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I. Changes Over Time in Methods of Coping and Affective Disturbance

Fawzy I. Fawzy, MD; Norman Cousins; Nancy W. Fawzy, RN, MN; Margaret E. Kemeny, PhD; Robert Elashoff, PhD; Donald Morton, MD

Arch Gen Psychiatry. 1990;47(8):720-725.

Abstract
• We evaluated the immediate and long-term effects on psychological distress and coping methods of a 6-week, structured, psychiatric group intervention for postsurgical patients with malignant melanoma. The intervention consisted of health education, enhancement of problem-solving skills, stress management (eg, relaxation techniques), and psychological support. In spite of good prognosis, most patients had high levels of psychological distress at baseline, comparable with other patients with cancer. However, at the end of brief psychiatric intervention, the experimental subjects (n = 38), while not without some distress, exhibited higher vigor and greater use of active-behavioral coping than the controls (n = 28). At 6 months' follow-up, the group differences were even more pronounced. The intervention-group patients then showed significantly lower depression, fatigue, confusion, and total mood disturbance as well as higher vigor. They were also using significantly more active-behavioral and active-cognitive coping than the controls. These results indicate that a short-term psychiatric group intervention for patients with malignant melanoma effectively reduces psychological distress and enhances longer-term effective coping.

Author Affiliations
From the Departments of Psychiatry (Drs Fawzy and Kemeny, Mr Cousins, and Ms Fawzy), Microbiology and Immunology (Dr Kemeny), and Biomathematics (Dr Elashoff), the Dean's Office (Mr Cousins), the John Wayne Cancer Clinic/Division of Surgical Oncology (Dr Morton), and the Jonsson Comprehensive Cancer Center (Drs Fawzy, Elashoff, and Morton and Mr Cousins), UCLA School of Medicine.

Footnotes
Accepted for publication March 22, 1990.

Reprint requests to UCLA/Neuropsychiatric Institute, 760 Westwood Plaza, Los Angeles, CA 90024-175919 (Dr Fawzy).

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