Somatic symptoms in patients with cancer experiencing pain or depression: Prevalence, disability, and health care use

Kurt Kroenke, Xin Zhong, Dale Theobald, Jingwei Wu, Wanzhu Tu, Janet Carpenter

Research output: Contribution to journalArticle

64 Citations (Scopus)

Abstract

Background: The adverse impact of a high somatic symptom burden is well established for primary care and other noncancer populations with chronic medical disorders. Methods: This study examines the impact of somatic symptom burden on disability and health care use in patients with cancer experiencing pain, depression, or both. We performed secondary analyses of baseline data from 405 patients with cancer enrolled in a telecare management trial for pain or depression. Somatic symptom burden was measured using a 22-item scale. Multivariable models were conducted to determine the association of somatic symptom burden with the Sheehan Disability Scale (SDS) score, the number of self-reported disability days in the past 3 months, and health care use. Models were adjusted for sociodemographic characteristics, medical comorbidity, and depression and pain severity. Results: Somatic symptoms were highly prevalent, with 15 of the 22 symptoms reported by more than 50% of patients. The somatic symptom burden was similar across different types and phases of cancer. The mean SDS score (scored 0-10 [not at all disabled to unable to carry out any activities]) was 5.4, and the mean number of self-reported disability days in the past 4 weeks was 16.9. In multivariable models, somatic symptom burden was associated with SDS score (P<.001) and the likelihood of at least 14 disability days in the past 4 weeks (odds ratio, 1.51; 95% confidence interval, 1.19-1.92) but not with increased health care use. Conclusions: The somatic symptom burden is high in patients with cancer who experience pain or depression. Given the strong association with disability and the high prevalence of many types of symptoms, recognizing and managing somatic symptoms may be important in improving quality of life and functional status regardless of type or phase of cancer. Trial Registration: clinicaltrials.gov Identifier: NCT00313573.

Original languageEnglish
Pages (from-to)1686-1694
Number of pages9
JournalArchives of Internal Medicine
Volume170
Issue number18
DOIs
StatePublished - Oct 11 2010

Fingerprint

Depression
Delivery of Health Care
Neoplasms
Medically Unexplained Symptoms
Cancer Pain
Pain
Pain Management
Comorbidity
Primary Health Care
Odds Ratio
Quality of Life
Confidence Intervals
Population

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Somatic symptoms in patients with cancer experiencing pain or depression : Prevalence, disability, and health care use. / Kroenke, Kurt; Zhong, Xin; Theobald, Dale; Wu, Jingwei; Tu, Wanzhu; Carpenter, Janet.

In: Archives of Internal Medicine, Vol. 170, No. 18, 11.10.2010, p. 1686-1694.

Research output: Contribution to journalArticle

@article{1328f2dc04b443a19f997c1571683ec4,
title = "Somatic symptoms in patients with cancer experiencing pain or depression: Prevalence, disability, and health care use",
abstract = "Background: The adverse impact of a high somatic symptom burden is well established for primary care and other noncancer populations with chronic medical disorders. Methods: This study examines the impact of somatic symptom burden on disability and health care use in patients with cancer experiencing pain, depression, or both. We performed secondary analyses of baseline data from 405 patients with cancer enrolled in a telecare management trial for pain or depression. Somatic symptom burden was measured using a 22-item scale. Multivariable models were conducted to determine the association of somatic symptom burden with the Sheehan Disability Scale (SDS) score, the number of self-reported disability days in the past 3 months, and health care use. Models were adjusted for sociodemographic characteristics, medical comorbidity, and depression and pain severity. Results: Somatic symptoms were highly prevalent, with 15 of the 22 symptoms reported by more than 50{\%} of patients. The somatic symptom burden was similar across different types and phases of cancer. The mean SDS score (scored 0-10 [not at all disabled to unable to carry out any activities]) was 5.4, and the mean number of self-reported disability days in the past 4 weeks was 16.9. In multivariable models, somatic symptom burden was associated with SDS score (P<.001) and the likelihood of at least 14 disability days in the past 4 weeks (odds ratio, 1.51; 95{\%} confidence interval, 1.19-1.92) but not with increased health care use. Conclusions: The somatic symptom burden is high in patients with cancer who experience pain or depression. Given the strong association with disability and the high prevalence of many types of symptoms, recognizing and managing somatic symptoms may be important in improving quality of life and functional status regardless of type or phase of cancer. Trial Registration: clinicaltrials.gov Identifier: NCT00313573.",
author = "Kurt Kroenke and Xin Zhong and Dale Theobald and Jingwei Wu and Wanzhu Tu and Janet Carpenter",
year = "2010",
month = "10",
day = "11",
doi = "10.1001/archinternmed.2010.337",
language = "English",
volume = "170",
pages = "1686--1694",
journal = "JAMA Internal Medicine",
issn = "2168-6106",
publisher = "American Medical Association",
number = "18",

}

TY - JOUR

T1 - Somatic symptoms in patients with cancer experiencing pain or depression

T2 - Prevalence, disability, and health care use

AU - Kroenke, Kurt

AU - Zhong, Xin

AU - Theobald, Dale

AU - Wu, Jingwei

AU - Tu, Wanzhu

AU - Carpenter, Janet

PY - 2010/10/11

Y1 - 2010/10/11

N2 - Background: The adverse impact of a high somatic symptom burden is well established for primary care and other noncancer populations with chronic medical disorders. Methods: This study examines the impact of somatic symptom burden on disability and health care use in patients with cancer experiencing pain, depression, or both. We performed secondary analyses of baseline data from 405 patients with cancer enrolled in a telecare management trial for pain or depression. Somatic symptom burden was measured using a 22-item scale. Multivariable models were conducted to determine the association of somatic symptom burden with the Sheehan Disability Scale (SDS) score, the number of self-reported disability days in the past 3 months, and health care use. Models were adjusted for sociodemographic characteristics, medical comorbidity, and depression and pain severity. Results: Somatic symptoms were highly prevalent, with 15 of the 22 symptoms reported by more than 50% of patients. The somatic symptom burden was similar across different types and phases of cancer. The mean SDS score (scored 0-10 [not at all disabled to unable to carry out any activities]) was 5.4, and the mean number of self-reported disability days in the past 4 weeks was 16.9. In multivariable models, somatic symptom burden was associated with SDS score (P<.001) and the likelihood of at least 14 disability days in the past 4 weeks (odds ratio, 1.51; 95% confidence interval, 1.19-1.92) but not with increased health care use. Conclusions: The somatic symptom burden is high in patients with cancer who experience pain or depression. Given the strong association with disability and the high prevalence of many types of symptoms, recognizing and managing somatic symptoms may be important in improving quality of life and functional status regardless of type or phase of cancer. Trial Registration: clinicaltrials.gov Identifier: NCT00313573.

AB - Background: The adverse impact of a high somatic symptom burden is well established for primary care and other noncancer populations with chronic medical disorders. Methods: This study examines the impact of somatic symptom burden on disability and health care use in patients with cancer experiencing pain, depression, or both. We performed secondary analyses of baseline data from 405 patients with cancer enrolled in a telecare management trial for pain or depression. Somatic symptom burden was measured using a 22-item scale. Multivariable models were conducted to determine the association of somatic symptom burden with the Sheehan Disability Scale (SDS) score, the number of self-reported disability days in the past 3 months, and health care use. Models were adjusted for sociodemographic characteristics, medical comorbidity, and depression and pain severity. Results: Somatic symptoms were highly prevalent, with 15 of the 22 symptoms reported by more than 50% of patients. The somatic symptom burden was similar across different types and phases of cancer. The mean SDS score (scored 0-10 [not at all disabled to unable to carry out any activities]) was 5.4, and the mean number of self-reported disability days in the past 4 weeks was 16.9. In multivariable models, somatic symptom burden was associated with SDS score (P<.001) and the likelihood of at least 14 disability days in the past 4 weeks (odds ratio, 1.51; 95% confidence interval, 1.19-1.92) but not with increased health care use. Conclusions: The somatic symptom burden is high in patients with cancer who experience pain or depression. Given the strong association with disability and the high prevalence of many types of symptoms, recognizing and managing somatic symptoms may be important in improving quality of life and functional status regardless of type or phase of cancer. Trial Registration: clinicaltrials.gov Identifier: NCT00313573.

UR - http://www.scopus.com/inward/record.url?scp=77957957781&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77957957781&partnerID=8YFLogxK

U2 - 10.1001/archinternmed.2010.337

DO - 10.1001/archinternmed.2010.337

M3 - Article

C2 - 20937930

AN - SCOPUS:77957957781

VL - 170

SP - 1686

EP - 1694

JO - JAMA Internal Medicine

JF - JAMA Internal Medicine

SN - 2168-6106

IS - 18

ER -