Clinical psychology

Background. Gastrointestinal stromal tumors (GIST) represent 1% of all gastrointestinal tumors and are included in the list of rare diseases.

Objective. 1. to evaluate levels of psychological distress, fatigue, and quality of life. 2. To identify the variables that most influence distress among Mexican patients with GIST.

Design. A cross-sectional study was conducted with a consecutive sample of 100 patients with GIST, who completed the following questionnaires online: Hospital Anxiety and Depression Scale (HADS) as a measure of distress, Multidimensional Fatigue Inventory (MFI), and Quality of Life Questionnaire (QLQ C30).

Results. Distress was present in 31% of patients. No association was found between distress and sociodemographic/clinical variables. The patients with distress demonstrated higher scores in all fatigue dimensions and, regarding quality of life, had more symptoms and were lower functioning. Distress was positively associated with all fatigue dimensions and with QLQ C30 symptoms. Negative associations were found between distress and QLQ C30 functioning dimensions. The predictors of psychological distress were general fatigue, reduced motivation, and emotional functioning.

Conclusion. The percentage of patients with distress was akin to the levels found in patients with the most common types of cancer. Fatigue in patients with GIST should be evaluated and managed to improve distress levels.

Background. Initial psychological papers on COVID-19, mental health and well-being mostly focus on the aftermath lockdown-related stress and stress related to the disease itself. Still, we presume that personal well-being can be resistant to stressors depending on the way the person is settled in their life.

Objective. We seek to reconsider the contribution of lockdown-related stressors to existential well-being, to assess existential well-being during the outbreak and to compare the contribution of living conditions and COVID-19-related factors on well-being.

Design. An online survey was conducted during the peak of the outbreak in Moscow (April-May 2020) (N=880). The data was obtained using the “Test of Existential Motivations” questionnaire and a series of questions addressing (1) living conditions — mental and physical health, employment, and social distancing; (2) COVID-19-related stressors — non-chronic illness, financial losses, and unavailability of goods or services; (3) sociodemographic indicators — age, gender, and income. Data analysis included hierarchical multiple regression, one-sample t-test, and analysis of variance.

Results. Surprisingly, the existential well-being of Moscow citizens during the research period was moderate. Each of the three groups of factors predicted a similar proportion of the variance of well-being (3-3,9%). The strongest predictors of well-being were long-term mental health status and financial stability. The effect of COVID-19-related stressors was most pronounced when they co-occur.

Conclusion. The negative association between lockdown-related stressors and poor well-being is not universal. It is necessary to study the effect of COVID-19-related stressors in combination with individual living conditions and region-specific factors and to focus on the prevention of the occurrence of stressors.