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@ARTICLE{Maatouk:136880,
      author       = {I. Maatouk and S. He and N. Becker$^*$ and M. Hummel$^*$
                      and S. Hemmer and M. Hillengass and H. Goldschmidt$^*$ and
                      M. Hartmann and D. Schellberg and W. Herzog and J.
                      Hillengass},
      title        = {{A}ssociation of resilience with health-related quality of
                      life and depression in multiple myeloma and its precursors:
                      results of a {G}erman cross-sectional study.},
      journal      = {BMJ open},
      volume       = {8},
      number       = {7},
      issn         = {2044-6055},
      address      = {London},
      publisher    = {BMJ Publishing Group},
      reportid     = {DKFZ-2018-01318},
      pages        = {e021376 -},
      year         = {2018},
      abstract     = {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.Cross-sectional
                      study.MM outpatient department at a University Hospital in
                      Germany (tertiary care).292 consecutive patients from our MM
                      outpatient department.HRQOL, depression and psychological
                      resilience were assessed with validated
                      questionnaires.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).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.},
      cin          = {C060 / V964},
      ddc          = {610},
      cid          = {I:(DE-He78)C060-20160331 / I:(DE-He78)V964-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30061438},
      pmc          = {pmc:PMC6067407},
      doi          = {10.1136/bmjopen-2017-021376},
      url          = {https://inrepo02.dkfz.de/record/136880},
}