Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011570 (depression)
 172,036 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Psychological adjustment in 90 women (30 carriers and 60 non-carriers) who had undergone genetic testing for mutations in BRCA1 and BRCA2 breast/ovarian cancer susceptibility genes was compared with that of 53 women who were not offered genetic testing. Women were assessed prior to genetic testing and 7-10 days, 4 and 12 months after carrier status disclosure using self-administered questionnaires. Compared with women not offered testing, mutation carriers had significantly higher breast cancer distress 7-10 days (t=2.80, P=0.005) and 12 months (t=2.01, P=0.045) post-notification. Non-carriers showed a significant decrease in state anxiety 7-10 days post-notification (t=2.27, P=0.024) and in depression 4 months post-notification (t=2.26, P=0.024), compared with women not offered testing. These data show that non-carriers derive psychological benefits from genetic testing. Women testing positive may anticipate a sustained increase in breast cancer distress following disclosure, although no other adverse psychological outcomes were observed in this group.
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PMID:Psychological impact of genetic testing in women from high-risk breast cancer families. 1237 8

Today, the first line of chemotherapy for ovarian cancer is Taxol-carboplatin (T-J), but there are some problems including severe bone marrow depression and severe neuropathy, so-called poor compliance cases. By changing the method of administering Taxol, the key drug in chemotherapy for ovarian cancer, it is possible to make compliance more better, continue therapies and look after patients' PS and QOL. We have considered weekly Taxol based chemotherapy for early stage recurrence cases and poor compliance cases; For example, weekly Taxol in combination with carboplatin (monthly) for poor compliance cases, severe bone marrow depression and the like, and Taxol by drip infusion for 24 hours in cases of peripheral nerve disorder (severe neuropathy). Especially, weekly Taxol combination with carboplatin (monthly), with takes advantage of the repeated administration of Taxol and one time administration of carboplatin, is a highly beneficial therapy for ovarian cancer. With this protocol we can reduce side effects and continue long-term administration on an outpatient basis.
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PMID:[Practical use of taxol-based chemotherapy for poor compliance gynecologic cancers in Japanese woman]. 1266 98

The purpose of this study is to explore complementary and alternative medicine (CAM) use and factors influencing CAM use by women enrolled in a genetic testing program for predisposition to breast/ovarian cancer. A cohort of 236 high-risk women completed baseline questionnaires at enrollment into BRCA1/2 testing program. CAM use and correlates of use were assessed using logistic regression models. CAM was used by 53% of the overall cohort. Cancer survivors reported significantly more use of complementary treatments than did unaffected women (61 versus 42%; P < 0.05). Participants had good overall health behaviors; daily fruit/vegetable consumption was significantly related to CAM use. Increased depression level, knowledge of cancer genetics, and frequency of breast self-examination were significantly associated with using CAM for cancer survivors. Among unaffected women only, cancer risk perception and sunscreen use were significantly correlated with CAM use. Recognition of heightened breast cancer risk is correlated with increased complementary therapy use by unaffected women undergoing genetic testing for cancer predisposition but not to the extent that cancer survivors use these strategies. Any potential effects of the genetic information itself on CAM use, and any possible relationship of CAM use to other risk reduction behaviors, require further research.
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PMID:Complementary medicine use among women enrolled in a genetic testing program. 1269 6

Ovarian cancer represents about 4% of all cancers in women and is the fifth leading cause of death in the United States each year. Ovarian cancer is associated with uncertainty, anxiety, and depression. Many women present with advanced disease at diagnosis and are faced with aggressive surgical and medical protocols to treat them. To meet the needs of women with ovarian cancer, the effects of their physical problems on psychological adjustment must be identified. Health care professionals must closely monitor women with ovarian cancer to identify those who may require ongoing psychological care or psychiatric intervention. This article presents an overview of ovarian cancer, focusing on the psychological effects, and an intervention by oncology nurse specialists to address both the physical and emotional distress that accompanies ovarian cancer. The importance of screening for psychological distress is emphasized.
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PMID:The silent killer: psychological issues in ovarian cancer. 1465 May 72

To evaluate the impact of BRCA1/2 testing and disclosure of a positive test result on women affected and unaffected with cancer. Longitudinal cohort study including women affected and unaffected with breast or ovarian cancer testing for a BRCA1/2 mutation. Data on well-being (anxiety, depression, cancer related distress, general health), treatment choice, and decision making about cancer prevention were collected at baseline (1 week after blood sampling; affected n = 192, unaffected n = 176) and at follow-up (2 weeks after disclosure of a positive test result; affected n = 23, unaffected n = 66). Women affected and unaffected with breast or ovarian cancer were compared using univariate statistics. Change over time was examined using repeated measures analysis of variance. With respect to well-being, affected women scored worse at baseline. At follow-up, both affected and unaffected women experienced a decline in well-being, which tended to be stronger in affected women. Women diagnosed with cancer less than 1 year previously tended to report a worse well-being than those diagnosed longer ago. With respect to treatment choice, more affected women intended to obtain prophylactic surgery and valued it higher at both time points. With respect to decision making, affected women had a lower preference for participation in decision making at baseline; no differences were found at follow-up. At follow-up, both affected and unaffected women showed an increase in strength of treatment preference and a decrease in decision uncertainty. Disclosure of a positive test result had a negative impact on well-being. Affected women, especially those who have been recently diagnosed with cancer, experienced the worst well-being and could benefit from psychosocial support.
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PMID:Impact of BRCA1/2 testing and disclosure of a positive test result on women affected and unaffected with breast or ovarian cancer. 1473 81

Ovarian cancer is the fourth leading cause of cancer mortality among women. Previous research has shown that initial ovarian cancer screening has the potential to cause depressive symptoms among women at increased risk for the disease but no study has evaluated depressive symptoms shortly after screening. This article explores depressive symptoms prescreening and postscreening in women returning to participate in an ovarian cancer early detection program. Seventy-two women, with a mean age of 48, most with a family history of ovarian cancer and/or a personal history of breast cancer, completed the Center for Epidemiologic Studies Depression Scale (CES-D) immediately prior to screening and 1 week following. CES-D scores at prescreening (13%) were significantly lower than previously reported. No statistical differences in CES-D scores before and after screening were found, although 75% of women with elevated pre-CES-D scores had scores below the cutoff at postscreening. Although our numbers are lower than reported in previous studies, they are important because they emphasize the need for continued assessment of individuals who may be at greater risk for psychological distress related to cancer screening. Internationally, nurses play an important role in the recognition and support of patients undergoing cancer screening.
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PMID:Depressive symptoms prescreening and postscreening among returning participants in an ovarian cancer early detection program. 1604 97

We conducted an exploratory, qualitative study investigating experiences of women who had developed breast cancer under the age of 40 and who were identified as BRCA1 or BRCA2 mutation carriers. These germline mutation carriers face an increased lifetime risk of a second primary breast cancer and an increased risk for a primary ovarian cancer. Thirteen women who fit this criteria participated in three focus groups conducted at a major cancer center in the UK during Spring 2003. We asked broad, open-ended questions that allowed for a wide range of responses about their cancer and genetic testing experiences, physical and psycho-social concerns, family and partner reactions and their need for social support. The women expressed feelings of devastation, loneliness, feeling different and isolation, ambivalence about having to support family members, worries about partner's anxiety and depression, and anxiety about talking to family members, especially children. These feelings were stronger after the cancer diagnosis and compounded by the genetic test results that occurred at a later time. We also found that, at least temporarily, the women experienced what we call "social separation"--emotional distance from, or dissonance with groups they interact with or are part of, e.g., family and friends, frequently leading to a reduction in communication or a change in previously unstated, but accepted normal interaction. We concentrate on a few characteristics of social separation-feelings of aloneness, isolation and separation, use of silence and verbal discretion, the relationship between estrangement and kinship interaction and norm disruption, and are looking at social patterns of interpersonal relationships that may occur when risk and illness statuses are new and framing and feeling rules have not as yet been clearly developed due to a cultural lag.
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PMID:"Social separation" among women under 40 years of age diagnosed with breast cancer and carrying a BRCA1 or BRCA2 mutation. 1672 73

This is a cross-sectional study of coping strategies in 174 healthy women who fulfill clinical criteria for familial breast/ovarian cancer in the absence of demonstrated mutations (ADM) compared to 68 healthy women with BRCA1 carrier status. Both groups got a mailed questionnaire after genetic counseling and testing, respectively. The questionnaire included demographic and cancer-related variables as well as the Hospital Anxiety and Depression Scale (HADS) and the Coping Orientation to Problems Experienced Scale (COPE). In both groups 24% of the women had an anxiety disorder. Coping strategies which helped the women to accept and make the best out of their situation were most frequently applied in both the ADM and the carrier groups. Compared to the carrier group, the ADM group had higher mean levels on both emotion-focused and problem-focused strategies. The emotion-focused strategies were all significantly associated with presence of HADS-defined anxiety disorder in the ADM group. In the carrier group problem-focused strategies were significantly associated with increased prevalence of such anxiety disorder. In multivariate analysis 'focus on emotions' was significantly associated with increased prevalence of HADS-defined anxiety disorder in both groups, and 'acceptance' was associated with reduced prevalence in both groups.
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PMID:The relationship between coping strategies and anxiety in women from families with familial breast-ovarian cancer in the absence of demonstrated mutations. 1738 92

Screening programs can reduce the burden of disease, however, they can be associated with raised levels of anxiety. The risk of endometrial and ovarian cancer is increased in hereditary nonpolyposis colorectal cancer (HNPCC). There is no prospective evidence to support screening for gynecological disease in HNPCC, however, current recommendations include the use of ultrasound and endometrial biopsy. This study assesses the impact of screening for gynecological cancer on self-reported symptoms of anxiety, depression, and perceptions of health. Women from HNPCC families attending gynecological screening (n = 26) completed the Hospital Anxiety and Depression Scale and the ShortForm36v2 questionnaires prior to screening with transvaginal ultrasound, outpatient/office hysteroscopy, endometrial biopsy, and ovarian tumor marker assessment (CA125). The same questionnaires were completed at 3 and 6 months following screening (15/26). Women in HNPCC families attending for gynecological screening did not have excess symptoms of anxiety or depression at baseline in subjective comparison to other populations. The process of screening and false positive screening results had no significant impact on symptoms of anxiety and depression or perceptions of health. We conclude that within the limitations of analysis in this small study group, screening for gynecological disease in HNPCC does not appear to be associated with any psychological morbidity.
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PMID:Does a "one-stop" gynecology screening clinic for women in hereditary nonpolyposis colorectal cancer families have an impact on their psychological morbidity and perception of health? 1758 21

We conducted a psychological assessment during oncogenetic counseling for hereditary breast/ovarian cancer. Anxiety and depression were assessed with the HAD scale, and family functioning and satisfaction with FACES III. HAD was administered at baseline (t(1)), at risk communication (t(2)), at genetic test result communication, or at first surveillance in not tested subjects (t(3)); FACES III was administered at baseline only. We analysed a total of 185 questionnaires administered to the 37 subjects studied. Although not pathological, distress was significantly higher at t(2) and t(3) (p = 0.027 and p = 0.039, respectively). Health and marital status were significantly associated with distress. In a disease-free condition, anxiety was higher (p = 0.027) at t(2), and for single status, depression increased from t(1) to t(2) (p = 0.026). Families were perceived to be well functioning, and subjects were satisfied with their families. The data collected in this analysis could help to improve the quality of oncogenetic counselling in clinical practice.
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PMID:Distress and family functioning in oncogenetic counselling for hereditary and familial breast and/or ovarian cancers. 1770 29


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