Trajectories of anxiety and depressive symptoms during hospitalization for hematopoietic stem cell transplantation
摘要
Hematopoietic stem cell transplantation (HSCT) is an intensive and physically demanding treatment used in patients with hematological malignancies and is associated with substantial psychological burden. This study aimed to examine the temporal trajectories of depressive and anxiety symptoms during hospitalization for HSCT. A total of 169 patients undergoing HSCT completed the hospital anxiety and depression scale (HADS) at four time points: at hospital admission (T1), one day before transplantation (T2), six days post-transplantation (T3), and at discharge (T4). Changes over time were analyzed using repeated-measures analysis of variance. The proportion of patients with moderate-to-severe depressive symptoms increased from 14.2% at admission to 42.6% six days after HSCT and remained elevated at discharge (33.2%). Anxiety symptom severity remained relatively stable across hospitalization. A significant effect of time was observed for both depressive and anxiety symptoms. Depressive symptoms increased during hospitalization, reaching their highest levels six days after transplantation (T3), followed by partial improvement at discharge; however, symptom severity remained higher than at admission. The proportion of patients presenting moderate and severe depressive symptoms also increased over the course of hospitalization. In contrast, anxiety symptoms remained relatively stable from admission to the early post-transplant phase and decreased significantly at discharge. Patients with high baseline levels of depressive or anxiety symptoms continued to report elevated symptom severity throughout hospitalization. Depression and anxiety follow distinct temporal patterns during HSCT hospitalization. These findings highlight the need for systematic psychological monitoring and phase-specific supportive interventions tailored to symptom type and baseline emotional burden.