The Impact of COVID-19 and Socioeconomic Status on Psychological Distress in Cancer Patients

Overview

Journal Int J Clin Health Psychol

Specialty Psychology

Date 2023 Sep 4

PMID 37663044

Authors

Elisabeth Lucia Zeilinger

Matthias Knefel

Carmen Schneckenreiter

Jakob Pietschnig

Simone Lubowitzki

Matthias Unseld

Thorsten Fureder

Rupert Bartsch

Eva Katharina Masel

Feroniki Adamidis

Lea Kum

Barbara Kiesewetter

Sabine Zochbauer-Muller

Markus Raderer

Maria Theresa Krauth

Philipp B Staber

Peter Valent

Alexander Gaiger

Affiliations

Soon will be listed here.

Abstract

Objective: We aimed to investigate the impact of the COVID-19 pandemic on psychological symptom burden against the socioeconomic background of cancer patients using data from routine assessments before and during the pandemic.

Method: In this cross-sectional study, standardised assessment instruments were applied in = 1,329 patients to screen for symptoms of anxiety, depression, post-traumatic stress, and fatigue from 2018 to 2022. Two MANOVAs with post-hoc tests were computed. First, only time was included as predictor to examine the isolated impact of the pandemic. Second, income level and education level were included as further predictors to additionally test the predictive power of socioeconomic factors.

Results: In the final model, only income had a significant impact on all aspects of psychological symptom burden, with patients with low income being highly burdened (partial η² = .01, p = .023). The highest mean difference was found for depressive symptoms ( = 0.13, = [0.07; 0.19], < .001). The pandemic had no further influence on psychological distress.

Conclusions: Although the pandemic is a major stressor in many respects, poverty may be the more important risk factor for psychological symptom burden in cancer outpatients, outweighing the impact of the pandemic.

Citing Articles

Prevalence and biopsychosocial indicators of fatigue in cancer patients.

Zeilinger E, Zrnic-Novakovic I, Oppenauer C, Fellinger M, Knefel M, Unseld M Cancer Med. 2024; 13(11):e7293.

PMID: 38819432 PMC: 11141333. DOI: 10.1002/cam4.7293.

References

Serrano-Alarcon M, Kentikelenis A, Mckee M, Stuckler D . Impact of COVID-19 lockdowns on mental health: Evidence from a quasi-natural experiment in England and Scotland. Health Econ. 2021; 31(2):284-296. PMC: 8646947. DOI: 10.1002/hec.4453. View

Grant S, Aitchison T, Henderson E, Christie J, Zare S, McMURRAY J . A comparison of the reproducibility and the sensitivity to change of visual analogue scales, Borg scales, and Likert scales in normal subjects during submaximal exercise. Chest. 1999; 116(5):1208-17. DOI: 10.1378/chest.116.5.1208. View

von Elm E, Altman D, Egger M, Pocock S, Gotzsche P, Vandenbroucke J . The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007; 370(9596):1453-7. DOI: 10.1016/S0140-6736(07)61602-X. View

Maunder R, Heeney N, Kiss A, Hunter J, Jeffs L, Ginty L . Psychological impact of the COVID-19 pandemic on hospital workers over time: Relationship to occupational role, living with children and elders, and modifiable factors. Gen Hosp Psychiatry. 2021; 71:88-94. PMC: 8096521. DOI: 10.1016/j.genhosppsych.2021.04.012. View

Gaiger A, Lubowitzki S, Krammer K, Zeilinger E, Acel A, Cenic O . The cancer survival index-A prognostic score integrating psychosocial and biological factors in patients diagnosed with cancer or haematologic malignancies. Cancer Med. 2022; 11(18):3387-3396. PMC: 9487871. DOI: 10.1002/cam4.4697. View

Shechter A, Diaz F, Moise N, Anstey D, Ye S, Agarwal S . Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic. Gen Hosp Psychiatry. 2020; 66:1-8. PMC: 7297159. DOI: 10.1016/j.genhosppsych.2020.06.007. View

Islam J, Vidot D, Camacho-Rivera M . Evaluating Mental Health-Related Symptoms Among Cancer Survivors During the COVID-19 Pandemic: An Analysis of the COVID Impact Survey. JCO Oncol Pract. 2021; 17(9):e1258-e1269. PMC: 8457802. DOI: 10.1200/OP.20.00752. View

Hajek A, Neumann-Bohme S, Sabat I, Torbica A, Schreyogg J, Pita Barros P . Depression and anxiety in later COVID-19 waves across Europe: New evidence from the European COvid Survey (ECOS). Psychiatry Res. 2023; 317:114902. PMC: 9576549. DOI: 10.1016/j.psychres.2022.114902. View

Ayubi E, Bashirian S, Khazaei S . Depression and Anxiety Among Patients with Cancer During COVID-19 Pandemic: A Systematic Review and Meta-analysis. J Gastrointest Cancer. 2021; 52(2):499-507. PMC: 8096890. DOI: 10.1007/s12029-021-00643-9. View

10.

Mehta S, Yarnell C, Shah S, Dodek P, Parsons-Leigh J, Maunder R . The impact of the COVID-19 pandemic on intensive care unit workers: a nationwide survey. Can J Anaesth. 2021; 69(4):472-484. PMC: 8697539. DOI: 10.1007/s12630-021-02175-z. View

11.

Knefel M, Zeilinger E, Lubowitzki S, Krammer K, Unseld M, Bartsch R . Risk as a pattern over time: Delineation of time-dependent risk factors in biological, psychological, and social variables in cancer patients. Cancer. 2023; 129(21):3466-3475. DOI: 10.1002/cncr.34953. View

12.

Zeilinger E, Oppenauer C, Knefel M, Kantor V, Schneckenreiter C, Lubowitzki S . Prevalence of anxiety and depression in people with different types of cancer or haematologic malignancies: a cross-sectional study. Epidemiol Psychiatr Sci. 2022; 31:e74. PMC: 9583630. DOI: 10.1017/S2045796022000592. View

13.

Ernst M, Beutel M, Brahler E . Cancer as a risk factor for distress and its interactions with sociodemographic variables in the context of the first wave of the COVID-19 pandemic in Germany. Sci Rep. 2022; 12(1):2021. PMC: 8821553. DOI: 10.1038/s41598-022-06016-x. View

14.

Temel J, Pirl W, Recklitis C, Cashavelly B, Lynch T . Feasibility and validity of a one-item fatigue screen in a thoracic oncology clinic. J Thorac Oncol. 2007; 1(5):454-9. View

15.

Amram O, Robison J, Amiri S, Pflugeisen B, Roll J, Monsivais P . Socioeconomic and Racial Inequities in Breast Cancer Screening During the COVID-19 Pandemic in Washington State. JAMA Netw Open. 2021; 4(5):e2110946. PMC: 8144923. DOI: 10.1001/jamanetworkopen.2021.10946. View

16.

Stoll C, Kapfhammer H, Rothenhausler H, Haller M, Briegel J, Schmidt M . Sensitivity and specificity of a screening test to document traumatic experiences and to diagnose post-traumatic stress disorder in ARDS patients after intensive care treatment. Intensive Care Med. 1999; 25(7):697-704. DOI: 10.1007/s001340050932. View

17.

Brunoni A, Suen P, Bacchi P, Razza L, Klein I, Dos Santos L . Prevalence and risk factors of psychiatric symptoms and diagnoses before and during the COVID-19 pandemic: findings from the ELSA-Brasil COVID-19 mental health cohort. Psychol Med. 2021; 53(2):446-457. PMC: 8144814. DOI: 10.1017/S0033291721001719. View

18.

van de Poll-Franse L, de Rooij B, Horevoorts N, May A, Vink G, Koopman M . Perceived Care and Well-being of Patients With Cancer and Matched Norm Participants in the COVID-19 Crisis: Results of a Survey of Participants in the Dutch PROFILES Registry. JAMA Oncol. 2020; 7(2):279-284. PMC: 7689559. DOI: 10.1001/jamaoncol.2020.6093. View

19.

Zeilinger E, Nader I, Wiedermann W, Gutierrez-Colosia M, Unseld M, Lubowitzki S . Latent structure and measurement invariance of the Hospital Anxiety and Depression Scale in cancer outpatients. Int J Clin Health Psychol. 2022; 22(3):100315. PMC: 9157192. DOI: 10.1016/j.ijchp.2022.100315. View

20.

Lafta R, Mawlood N . Mental and social burden of COVID-19 on the Iraqi people. Int J Soc Psychiatry. 2022; 69(1):200-207. PMC: 9939619. DOI: 10.1177/00207640221077618. View