Survivorship and Patients Perspective
E. G. Vinokurova2, A. A. Marchenko2, S. O. Khrushchev1,2, L. V. Olexenko1, G. E. Rupchev2,3, D. E. Vybornykh1, T. N. Moiseeva1
1 National Research Center for Hematology, Moscow, Russia, 2 Lomonosov Moscow State University, Moscow, Russia, 3 Mental Health Research Center, Moscow, Russia
Introduction: Treatment protocols for Hodgkin's lymphoma patients contain severe and multiple courses of chemotherapy and medical manipulations which can be a source of neurological, mental and psychological disturbances. In particular neurocognitive impairments can occur during treatment period and early stages of remission. Subjective complaints confirm that HL survivors lower cognitive functioning compared to healthy subjects, however qualitative objective research are rare.
Objectives: Research cognitive functioning of HL patients by BACS («Brief Assessment of Cognition in Schizophrenia») and analysis the specifics of cognitive functioning of patients with HL to develop prospective psychosocial rehabilitation programs.
Methods: Patients with HL (N = 22, 12 females, mean age 32 y.) were observed. The procedure of examination included: pathopsychological examination, assessment patients with BACS. Patients were assessed with: PANNS, scales evaluating test execution strategies (from TOL-DX) and expert scales (from WCST).
Results: Qualitative analysis of pilot research stage showed that: 20% of patients have difficulties in performing the subtests «Verbal Memory», «Digit Sequencing» (working memory) and «Verbal Fluency» (BACS). 35% of patients were observed decrease in the «Symbol Coding» subtest scores (visual-motor coordination). 10% of patients have problems in performing the subtest «Tower of London» (problem-solving skills). Only about 50% of patients managed with the task «Proverbs» successfully and with less than 75% with the task «Similarity». 34% percent of patients almost cannot solve the task «Exclusion of objects». BACS (T-Scores: average mean, st.dev, min and max value were analysed with SPSS).
Conclusions: It is supposed that patients with HL have partial cognitive dysfunction as a side effect of chemotherapy and distress (anxiety, depression, PTSD etc.). They have impairments in abstract thought, especially problems with definition of figurative sense and the decrease in the level of making general conclusions. Although it is difficult connect such cognitive decline to chemotherapy or distress - psychosocial interventions can be beneficial to adopt patients to somatic/psychological changes (fatigue, depression, self-esteem, professional and social isolation) and improve their quality of life. Further research data can be used to develop neuropsychological cognitive rehabilitation for patients with evident cognitive deficit.