Return to work after cancer: Improved mental health in working cancer survivors

Marietta Lieb; Alexander Wünsch; Katharina Schieber; Corinna Bergelt; Hermann Faller; Franziska Geiser; Ute Goerling; Klaus Hönig; Beate Hornemann; Imad Maatouk; Alexander Niecke; Barbara Stein; Martin Teufel; Martin Wickert; Antje Büttner-Teleagă; Yesim Erim; Joachim Weis

doi:10.1002/pon.5877

Return to work after cancer: Improved mental health in working cancer survivors

Psychooncology. 2022 Jun;31(6):893-901. doi: 10.1002/pon.5877. Epub 2022 Jan 11.

Authors

Marietta Lieb¹, Alexander Wünsch², Katharina Schieber¹, Corinna Bergelt³, Hermann Faller⁴, Franziska Geiser⁵, Ute Goerling⁶, Klaus Hönig⁷, Beate Hornemann⁸, Imad Maatouk⁹, Alexander Niecke¹⁰, Barbara Stein¹¹, Martin Teufel¹², Martin Wickert¹³, Antje Büttner-Teleagă¹⁴, Yesim Erim¹, Joachim Weis¹⁵

Affiliations

¹ Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital of Erlangen, Erlangen, Germany.
² Clinic for Psychosomatic Medicine and Psychotherapy, Medical Center Freiburg, Faculty of Medicine, University Freiburg in Cooperation with Outpatient Support for Cancer Patients, Comprehensive Cancer Center Freiburg, Freiburg, Germany.
³ Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Center for Psychosocial Medicine, Hamburg, Germany.
⁴ Department of Medical Psychology and Psychotherapy, Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany.
⁵ University of Bonn, Clinic for Psychosomatic Medicine and Psychotherapy, Bonn, Germany.
⁶ Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität and Berlin Institute of Health, Berlin, Germany.
⁷ Ulm University Clinic Department of Psychosomatic Medicine and Psychotherapy, Comprehensive Cancer Center Ulm (CCCU), Ulm, Germany.
⁸ Comprehensive Cancer Center, University Clinic Center Dresden, Dresden, Germany.
⁹ Department of General Internal Medicine and Psychosomatics, Medical University Hospital Heidelberg, Heidelberg, Germany.
¹⁰ Department of Psychosomatics and Psychotherapy, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
¹¹ Department of Psychosomatic Medicine and Psychotherapy, Paracelsus Medical University, Nuremberg General Hospital, Nuremberg, Germany.
¹² Department of Psychosomatic Medicine and Psychotherapy, University of Duisburg-Essen, Comprehensive Cancer Center Essen (WTZ) and LVR Hospital, Essen, Germany.
¹³ Medical University Hospital Tuebingen, Universitätsklinikum Tübingen, Comprehensive Cancer Center Tübingen-Stuttgart, Tübingen, Germany.
¹⁴ Institute of Cognitive Science, Woosuk University, Jeonbuk, Republic of Korea.
¹⁵ Comprehensive Cancer Center, Department Self-help Research, Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.

PMID: 34989051
DOI: 10.1002/pon.5877

Abstract

Objective: Aim of the study was to compare working and non-working patients over a period of 12 months regarding socio-demographic, cancer-specific and mental health parameters.

Methods: This study was conducted as part of a Germany-wide longitudinal survey among 1398 patients in 13 national Comprehensive Cancer Centers. The sample used for analysis consisted of n = 430 cancer patients younger than 65 years (age M = 52.4 years, SD = 8.1; 67.0% females). Socio-demographic, cancer-specific and mental health parameters (Depression: Patient Health Questionnaire, Anxiety: Generalized Anxiety Disorder Scale, Distress: Distress Thermometer) were assessed at baseline during hospitalization and at 12 months follow-up.

Results: 73.7% of all patients (n = 317) have returned to work after one year. While working and non-working patients did not differ in socio-demographic parameters, there were significant differences in the presence of metastases, tumor and treatment status. Mixed analysis of variances revealed significant interactions between working status and time for depression (p = 0.009), anxiety (p = 0.003) and distress (p = 0.007). Non-working patients reported higher levels of depression, anxiety and distress than working patients over time. A logistic regression showed significant associations between lower depression (p = 0.019), lower distress (p = 0.033) and the absence of a tumor (p = 0.015) with working status.

Conclusions: The majority of cancer survivors returned to work. Non-working patients had higher levels of depression, anxiety and distress than working patients. After controlling for cancer-specific factors, mental health parameters were still independently associated with working status. Return to work can thus be associated with an improved mental health in cancer survivors. In order to establish causality, further research is necessary.

Keywords: cancer; cancer survivors; comprehensive cancer center; mental health; prospective study; psycho-oncology; return to work.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anxiety / epidemiology
Anxiety / psychology
Cancer Survivors* / psychology
Depression / epidemiology
Depression / psychology
Female
Humans
Male
Mental Health
Middle Aged
Neoplasms* / psychology
Neoplasms* / therapy
Return to Work / psychology