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Background This study aims to explore differences in personal narratives of the experience of illness and treatment in depressed oncologic patients who received either combined treatment for depression (psychotherapy plus antidepressants) or standard treatment (antidepressants alone). Methods We employed a qualitative research design based on grounded theory. Data were collected from eight videotaped focus groups and semi-structured interviews with a total of 28 participants. The research team reviewed interview transcripts and categorized the participants' responses using the ATLAS.ti (ATLAS.ti Scientific Software Development GmbH Hardenbergstr. 7 D-10623, Berlin) software package. Results Compared with patients in the standard treatment group, patients in the combined treatment group were better able to relate their experiences of physical and emotional discomfort and find meaning in the experience of illness by viewing cancer as a transformative experience. In addition, patients in the combined treatment group tended to use more active coping strategies based on acceptance of their situation and emphasized that psychotherapy had been helpful. Conclusions Qualitative analysis is an efficient method of examining the meaning of quantitative results in depth, particularly patients' perspectives on quality of life. Patients undergoing combined treatment consider psychotherapy to be a helpful tool and exhibit more personal growth than do patients undergoing standard treatment. Copyright © 2011 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Summary backgbound Tumour necrosis factor-α (TNF-α) is a cytokine with numerous immunological and metabolic activities. Receptors for TNF-α have been demonstrated in thyroid follicular cells and TNF-α and its receptors have been implicated in the cytotoxic mechanisms that characterize the thyroid destruction in autoimmune thyroid disease. In patients with Graves’ disease, serum levels of TNF-α have been reported to be elevated and administration of TNF-α to humans has been shown to induce hormonal alterations resembling those seen in the nonthyroidal illness syndrome. objective To evaluate serum concentrations of TNF-α and the soluble receptor for TNF-α (sTNFR-I) in a group of patients with thyroid dysfunction before and after normalization of thyroid function with appropriate therapy. design We studied 20 patients with hypothyroidism (18 women and 2 men, mean age ± SD, 48·8 ± 16·1 years) and 20 patients with hyperthyroidism (14 women and 6 men, age 44·6 ± 15·9 years). Patients were assessed at the time of diagnosis and again after normalization of thyroid function tests with appropriate therapy. A group of 20 healthy subjects (15 women and 5 men, age 44·9 ± 15·1 years) were also studied as a control group. setting All subjects were ambulatory and were studied as outpatients during visits to the endocrinology clinic. measurements Serum concentrations of free T4 (FT4), total T3, TSH, TNF-α and sTNFR-I were measured in all subjects. TNF-α and sTNFR-I were measured using a quantitative enzyme immunoassay. results In patients with hypothyroidism serum concentrations of TNF-α (3·17 ± 1·18 pg/ml) and sTNFR-I (1273 ± 364 pg/ml) were significantly higher than those found in controls (2·42 ± 0·76 pg/ml, P < 0·05, and 971 ± 235 pg/ml, P < 0·01, respectively). Normalization of thyroid function with... [ABSTRACT FROM AUTHOR]