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Association of resilience with health-related quality of life and depression in multiple myeloma and its precursors: results of a German cross-sectional study
  1. Imad Maatouk1,2,
  2. Susanne He3,
  3. Natalia Becker4,
  4. Manuela Hummel4,
  5. Stefan Hemmer5,
  6. Michaela Hillengass3,
  7. Hartmut Goldschmidt3,6,
  8. Mechthild Hartmann1,
  9. Dieter Schellberg1,
  10. Wolfgang Herzog1,
  11. Jens Hillengass3
  1. 1 Department of General Internal Medicine and Psychosomatics, Medical University Hospital Heidelberg, Heidelberg, Germany
  2. 2 Section of Psychooncology, National Center for Tumor Diseases, Heidelberg, Germany
  3. 3 Department of Hematology, Oncology and Rheumatology, Medical University Hospital Heidelberg, Heidelberg, Germany
  4. 4 Department of Biostatistics, German Cancer Research Center, Heidelberg, Germany
  5. 5 Department of Orthopedics and Traumatology, University Hospital Heidelberg, Heidelberg, Germany
  6. 6 Section of Multiple Myeloma, National Center for Tumor Diseases, Heidelberg, Germany
  1. Correspondence to Dr Imad Maatouk; imad.maatouk{at}med.uni-heidelberg.de

Abstract

Objectives To investigate the relation between resilience, health-related quality of life (HRQOL) and depression in multiple myeloma (MM) and its premalignant stages. MM is one of the most frequent haematological disorders. It is regularly preceded by asymptomatic stages of the disease namely monoclonal gammopathy of undetermined significance (MGUS) and smouldering multiple myeloma (SMM). Survivors have to cope with mental and physical impairment in terms of HRQOL and depression. The concept of resilience refers to a person’s ability to adapt to adversity.

Design Cross-sectional study.

Setting MM outpatient department at a University Hospital in Germany (tertiary care).

Participants 292 consecutive patients from our MM outpatient department.

Outcome measures HRQOL, depression and psychological resilience were assessed with validated questionnaires.

Results Regression analyses were performed to determine associations between resilience, HRQOL and depression. 98 patients (33.6%) had a new diagnosis of active MM, 106 patients (36.3%) were already treated for MM and 88 patients had the diagnosis of a precursor (MGUS or SMM; 30.1%) of MM. Multivariate linear regression analyses revealed a strong positive impact of resilience on physical (b 7.20; 95% CI 4.43 to 9.98; p<0.001) and mental (b 12.12; 95% CI 9.36 to 14.87; p<0.001) HRQOL. Ordered logistic regression analysis showed that the odds for higher depression severity were lowered for individuals with a high level of resilience in comparison to the individuals with a low level of resilience (OR 0.11; 95% CI 0.06 to 0.19; p<0.001).

Conclusions Resilience may be a protective factor in the disease trajectory of MM and its precursors. As a next step, future research should focus on longitudinal assessments at various time points to elucidate the role of resilience in one of the most frequent haematological malignancies.

  • monoclonal gammopathy of undetermined significance
  • multiple myeloma
  • quality of life
  • depression
  • resilience, psychological

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors IM: conceptualisation, data curation, formal analysis, methodology, writing original draft, and writing—review and editing. SH: investigation, data curation, methodology, project administration, visualisation, writing—review and editing. NB and MH: data curation, formal analysis, software, methodology, visualisation, writing—original draft and writing—review and editing. SH: conceptualisation, methodology, writing—review and editing. MH: project administration, conceptualisation, data curation, investigation, and writing—review and editing. HG: project administration, conceptualisation, supervision, data curation, and writing—review and editing. MH: conceptualisation, methodology, supervision, data curation, and writing—review and editing. WH: project administration, conceptualisation, supervision, data curation, investigation, and writing—review and editing. DS: data curation, formal analysis, software, methodology, writing—original draft and writing—review and editing. JH: conceptualisation, investigation, data curation, formal analysis, methodology, writing—original draft, and writing—review and editing.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Ethical approval was obtained from the ethics committee of the Medical Faculty of Heidelberg.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data are available (for researchers) from the corresponding author.

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