The course of anxiety and depression during the first year after allogeneic or autologous stem cell transplantation

Psychological distress is frequently reported in transplant survivors. We p rospectively assessed anxiety and depression before transplant, in the isol ation period and during a follow-up period of 1 year. The Hospital Anxiety and Depression Scale (HADS) was administered to 131 cancer patients treated with high-dose chemotherapy followed by allogeneic (SCT) or autologous (AS CT) stem cell transplantation, and a concurrent group of 123 lymphoma patie nts receiving standard chemotherapy (CT) who served as a reference group. R elatively low levels of anxiety and depression were found. The level of anx iety slightly declined from baseline during follow-up (mean scores SCT: fro m 5.3 to 3.6, CT: from 6.0 to 4.2) or remained fairly stable (ASCT: from 5. 4 to 4.8). The level of depression peaked when the transplant patients were in protective isolation or shortly thereafter (SCT: 6.1, ASCT: 6.4), but s tabilized at baseline levels after 4 months. The highest level of depressio n in the CT group was reported 4 months after start of chemotherapy (3.4). Elevated levels of anxiety and depression at baseline predicted more anxiet y and depression at the later assessments (P values <0.0001). The ASCT grou p had higher levels of anxiety after 1 year (mean 4.8) than those found in the other two groups (SCT: 3.6, CT: 4.2), although they were not statistica lly significant. This study revealed lower than expected levels of anxiety and depression after intensive chemotherapy followed by SCT or ASCT, There was a decline in psychological distress during the 1-year follow-up period.