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ABSTRACT: Temporal interrelationships among fatigue, circadian
rhythm and depression in breast cancer patients undergoing chemotherapy
treatment
Seventy-eight female breast cancer patients were assessed for
fatigue, depression, overall mood, and circadian rhythm at their
second and fourth on-study chemotherapy cycles as part of a
larger study examining the efficacy of paroxetine in reducing
chemotherapy-induced fatigue.
The Multidimensional Assessment of
Fatigue (MAF), the Fatigue Symptom Checklist (FSCL), the Center
for Epidemiologic Studies-Depression [CES-D) questionnaire, the
Hamilton Depression Inventory (HDI), and the Profile of Mood States
(POMS) were completed by patients at home 7 days after each treatment
to assess symptom severity.
Circadian rhythm was assessed over a
72-h period with the Mini-Motionlogger Actigraph (Ambulatory Monitoring,
Ardsley, NY), starting 6 days after treatment.
Daily patterns of
sleep and activity were compared across the 3-day period by
autocorrelation analyses to calculate a circadian rhythm score for
each patient, with higher scores associated with lower disruption.
Comparisons of fatigue, depression, and mood with patient circadian
rhythm measures taken after the second cycle indicate that all five
paper and pencil measures correlated well with the measure of
circadian rhythm (all rpartial <-0.30, all P <0.05).
Changes in the
fatigue, depression and mood measures from the second on-study
treatment to the fourth were significantly correlated with concurrent
changes in circadian rhythm (MAF r=-0.31; P=0.04; FSCL r=-0.30;
P=0.04; CES-D r=-0.39; P=0.008; HDI r=-0.34; P=0.03; POMS r=-0.40;
P =.007).
These findings provide evidence that circadian rhythm
disruption is involved in the experience of fatigue and depression
in cancer patients.
[05/29/2002; Supportive Care in Cancer]
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