Endocrine Abstracts

The treatment with multi kinase inhibitors (MKI) under clinical trials due to advanced thyroid cancer (TC) may postpone moving on the patients with advanced disease to the palliative care stage. However, chronic and escalating somatic symptoms during the treatment may promote the appearance of depressive reactions. It can be expected that a cognitive image of the disease, as a collection of subjective beliefs concerning patient’s own illness and treatment, will be an important determinant of mental functioning. The aim of the study was to define a mutual dependence between the intensity of somatic problems, self-image of the illness and depression in patients receiving an experimental treatment of TC.

Material and methods: The study included 32 patients treated with MKI due to TC for at least one year. The study was cross-sectional and it based on different questionnaires: List of Somatic Problems, Beck’s Depression Inventory and Short Questionnaire of Diseases Perception (B-IPQ).

Results: Nineteen patients showed severe somatic symptoms (HSS; High Somatic Symptoms), whereas 13 patiens demonstrated none or mild physical symptoms (LSS; Low Somatic Symptoms). The depression intensity was higher in HSS patients than in LSS group. In HSS group a mediating role of self-image relationship to disease somatic symptoms and depression was noticed. The direct effect of somatic symptoms on depression severity was insignificant. While, the belief about a negative impact of physical symptoms on the daily functioning was an important mediator of relations between somatic symptoms and depression in the study group.

Conclusions: The inclusion of interaction aimed at changing the perception of a negative impact of the disease and its treatment on daily life in TC patients can reduce the risk of deterioration in depressive symptoms. The role of a nurse in psychologist-physician-nurse team is crucial for better patients care and quality of life.