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CoRPS Center of Research on Psychology in Somatic diseases subjective cognitive functioning in patients with breast problems.

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Presentation on theme: "CoRPS Center of Research on Psychology in Somatic diseases subjective cognitive functioning in patients with breast problems."— Presentation transcript:

1 CoRPS Center of Research on Psychology in Somatic diseases subjective cognitive functioning in patients with breast problems

2 CoRPS Subjective cognitive functioning (SCF) in patients with breast problems Jolanda De Vries, PhD Jan A. Roukema, MD, PhD Marleen J.J. Pullens, MSc Laurence L.C Van Warmerdam, MD, PhD Funded by the Dutch Cancer Society (KWF-kankerbestrijding)

3 CoRPS Background One in eight women will develop breast cancer (BC) Increasing number of BC survivors Research has been focusing on: –Physical aspects (e.g. hair loss) –Fear, fatigue, depression –Decreased Quality of Life –‘Chemobrain’ (objective/subjective) Ganz et al. J Natl Cancer Inst, 2002; Schreier et al. Oncol Nurs Forum, 2004; Wefel et al. Cancer, 2004.

4 CoRPS Background Chemobrain: Objective cognitive function (OCF): neuropsychological function Subjective cognitive function (SCF): self-reported cognitive complaints and satisfaction with cognitive function in daily life Pullens et al. Psycho-Oncol, 2010

5 CoRPS Subjective cognitive functioning (SCF) in patients with breast problems BC patients with chemotherapy complained more about SCF compared to BC patients who did not receive adjuvant chemotherapy. Chemotherapy, depression and fatigue were significant predictors of impaired SCF in daily life.  Research regarding the influence of adjuvant therapy on SCF is scarce, inconsistent and methodologically heterogeneous, it is hard to draw definitive conclusions. Schagen et al 1999, Hermelink et al 2010, Smith et al 2003, Pullens et al 2010

6 CoRPS Subjective cognitive functioning (SCF) in patients with breast problems Aims: - To examine the effect of systemic therapy on SCF in BC patients. - To find socio-demographical, clinical and/or psychosocial predictors of impaired SCF.

7 CoRPS Methods Patients –74 BC patients who were about to receive chemotherapy –63 controls (benign breast problems (BBP)) –Exclusion criteria Disease recurrence at baseline or metastases History of neuropsychologic and/or psychiatric signs that lead to deviant test results Use of medication that lead to deviant test results Alcohol or drug addiction Poor expression in the Dutch language

8 CoRPS Study design Diagnosis BC or BBP Start chemotherapy T1: Baseline Finish chemotherapy T2 3 days 3 months time 3 to 4 months

9 CoRPS Measures Questionnaires –subjective cognitive failures (CFQ) –cognitive functioning facet from a quality of life measure (WHOQOL-100) –depressive symptoms (CES-D) –fatigue (FAS) –state/trait anxiety symptoms (STAI) –stress (PSS-10)

10 CoRPS Results Significant differences on socio-demographic, clinical and psychological characteristics at baseline: CharacteristicBC-group BBP-group P-value State anxiety12.1±3.59.7±3.5<.001* Stress21.3±5.519.6±4.6.049*

11 CoRPS Frequency of complaints about SCF Hierbij 1 figuur van de totaalscore, of van alle subschalen erbij?

12 CoRPS Satisfaction with SCF An interaction effect was found (p <.001). BC patients were less satisfied with their SCF after their treatment compared to their satisfaction before the start of the chemotherapy. BBP patients were stable in their satisfaction with SCF over time.

13 CoRPS Predictors of frequency of complaints about SCF Dependent variablePredictorsBetap-valueAdjusted R 2 CFQ-25 itemsDepressive symptoms.394<.001*.148 CFQ-16 itemsDepressive symptoms.389<.001*.144 CFQ ForgetfulnessDepressive symptoms.370<.001*.130 CFQ Absent mindedness Depressive symptoms.372<.001*.132 CFQ Social recklessness Depressive symptoms Co morbidity Age.340 -.160 -.192 <.001*.078.032*.144

14 CoRPS Predictors of satisfaction with SCF Satisfaction with SCF PredictorBetaP-valueAdjusted R 2 WHOQOL-100 Cognitive functioning facet State anxiety Fatigue Diagnosis Visited psychologist or psychiatrist in history Diagnosis X state anxiety -.429 -.272 -.642 -.164.607.001*.006*.010.035*.031*.313

15 CoRPS Subjective cognitive functioning (SCF) in patients with breast problems -Frequency of complaints about SCF -BC patients do not report more complaints about SCF compared to patients with a BBP before or after treatment. -Both BC and BBP patients experience an increase in frequency of complaints about SCF over time. However, this effect for time did not remain significant after controlling for state anxiety and stress. -Satisfaction with SCF -Satisfaction with SCF decreases over time in BC patients and remains stable over time in BBP patients.

16 CoRPS Subjective cognitive functioning (SCF) in patients with breast problems Predictors -Frequency of complaints about SCF: depressive symptoms -Satisfaction with SCF: state anxiety, fatigue, visiting psychologist/psychiatrist in history, interaction between state anxiety and diagnosis

17 CoRPS Subjective cognitive functioning (SCF) in patients with breast problems Strenghts of this study –Longitudinal design –Two measures of SCF: both the frequency of complaints about SCF and the satisfaction with SCF. –The factor structure of the CFQ used in this study is validated for the population of patients with breast problems. Limitations of this study –Not enough power to run separate mulitvariate regression analyses for BC patients only. –Influence of hormonal therapy could not be assessed because of the relative short time-interval

18 CoRPS Subjective cognitive functioning in patients with breast problems Questions or comments Thank you for your attention!


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