Journal of psychosomatic research · 2026
Depression and psycho-existential correlates in cancer outpatients: A longitudinal real-life study.
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Caruso Rosangela, Cruciata Marco, Nanni Maria Giulia, Belvederi Murri Martino, Zerbinati Luigi, Tugnoli Stefano, Allegro Ester, Pantuso Marina, Shakaj Klaudio, Toffanin Tommaso, Ferrara Maria, Zaccagnino Barbara, Olivetti Anna Francesca, Dominicano Ilaria, Grassi Luigi
Аннотация
BACKGROUND: Depression is prevalent and clinically significant among cancer patients, being associated with poorer quality of life, treatment non-adherence, and increased mortality. However, few studies have investigated major depression and its relationship with psycho-existential dimensions using structured diagnostic tools and longitudinal designs in real-world psycho-oncology settings.
AIM AND METHOD: This study aimed to assess the prevalence of major depression in cancer outpatients receiving integrated psycho-oncology care and to examine longitudinal changes in psychological and existential variables over six months, with a focus on baseline depression status. A total of 221 outpatients were assessed at baseline using the Patient Health Questionnaire-9. Measures included distress, anxiety, somatization, embitterment, loss of dignity, demoralization, post-traumatic growth, and traumatic stress. At six months, 156 patients completed follow-up assessments. All participants received supportive-expressive psychotherapy with elements of meaning-centered therapy and pharmacological treatment when indicated. Data were analyzed using paired t-tests and mixed models for repeated measures..
RESULTS: At baseline, 35.3% of patients met criteria for major depression. Depressed patients showed higher levels across all psychological and existential measures and lower post-traumatic growth. Longitudinal analyses revealed significant improvements across multiple domains, particularly among depressed patients, including embitterment and loss of dignity. Mixed-model analyses indicated significant group-by-time interactions in most variables.
CONCLUSIONS: These findings confirm the high prevalence of major depression in cancer outpatients and its association with emotional and existential distress. Integrated psycho-oncological care was associated with meaningful psychological improvements over time, especially in patients with baseline depression, supporting the need for structured screening and tailored interventions.
AIM AND METHOD: This study aimed to assess the prevalence of major depression in cancer outpatients receiving integrated psycho-oncology care and to examine longitudinal changes in psychological and existential variables over six months, with a focus on baseline depression status. A total of 221 outpatients were assessed at baseline using the Patient Health Questionnaire-9. Measures included distress, anxiety, somatization, embitterment, loss of dignity, demoralization, post-traumatic growth, and traumatic stress. At six months, 156 patients completed follow-up assessments. All participants received supportive-expressive psychotherapy with elements of meaning-centered therapy and pharmacological treatment when indicated. Data were analyzed using paired t-tests and mixed models for repeated measures..
RESULTS: At baseline, 35.3% of patients met criteria for major depression. Depressed patients showed higher levels across all psychological and existential measures and lower post-traumatic growth. Longitudinal analyses revealed significant improvements across multiple domains, particularly among depressed patients, including embitterment and loss of dignity. Mixed-model analyses indicated significant group-by-time interactions in most variables.
CONCLUSIONS: These findings confirm the high prevalence of major depression in cancer outpatients and its association with emotional and existential distress. Integrated psycho-oncological care was associated with meaningful psychological improvements over time, especially in patients with baseline depression, supporting the need for structured screening and tailored interventions.