoplasms treated with interferon-alpha. Methods: The studies were carried out at the Hematology Clinic of the University Hospital (SU) in Kraków and the Clinic of Hematology, Blood Cancer and Bone Marrow Transplantation in Wrocław, involving 175 patients with myeloproliferative neoplasms (91- CML, 84 - MPN). The self-questionnaire ; , David Goldberg's GHQ-28 Questionnaire, and the four-dimensional 4DSQ Questionnaire were used to analyze the occurrence of anxiety, depression, and somatization symptoms. The list of common side effects of treatment with interferon-alpha and IKT was created based on the results of research analyzing their effects and toxicity. Results: The research has shown that every third person suffering from MPN and CML is at risk of developing mental disorders. In addition, a moderately and strongly increased result was obtained in both groups: on the scale of depressive symptoms from 20% to almost 40% of respondents, on the scale of anxiety symptoms from 20% to less than 50% of patients, and on the scale of somatization symptoms from over 35% to over 70% of respondents. Somatization symptoms had the most significant impact on the occurrence of mental disorders, then anxiety and insomnia. In both groups, age, as well as the number of experienced side effects significantly influenced the intensity of depression, anxiety, and somatization symptoms. The results of the studies showed that age, number of side effects, and female gender were predictors of the occurrence of somatization and anxiety symptoms in the group of patients with CML. In the same group, age (B = 0.082; p = 0.008) and the number of side effects (B = 0.726; p = 0.000) were factors increasing ; the risk of depressive symptoms. In patients with MPN, a common predictor of the severity of somatization symptoms (B = 0.760; p = <0.001), anxiety (B = 0.749; p = <0.001), and depressive symptoms (B = 0.635; p = <0.001) was the number of side effects. Additionally, age was an important prognostic factor for anxiety symptoms (B = -0.082; p = <0.046), and female gender was a significant prognostic factor for depressive symptoms (B = -1.377; p = <0.043). The study showed that individual side effects of IFN- treatment have an impact on the increase of anxiety, somatization, and depressive symptoms, as well as anxiety symptoms in patients treated with IKT. Conclusions: The collected data on patients with myeloproliferative neoplasms who have suffered from mental and physical symptoms of the disease, or its treatment justifies the need for caring psychological, psychiatric, and educational care. The collaborative work of physicians, psychologists, and pharmaceutical companies on reducing/alleviating side effects may establish a better quality of life for these patients in the future. In the future, it would be recommended to monitor the mental condition of patients suffering from disorders of the hematopoietic system through a preliminary survey of newly diagnosed patients and then periodically conduct similar tests during their treatment. If depression ; , anxiety, or somatization symptoms appear, the patient may be offered psychiatric treatment and/or psychological support. Having healthcare professionals converse with patients about possible side effects of treatment and how to deal with them can increase the patient's overall understanding of the process and thus reduce possible depressive, anxiety, or somatization symptoms and improve quality of life.

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Level of degree:

2 - studia doktoranckie

Degree grantor:

Rada Dyscypliny Nauki medyczne


Sacha, Tomasz ; Cyranka, Katarzyna

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pol; eng

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tylko w bibliotece

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Jun 28, 2024

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Apr 12, 2024

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UJCMe36017af8a8c44d08ad8c6df48967785 Jun 28, 2024


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