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Actigraphic assessment of daily sleep-activity pattern abnormalities reflects self-assessed depression and anxiety in outpatients with advanced non-small cell lung cancer
Psycho-Oncology, 02/17/09

Du-Quiton J et al. - In a study to determine whether cancer-associated depression and anxiety are accompanied by characteristic circadian rhythm abnormalities in outpts with advanced non-small cell lung cancer (NSCLC), it was found that these pts whose diurnal activity is disturbed by prolonged and frequent sedentary episodes and whose sleep is disturbed by frequent and prolonged waking are most anxious and depressed. These findings and relationships are masked by hospitalization.

• Equal numbers of inpts (n=42) and outpatients (n=42) with advanced NSCLC were studied.
• Baseline depression and anxiety and actigraphy were recorded before chemotherapy initiation.
• Effects of the presence and severity of chronic obstructive pulmonary disease (COPD) on depression, anxiety, and actigraphy were assessed only among the 42 outpts.

• Anxiety occurred in 40% and depression in 25% of these lung cancer pts, equally among inpts and outpts.
• All pts suffer extremely disturbed daily sleep-activity cycles but each pt also maintains some degree of circadian organization.
• Outpts maintain more robust daily activity patterns and longer, more consolidated nighttime sleep vs inpts.
• The more disrupted the daily sleep-activity rhythm, the worse the depression and/or anxiety scores for outpts.
• These relationships are obscured among inpts.
• COPD has no independent measurable effects on daily organization of sleep-activity, depression, or anxiety.

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