Comorbidity of fear of progression and anxiety disorders in cancer patients

• Published in: General hospital psychiatry 2014-11, Vol.36 (6), p.613-619
• Main Authors: Dinkel, Andreas, D.Sc, Kremsreiter, Katrin, Dipl.-Psych, Marten-Mittag, Birgitt, Ph.D, Lahmann, Claas, M.D
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anxiety disorders; Anxiety Disorders - epidemiology; Anxiety Disorders - psychology; Biological and medical sciences; Comorbidity; Cross-Sectional Studies; Disease Progression; Fear - psychology; Fear of progression; Fear of recurrence; Female; Humans; Illness-related fears; Male; Medical sciences; Middle Aged; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoplasms - psychology; Psychiatry; Psycho-oncology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Tumors; Young Adult
• ISSN: 0163-8343; 1873-7714
• DOI: 10.1016/j.genhosppsych.2014.08.006

Abstract Objective The relation between fear of progression (FoP) and anxiety disorders remains unclear. Therefore, we investigated the comorbidity between clinical FoP and psychiatric anxiety disorders. Method In this cross-sectional study, 341 cancer patients undergoing acute inpatient care participated. A structured clinical interview (Structured Clinical Interview for DSM-IV Axis I) was used to identify Diagnostic and Statistical Manual of Mental Disorders: Fourth Edition anxiety disorders and hypochondriasis. Patients completed measures of FoP (Fear of Progression Questionnaire), worries (Penn State Worry Questionnaire, Worry Domains Questionnaire), depression [Patient Health Questionnaire (PHQ): Depression], anxiety (PHQ: General Anxiety Disorder) and somatic symptoms (PHQ: Somatic Symptoms). We cross-tabulated FoP with the presence of anxiety disorders and studied associated variables. Results Of all patients studied, 17.6% suffered from an anxiety disorder. With regard to comorbidity, 68.3% suffered neither from clinical FoP nor from any anxiety disorder, 13.4% had not been diagnosed with an anxiety disorder but experienced clinical FoP, and 11.6% only suffered from an anxiety disorder. The remaining 6.7% suffered from FoP that was comorbid with an anxiety disorder. Patients with a pure FoP did not differ from patients with a pure anxiety disorder on nearly all symptom measures. Only a few associations between the comorbidity pattern and sociodemographic and clinical variables emerged. Conclusion Clinical FoP appears to be a distinct phenomenon. It does not differ from anxiety disorders in its psychological and somatic burdens.