The relationship between psychological distress with salivary α-amylase and stress related symptoms among breast cancer survivors

Abstract

Background and Aims: This study examined the stress levels, the stressors and biomarker such as Alpha (α)-Amylase enzyme which is secreted under distress conditions. The aim was to determine the relationship between these three variables. Methods: The study respondents were made up of cancer outpatients from 3 hospitals namely the Hospital Kuala Lumpur, Seberang Jaya and Johor Baru, Pantai Ipoh and Putrajaya. The Personal Stress Inventory (PSI) questionnaire was used to identify stressors, while the Hospital Anxiety and Depression Scale (HADS) were used to determine the psychological distress levels. The Salimentary Oral Swab (SOS) Technique was used to collect the saliva and then the Salivary α-Amylase Assay Kit was used to analyse for α amylase. Results: The majority of respondents were stressed due to their sensitive emotion and nervousness in their daily lives (68.7%), they had poor memory and short attention spans of carrying out job tasks (67.3%) as well as they were emotionally depressed (65.3%). Their poor memory and short attention span (p = 0.037), heavy work load and poor task delivery (p = 0.008) were predictors for distress using HADS. The salivary α-amylase concentration was significantly related to the stress levels (p = 0.002). Conclusion: Breast cancer respondents with musculoskeletal system related symptoms, with heavy work load and poor task delivery, as well as had poor memory and short attention span were at higher risk of experiencing psychological distress. The salivary α-amylase which had significant relationships with psychological distress was therefore, a potential biological indicator for distress, while the musculoskeletal system related symptoms from the PSI questionnaire were predictors for distress.

Share and Cite:

Yong, H. , Zailina, H. , Zubaidah, J. , Saidi, M. , Yong, H. and Zalilah, M. (2013) The relationship between psychological distress with salivary α-amylase and stress related symptoms among breast cancer survivors. Health, 5, 811-816. doi: 10.4236/health.2013.54107.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] US Department of Health and Human Services (2010) Stress and your health fact sheet. http://www.womenshealth.gov
[2] Uchida, M., Akechi, T., Okuyama, T., Sagawa, R., Nakaguchi, T., Endo, C., Yamashita, H., Toyama, T. and Furukawa, T.A. (2010) Patients’ supportive care needs and psychological distress in advanced breast cancer patients in Japan. Japanese Journal of Clinical Oncology, 41, 530-536.
[3] Kaufman, E. and Lamster, I.B. (2002) The diagnostic applications of saliva: A review. Critical Reviews in Oral Biology and Medicine, 13, 197-212. doi:10.1177/154411130201300209
[4] Nater, U.M., Rohleder, N., Gaab, J., Berger, S., Jud, A., Kirschbaum, C. and Ehlert, U. (2005) Human salivary α- amylase reactivity in a psychosocial stress paradigm. International Journal of Psychophysiology, 55, 333-342. doi:10.1016/j.ijpsycho.2004.09.009
[5] van Stegeren, A., Rohleder, N. and Everaerd, W. (2006) Salivary alpha-amylase as marker for adregenic activity during stress: Effect of betablockade. Psychoneuroendocrinology, 31, 137-141. doi:10.1016/j.psyneuen.2005.05.012
[6] Granger, D.A., Kivlighan, K.T., El-Sheikh, M., Bordis, E.B. and Stroud, L.R. (2007) Salivary α-amylase in biobehavioral research. Recent developments and applications. Annals of New York Academy of Sciences, 1098, 122-144. doi:10.1196/annals.1384.008
[7] Ruttle, P.P. (2008) Stress and the role of alpha-amylase. http://www.lepanoptique.com/sections/sciences/stress-and-the-role-of-alpha-amylase
[8] Rohleder, N., Nater, U.M., Wolf, J.M., Ehlert, U. and Kirschbaum, C. (2004) Psychosocial stress-induced activation of salivary alpha-amylase. An indicator of sympathetic activity? Annals of New York Academy of Sciences, 1032, 258-263. doi:10.1196/annals.1314.033
[9] Nater, U.M., La Marca, R., Florin, L., Moses, A., Langhans, W., Koller, M.M. and Ehlert, U. (2006) Stress-induced changes in human salivary alpha-amylase activity- associations with adrenergic activity. Psychoneuroendocrinology, 31, 49-58. doi:10.1016/j.psyneuen.2005.05.010
[10] Takai, N., Yamaguchi, M., Aragaki, T., Eto, K., Uchihashi, K. and Nishikawa, Y. (2004) Effect of psychological stress on the salivary cortisol and amylase levels in healthy young adults. Archives of Oral Biology, 49, 963-968. doi:10.1016/j.archoralbio.2004.06.007
[11] Chatterton Jr., R.T., Vogelsong, K.M., Lu, Y.C. and Hudgens, G.A. (1997) Hormonal responses to psychological stress in men preparing for skydiving. Journal of Clinical Physiology, 16, 433-448. doi:10.1111/j.1475-097X.1996.tb00731.x
[12] O’Donnell, M.P., Jaffe, D.T. and Zindler Wernet P. (1984) Stress assessment. In: O’Donnell, M.P. and Ainsworth, T.H., Eds., Health Promotion in the Work Place, John Wiley, New York, 185-220.
[13] Terluin, B., Brouwers, E.P.M., van Marwijk, H.W.J., Verhaak, P.F.M. and van der Horst, H.E. (2009) Detecting depressive and anxiety disorders in distressed patients in primary care; comparative diagnostic accuracy of the Four-Dimensional Symptom Questionnaire (4DSQ) and the Hospital Anxiety and Depression Scale (HADS). BMC Family Practice, 10, 58. doi:10.1186/1471-2296-10-58
[14] Cohen, M., Hoffman, R.G., Cromwell, C., Schmeidler, J., Ebrahim, F., Carrera, G., Endorf, F., Alfonso, C.A. and Jacobson, J.M. (2002) The prevalence of distress in persons with human immunodeficiency virus infection. Psychosomatics, 43, 10-15. doi:10.1176/appi.psy.43.1.10
[15] Shim, E.J., Shin, Y.W., Jeon, H.J. and Hahm, B.J. (2008) Distress and its correlates in Korean cancer patients: Pilot use of the distress thermometer and the problem list. Psycho-Oncology, 17, 548-555. doi:10.1002/pon.1275
[16] NCCN (2002) Practice guidelines in oncology—v. distress management. National Comprehensive Cancer Network.
[17] Hoffman, B. (2005) Cancer survivors at work: A generation of progress. A Cancer Journal for Clinicians, 55, 271-280. doi:10.3322/canjclin.55.5.271
[18] Paige, S.Z. and Streckfus, C.F. (2007) Salivary analysis in the diagnosis and treatment of breast cancer. General Dentistry, 55, 156-157.
[19] Harmon, A.G., Towe-Goodman, N.R., Fortunato, C.K. and Granger, D.A. (2008) Differences in saliva collection location and disparities in baseline and diurnal rhythms of alpha-amylase: A prelimary note of caution. Hormones and Behavior, 54, 592-596. doi:10.1016/j.yhbeh.2008.05.019
[20] Yamaguchi, M., Wakasugi, J. and Sakakima, J. (2008) Competitive and product inhibition-based alpha-amylase activity analysis method. Clinical Biochemistry, 41, 325- 330. doi:10.1016/j.clinbiochem.2007.10.016
[21] Shamsul, I.A.A. and Hassim, N.J. (2005) The prevalence of occupational stress among general practitioner in Ampang, Selangor. Malaysian Journal of Community Health, 11, 44-50.
[22] Schou, I., Ekeberc, Q. and Sandvick, L. (2005) Multiple predictors of health-related quality of life in early stage breast cancer. Data from a year follow-up study compared with the general population. Quality of Life Research, 14, 1813-1823. doi:10.1007/s11136-005-4344-z
[23] Thewes, B., Butow, P., Girgis, A. and Pendlebury, S. (2004) The psychosocial needs of breast cancer survivors; A qualitative study of the shared and unique needs of younger versus older survivors. Psycho-Oncology, 13, 177- 189. doi:10.1002/pon.710
[24] Nater, U.M., Rohleder, N., Schlotz, W., Ehlert, U. and Kirschbaum, C. (2007) Determinants of the diurnal course of salivary alpha-amylase. Psychoneuroendocrinology, 32, 392-401. doi:10.1016/j.psyneuen.2007.02.007
[25] Inagaki, T., Miyaoka, T., Okazaki, S., Yasuda, H., Tetsuya, K., Utani, E., Wake, R., Hayashida, M., Horiguchi, J. and Tsuji, S. (2010) High salivary alpha amylase levels in patients with schizophrenia: A pilot study. Neuro-Psychopharmacology and Biological Psychiatry, 34.
[26] Garrett, J.R. (1999) Effects of autonomic nerve stimulations on salivary parenchyma and protein secretion. In: Garrett, J.R., Ekstrom, J. and Anderson, L.C., Eds., Neural Mechanisms of Salivary Gland Secretion, Karger, Basel, 59-79.
[27] Chatterton, R.T.J., Vogelsong, K.M., Lu, Y.C., Ellman, A.B. and Hudgens, G.A. (1996) Salivary alpha-amylase as a measure of endogenous adregenic activity. Clinical Physiology, 16, 433-448. doi:10.1111/j.1475-097X.1996.tb00731.x
[28] Noto, Y., Sato, T., Kudo, M., Kurata, K. and Hirota, K. (2005) The relationship between salivary biomarkers and state-anxiety anxiety inventory score under mental arithmetric stress: A pilot study. Anesthesia and Analgesia, 101, 1873-1876. doi:10.1213/01.ANE.0000184196.60838.8D
[29] Bosch, J.A., Brand, H.S., Ligtenberg, T.J.M., Bermond, B., Hoogstraten, J. and Nieuw Amerongen, A.V. (1996) Psychological stress as a determinant of protein levels and salivary-induced aggregation of Streptococcus gordonii in human whole saliva. Psychosomatic Medicine, 58, 374-382.
[30] Rohleder, N., Chen, E., Wolf, J.M. and Miller, G.E. (2008) The psychobiology of trait shame in young women: Extending the social self preservation theory. Health Psychology, 27, 523-532. doi:10.1037/0278-6133.27.5.523

Copyright © 2024 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.