Anxiety and depression mediate the association between chemotherapy-induced peripheral neuropathy and fatigue: Results from the population-based PROFILES registry

C.S. Bonhof*, L. van de Poll-Franse, P.A.J. Vissers, D.K. Wasowicz, J.A. Wegdam, D. Révész, G. Vreugdenhil

*Corresponding author for this work

Research output: Contribution to journalArticleScientificpeer-review

1 Downloads (Pure)

Abstract

Objective
Chemotherapy‐induced sensory peripheral neuropathy (CIPN) is common among colorectal cancer (CRC) survivors. The aim of this study was to examine whether CIPN is associated with both psychological distress (ie, anxiety and depression) and fatigue and whether the relationship between CIPN and fatigue can (partly) be explained by psychological distress.

Methods
All CRC survivors diagnosed between 2000 and 2009 as registered by the population‐based Netherlands Cancer Registry (Eindhoven region) were eligible for participation. Chemotherapy‐treated survivors completed questions on CIPN (EORTC QLQ‐CIPN20), psychological distress (HADS), and fatigue (FAS) on average 5.6 years after diagnosis. Simple and multiple mediation analyses were performed to examine anxiety and depression as possible mediators in the association between CIPN and fatigue.

Results
Survivors with high (ie, upper 30% of scores) CIPN (n = 172) reported more anxiety and depressive symptoms and more fatigue compared with those with low CIPN (n = 299). Furthermore, among survivors with high CIPN, those who were anxious, depressed, or both reported more fatigue compared with those without psychological distress. These differences were clinically relevant. Finally, mediation analyses showed that while CIPN was directly associated with fatigue, the relationship between CIPN and fatigue was also significantly mediated by both anxiety and depression.

Conclusions
CRC survivors with high CIPN report more fatigue, especially those who are also anxious and/or depressed. More research is needed on the direction of the relationship between CIPN, psychological distress, and fatigue. For now, the treatment of fatigue should also focus on addressing psychological distress, as treating fatigue alone might not be sufficient.
Original languageEnglish
Pages (from-to)1926-1933
JournalPsycho-Oncology
Volume28
Issue number9
DOIs
Publication statusPublished - 2019

Fingerprint

Peripheral Nervous System Diseases
Depression
Survivors
Netherlands

Keywords

  • COLORECTAL-CANCER SURVIVORS
  • COMORBIDITY
  • HOSPITAL ANXIETY
  • PREVALENCE
  • PROFILES
  • PSYCHOLOGICAL DISTRESS
  • QUALITY-OF-LIFE
  • QUESTIONNAIRE
  • anxiety
  • chemotherapy-induced peripheral neuropathy
  • colorectal cancer
  • depression
  • fatigue
  • oncology

Cite this

@article{36c00603378a4dadac96bc99d6c91500,
title = "Anxiety and depression mediate the association between chemotherapy-induced peripheral neuropathy and fatigue: Results from the population-based PROFILES registry",
abstract = "ObjectiveChemotherapy‐induced sensory peripheral neuropathy (CIPN) is common among colorectal cancer (CRC) survivors. The aim of this study was to examine whether CIPN is associated with both psychological distress (ie, anxiety and depression) and fatigue and whether the relationship between CIPN and fatigue can (partly) be explained by psychological distress.MethodsAll CRC survivors diagnosed between 2000 and 2009 as registered by the population‐based Netherlands Cancer Registry (Eindhoven region) were eligible for participation. Chemotherapy‐treated survivors completed questions on CIPN (EORTC QLQ‐CIPN20), psychological distress (HADS), and fatigue (FAS) on average 5.6 years after diagnosis. Simple and multiple mediation analyses were performed to examine anxiety and depression as possible mediators in the association between CIPN and fatigue.ResultsSurvivors with high (ie, upper 30{\%} of scores) CIPN (n = 172) reported more anxiety and depressive symptoms and more fatigue compared with those with low CIPN (n = 299). Furthermore, among survivors with high CIPN, those who were anxious, depressed, or both reported more fatigue compared with those without psychological distress. These differences were clinically relevant. Finally, mediation analyses showed that while CIPN was directly associated with fatigue, the relationship between CIPN and fatigue was also significantly mediated by both anxiety and depression.ConclusionsCRC survivors with high CIPN report more fatigue, especially those who are also anxious and/or depressed. More research is needed on the direction of the relationship between CIPN, psychological distress, and fatigue. For now, the treatment of fatigue should also focus on addressing psychological distress, as treating fatigue alone might not be sufficient.",
keywords = "COLORECTAL-CANCER SURVIVORS, COMORBIDITY, HOSPITAL ANXIETY, PREVALENCE, PROFILES, PSYCHOLOGICAL DISTRESS, QUALITY-OF-LIFE, QUESTIONNAIRE, anxiety, chemotherapy-induced peripheral neuropathy, colorectal cancer, depression, fatigue, oncology",
author = "C.S. Bonhof and {van de Poll-Franse}, L. and P.A.J. Vissers and D.K. Wasowicz and J.A. Wegdam and D. R{\'e}v{\'e}sz and G. Vreugdenhil",
year = "2019",
doi = "10.1002/pon.5176",
language = "English",
volume = "28",
pages = "1926--1933",
journal = "Psycho-Oncology",
issn = "1057-9249",
publisher = "Wiley",
number = "9",

}

Anxiety and depression mediate the association between chemotherapy-induced peripheral neuropathy and fatigue : Results from the population-based PROFILES registry. / Bonhof, C.S.; van de Poll-Franse, L.; Vissers, P.A.J.; Wasowicz, D.K.; Wegdam, J.A.; Révész, D.; Vreugdenhil, G.

In: Psycho-Oncology, Vol. 28, No. 9, 2019, p. 1926-1933.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Anxiety and depression mediate the association between chemotherapy-induced peripheral neuropathy and fatigue

T2 - Results from the population-based PROFILES registry

AU - Bonhof, C.S.

AU - van de Poll-Franse, L.

AU - Vissers, P.A.J.

AU - Wasowicz, D.K.

AU - Wegdam, J.A.

AU - Révész, D.

AU - Vreugdenhil, G.

PY - 2019

Y1 - 2019

N2 - ObjectiveChemotherapy‐induced sensory peripheral neuropathy (CIPN) is common among colorectal cancer (CRC) survivors. The aim of this study was to examine whether CIPN is associated with both psychological distress (ie, anxiety and depression) and fatigue and whether the relationship between CIPN and fatigue can (partly) be explained by psychological distress.MethodsAll CRC survivors diagnosed between 2000 and 2009 as registered by the population‐based Netherlands Cancer Registry (Eindhoven region) were eligible for participation. Chemotherapy‐treated survivors completed questions on CIPN (EORTC QLQ‐CIPN20), psychological distress (HADS), and fatigue (FAS) on average 5.6 years after diagnosis. Simple and multiple mediation analyses were performed to examine anxiety and depression as possible mediators in the association between CIPN and fatigue.ResultsSurvivors with high (ie, upper 30% of scores) CIPN (n = 172) reported more anxiety and depressive symptoms and more fatigue compared with those with low CIPN (n = 299). Furthermore, among survivors with high CIPN, those who were anxious, depressed, or both reported more fatigue compared with those without psychological distress. These differences were clinically relevant. Finally, mediation analyses showed that while CIPN was directly associated with fatigue, the relationship between CIPN and fatigue was also significantly mediated by both anxiety and depression.ConclusionsCRC survivors with high CIPN report more fatigue, especially those who are also anxious and/or depressed. More research is needed on the direction of the relationship between CIPN, psychological distress, and fatigue. For now, the treatment of fatigue should also focus on addressing psychological distress, as treating fatigue alone might not be sufficient.

AB - ObjectiveChemotherapy‐induced sensory peripheral neuropathy (CIPN) is common among colorectal cancer (CRC) survivors. The aim of this study was to examine whether CIPN is associated with both psychological distress (ie, anxiety and depression) and fatigue and whether the relationship between CIPN and fatigue can (partly) be explained by psychological distress.MethodsAll CRC survivors diagnosed between 2000 and 2009 as registered by the population‐based Netherlands Cancer Registry (Eindhoven region) were eligible for participation. Chemotherapy‐treated survivors completed questions on CIPN (EORTC QLQ‐CIPN20), psychological distress (HADS), and fatigue (FAS) on average 5.6 years after diagnosis. Simple and multiple mediation analyses were performed to examine anxiety and depression as possible mediators in the association between CIPN and fatigue.ResultsSurvivors with high (ie, upper 30% of scores) CIPN (n = 172) reported more anxiety and depressive symptoms and more fatigue compared with those with low CIPN (n = 299). Furthermore, among survivors with high CIPN, those who were anxious, depressed, or both reported more fatigue compared with those without psychological distress. These differences were clinically relevant. Finally, mediation analyses showed that while CIPN was directly associated with fatigue, the relationship between CIPN and fatigue was also significantly mediated by both anxiety and depression.ConclusionsCRC survivors with high CIPN report more fatigue, especially those who are also anxious and/or depressed. More research is needed on the direction of the relationship between CIPN, psychological distress, and fatigue. For now, the treatment of fatigue should also focus on addressing psychological distress, as treating fatigue alone might not be sufficient.

KW - COLORECTAL-CANCER SURVIVORS

KW - COMORBIDITY

KW - HOSPITAL ANXIETY

KW - PREVALENCE

KW - PROFILES

KW - PSYCHOLOGICAL DISTRESS

KW - QUALITY-OF-LIFE

KW - QUESTIONNAIRE

KW - anxiety

KW - chemotherapy-induced peripheral neuropathy

KW - colorectal cancer

KW - depression

KW - fatigue

KW - oncology

U2 - 10.1002/pon.5176

DO - 10.1002/pon.5176

M3 - Article

VL - 28

SP - 1926

EP - 1933

JO - Psycho-Oncology

JF - Psycho-Oncology

SN - 1057-9249

IS - 9

ER -