Health psychology and distress after haematopoietic stem
cell transplantation
V. DeMARINIS, phd, Department of Psychology, Uppsala University, Uppsala, Sweden and Department of Psy-
chiatry, Cambridge Health Alliance, Medford, MA, A.J. BARSKY, md, Department of Psychiatry, Harvard Medical
School and Brigham and Women’s Hospital, Boston, MA, J.H. ANTIN, md, Department of Medicine, Harvard
Medical School and Department of Medical Oncology, Dana-Farber Partners Cancer Institute, Boston, MA,&
G. CHANG, md, mph, Department of Psychiatry, Harvard Medical School and Brigham and Women’s Hospital,
Boston, MA, USA
DeMARINIS V., BARSKY A.J., ANTIN, J.H. & CHANG G. (2009) European Journal of Cancer Care 18, 57–63
Health psychology and distress after haematopoietic stem cell transplantation
The purpose of this study of 23 adult haematopoietic stem cell transplantation (HSCT) recipients is to compare
the presence of post-transplantation depression disorders by gender and to compare the outcomes among those
with and without depressive disorders using a health psychology focus. This cross-sectional pilot study of
mid-term survivors took place in hospital outpatient clinic. Main outcome measures are depression disorders,
health status (Short Form-12) and health anxiety. Female survivors had a higher rate of depression disorders,
but those with treated depressive disorders were similar to those without depression on health-related quality
of life and health anxiety. Neither patient age nor time since HSCT was associated with depressive disorders.
A health psychology approach may enhance management of HSCT survivorship.
Keywords: health psychology, cancer, depression, adults, quality of life, stem cell transplantation.
INTRODUCTION
The article uses a health psychology focus in preventive
psychiatry to analyse the findings of an original pilot
study of mid-term haematopoietic stem cell transplanta-
tion (HSCT) recipients. More than 40 000 haematopoietic
stem cell transplants are performed worldwide each year,
with tens of thousands of HSCT survivors (Rizzo et al.
2006). The procedure results in an adoptively transferred
immune and haematopoietic system, and is an effective
therapy for malignant as well as benign blood disorders
and diseases of immunity (Appelbaum 2003).
The health psychology focus in preventive psychiatry
is based on a trans-disciplinary and interactional under-
standing of biopsychosocial relationships in the patient’s
experience and expression of disease symptoms, illness
construction and treatment response. Patient differences
in gender, culture and socio-economic status are consid-
ered. As patient empowerment is the ultimate treatment
objective, a prevention philosophy is adopted no matter at
what stage intervention strategies are being planned.
Hence, a health psychology focus will influence both
methodology and interpretation of research findings, and
has been successfully applied across a range of settings
and contexts including the management of chronic and/or
life-threatening illness such as rheumatoid arthritis, dia-
betes and cancer; psychophysiological disorders such as
irritable bowel disorder; and psychological comorbidities
such as depression and anxiety (Nicassio et al. 2004). As
such, this approach is highly relevant to this study of 23
mid-term survivors of HSCT.
The existing literature on survivors of HSCT suggests a
generally high global quality of life after transplantation,
Correspondence address: Dr Grace Chang, Department of Psychiatry,
Brigham and Women’s Hospital, 75 Francis Street, Boston, MA, 02115,
USA (e-mail: gchang@partners.org).
Source of funding: This study was funded in part by K24 AA 00289 (GC)
from the National Institute on Alcohol Abuse and Alcoholism.
Accepted 21 January 2008
DOI: 10.1111/j.1365-2354.2008.00931.x
European Journal of Cancer Care, 2009, 18, 57–63
Original article
© 2008 The Authors
Journal compilation © 2008 Blackwell Publishing Ltd