|
1
|
Ajmera NB, Doss BD, Kim Y. Social support, social constraint, and psychological adjustment in patients with colorectal cancer. J Behav Med 2025; 48:414-429. [PMID: 40167855 PMCID: PMC12078434 DOI: 10.1007/s10865-025-00565-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2024] [Accepted: 02/26/2025] [Indexed: 04/02/2025]
Abstract
Cancer patients' social networks, particularly their spouses or romantic partners, can promote or undermine their psychological adjustment. This study examined the relative associations of partner social support and social constraint with patients' psychological adjustment and further tested gender's moderating role in these associations. Participants were 124 patients newly diagnosed with colorectal cancer (M age = 56.6 years, 34% female), who completed questionnaires on perceived spousal social support and social constraint, depressive symptoms, and life satisfaction. Findings revealed that greater social constraint was significantly associated with lower life satisfaction regardless of gender; however, greater social constraint was only associated with greater depressive symptoms in male patients. No significant associations or interactions with social support were found. Findings highlight the importance for patients-especially male patients-with cancer to feel able to disclose cancer-related thoughts and feelings to their partners and call for more consistent operationalization and measurement when studying patients' social functioning.
Collapse
Affiliation(s)
- Nirvi B Ajmera
- Department of Psychology, University of Miami, Miami, FL, USA.
| | - Brian D Doss
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Youngmee Kim
- Department of Psychology, University of Miami, Miami, FL, USA
| |
Collapse
|
|
2
|
Bentsen L, Belgers V, Giraldi A, von Heymann A, Johansen C, Piil K, Pappot H. Prevalence and Impact of Sexual Complaints on Depressive Symptoms in Adolescents and Young Adults with Cancer: A Cross-Sectional Sub-Study. J Adolesc Young Adult Oncol 2025. [PMID: 40331239 DOI: 10.1089/jayao.2024.0150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2025] Open
Abstract
Purpose: Adolescents and young adults (AYAs) diagnosed with cancer face unique psychosocial challenges, including sexual complaints. Despite the prevalence of these sexual issues, they are underexplored in AYA oncology care. The aim of this study is firstly to examine the prevalence of sexual complaints among AYAs with cancer across genders, age groups, and types of cancer. Second, we explore the association between sexual complaints and depressive symptoms. Methods: This cross-sectional sub-study included 305 AYAs (aged 15-39 at diagnosis) actively affiliated with the oncology department at Copenhagen University Hospital-Rigshospitalet. Participants completed questionnaires assessing sexual complaints and depressive symptoms. Sexual problems, distress, satisfaction, and willingness to discuss these issues were analyzed alongside demographic, clinical, and treatment data. Univariate and multivariable regression analyses evaluated associations with depressive symptoms. Results: Sexual problems affected 63.9% of AYAs, 49.5% experienced sexual distress, and 58.4% were dissatisfied with their sexual lives. Younger AYAs reported higher sexual satisfaction than older AYAs. Sexual distress, dissatisfaction, and reluctance to discuss sexual issues were associated with increased depressive symptoms in the univariate analysis. In the multivariable model, sexual distress remained independently associated with depressive symptoms, alongside age at diagnosis, civil status, cancer type, and pain. Conclusion: Sexual complaints, particularly distress, are prevalent among AYAs with cancer and are significantly associated with depressive symptoms. Integrating routine discussions about sexual health into oncology care could probably improve mental health outcomes and overall quality of life for this vulnerable group. Future research should focus on targeted interventions to address these interconnected challenges.
Collapse
Affiliation(s)
- Line Bentsen
- Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Vera Belgers
- Department of Neurology, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Brain Tumor Center, Amsterdam, The Netherlands
| | - Annamaria Giraldi
- Sexological Clinic, Psychiatric Centre Copenhagen, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark
- Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Annika von Heymann
- Department of Oncology, Cancer Survivorship and Treatment Late Effects (CASTLE)-Danish Cancer Society National Research Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Christoffer Johansen
- Department of Oncology, Cancer Survivorship and Treatment Late Effects (CASTLE)-Danish Cancer Society National Research Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Karin Piil
- Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Helle Pappot
- Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark
- Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
|
3
|
Nakamura ZM, Small BJ, Zhai W, Ahles TA, Ahn J, Artese AL, Bethea TN, Breen EC, Cohen HJ, Extermann M, Graham D, Irwin MR, Isaacs C, Jim HSL, Kuhlman KR, McDonald BC, Patel SK, Rentscher KE, Root JC, Saykin AJ, Tometich DB, Van Dyk K, Zhou X, Mandelblatt JS, Carroll JE. Depressive symptom trajectories in older breast cancer survivors: the Thinking and Living with Cancer Study. J Cancer Surviv 2025; 19:568-579. [PMID: 37924476 PMCID: PMC11068856 DOI: 10.1007/s11764-023-01490-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/21/2023] [Indexed: 11/06/2023]
Abstract
PURPOSE To identify trajectories of depressive symptoms in older breast cancer survivors and demographic, psychosocial, physical health, and cancer-related predictors of these trajectories. METHODS Recently diagnosed nonmetastatic breast cancer survivors (n = 272), ages 60-98 years, were evaluated for depressive symptoms (Center for Epidemiological Studies Depression Scale, CES-D; scores ≥16 suggestive of clinically significant depressive symptoms). CES-D scores were analyzed in growth-mixture models to determine depression trajectories from baseline (post-surgery, pre-systemic therapy) through 3-year annual follow-up. Multivariable, multinomial logistic regression was used to identify baseline predictors of depression trajectories. RESULTS Survivors had three distinct trajectories: stable (84.6%), emerging depressive symptoms (10.3%), and recovery from high depressive symptoms at baseline that improved slowly over time (5.1%). Compared to stable survivors, those in the emerging (OR = 1.16; 95% CI = 1.08-1.23) or recovery (OR = 1.26; 95% CI = 1.15-1.38) groups reported greater baseline anxiety. Greater baseline deficit accumulation (frailty composite measure) was associated with emerging depressive symptoms (OR = 3.71; 95% CI = 1.90-7.26). Less social support at baseline (OR = 0.38; 95% CI = 0.15-0.99), but greater improvement in emotional (F = 4.13; p = 0.0006) and tangible (F = 2.86; p = 0.01) social support over time, was associated with recovery from depressive symptoms. CONCLUSIONS Fifteen percent of older breast cancer survivors experienced emerging or recovery depressive symptom trajectories. Baseline anxiety, deficit accumulation, and lower social support were associated with worse outcomes. IMPLICATIONS FOR CANCER SURVIVORS Our results emphasize the importance of depression screening throughout the course of cancer care to facilitate early intervention. Factors associated with depressive symptoms, including lower levels of social support proximal to diagnosis, could serve as intervention levers.
Collapse
Affiliation(s)
- Zev M Nakamura
- Department of Psychiatry, University of North Carolina at Chapel Hill, 101 Manning Drive, Campus Box #7160, Chapel Hill, NC, 27599, USA.
| | - Brent J Small
- School of Aging Studies, University of South Florida, and Health Outcomes and Behavior Program, Moffitt Cancer Center, Tampa, FL, USA
| | - Wanting Zhai
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC, USA
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Tim A Ahles
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jaeil Ahn
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC, USA
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Ashley L Artese
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
| | - Traci N Bethea
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Elizabeth C Breen
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Harvey J Cohen
- Center for the Study of Aging and Human Development, Duke University Medical Center, Durham, NC, USA
| | - Martine Extermann
- Department of Oncology, Moffitt Cancer Center, University of South Florida, Tampa, FL, USA
| | - Deena Graham
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, NJ, USA
| | - Michael R Irwin
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Claudine Isaacs
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Heather S L Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Kate R Kuhlman
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychological Science, University of California, Irvine, CA, USA
- Institute for Interdisciplinary Salivary Bioscience Research, School of Social Ecology, University of California, Irvine, CA, USA
| | - Brenna C McDonald
- Department of Radiology and Imaging Sciences, Melvin and Bren Simon Comprehensive Cancer Center, and Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sunita K Patel
- City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - Kelly E Rentscher
- Department of Psychiatry and Behavioral Medicine, MCW Cancer Center, Medical College of Wisconsin, Milwaukee, WI, USA
| | - James C Root
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Melvin and Bren Simon Comprehensive Cancer Center, and Indiana Alzheimer's Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Danielle B Tometich
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA
| | - Kathleen Van Dyk
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Jonsson Comprehensive Cancer Center, University of California, Los Angeles, Los Angeles, CA, USA
| | - Xingtao Zhou
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC, USA
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Jeanne S Mandelblatt
- Georgetown Lombardi Institute for Cancer and Aging Research, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, DC, USA
| | - Judith E Carroll
- Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, USA
| |
Collapse
|
|
4
|
Belgers V, Tolver A, Klein M, Douw L, Niers JM, Piil K, de Witt Hamer PC. Baseline factors relating to depressive symptoms at one year postoperative in patients with diffuse glioma. Neurooncol Pract 2025; 12:122-130. [PMID: 39917762 PMCID: PMC11798611 DOI: 10.1093/nop/npae085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2025] Open
Abstract
Background Depressive symptoms are common in patients with diffuse glioma, potentially reducing their quality of life. Understanding baseline factors associated with the development of depressive symptoms is important for psychoeducation and early intervention. This study investigates the associations of baseline patient- and tumor-related characteristics and depressive symptoms 1 year after surgery. Methods We combined retrospective longitudinal datasets from Amsterdam UMC and Rigshospitalet Copenhagen. Several characteristics of patients and tumors were retrieved, in particular items of their mood and functioning status. Depression instruments were harmonized to the Patient-Reported Outcomes Measurement Information System Depression scale through previously developed item response theory. Functioning items were harmonized to the International Classification of Functioning, Disability, and Health (ICF) domains using linking methods published previously. We analyzed the associations of 25 baseline factors with depressive symptoms one year after surgery by multivariable stepwise backward linear regression models and verified model robustness using best subset selection. Results We included 118 patients with diffuse glioma with a mean age of 48 years and a glioblastoma in 29%. Baseline depressive symptoms, lower ICF energy, and impaired ICF language functioning were associated with more depressive symptoms at follow-up in the multivariable model (R-squared: 0.379). Conclusions We identified 3 key baseline factors associated with depressive symptoms one year after surgery. Clinically, our findings contribute to the comprehension of predictive factors for depressive symptoms, aiding healthcare providers and patients in understanding and possibly allowing for early intervention.
Collapse
Affiliation(s)
- Vera Belgers
- Amsterdam UMC location Vrije Universiteit Amsterdam, Neurology, 1081 HV Amsterdam, The Netherlands
- Cancer Center Amsterdam, Brain Tumor Center, Amsterdam, The Netherlands
| | - Anders Tolver
- Statistics and Data Analysis, Danish Cancer Institute, DK-2100 Copenhagen, Denmark
- Data Science Lab, Department of Mathematical Sciences, University of Copenhagen, DK-2100, Copenhagen, Denmark
| | - Martin Klein
- Amsterdam UMC location Vrije Universiteit Amsterdam, Medical Psychology, 1081 HV Amsterdam, The Netherlands
- Cancer Center Amsterdam, Brain Tumor Center, Amsterdam, The Netherlands
| | - Linda Douw
- Amsterdam UMC location Vrije Universiteit Amsterdam, Anatomy and Neurosciences, 1081 HV Amsterdam, The Netherlands
- Cancer Center Amsterdam, Brain Tumor Center, Amsterdam, The Netherlands
| | - Johanna M Niers
- Amsterdam UMC location Vrije Universiteit Amsterdam, Neurology, 1081 HV Amsterdam, The Netherlands
- Cancer Center Amsterdam, Brain Tumor Center, Amsterdam, The Netherlands
| | - Karin Piil
- Department of People and Technology, Roskilde University (K.P.)
- Department of Oncology, Rigshospitalet, 2100, Copenhagen, Denmark
| | - Philip C de Witt Hamer
- Cancer Center Amsterdam, Brain Tumor Center, Amsterdam, The Netherlands
- Amsterdam UMC location Vrije Universiteit Amsterdam, Neurosurgery, 1081 HV Amsterdam, The Netherlands
| |
Collapse
|
|
5
|
Dong J, Chen Q, Weng S, Liu L, Wang J, Fang S, Fan X, Jiang T. The effect of depression and anxiety on survival in patients with glioma: a systematic review and meta-analysis. J Neurooncol 2024; 170:265-275. [PMID: 39225956 DOI: 10.1007/s11060-024-04799-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 08/07/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE Depression and anxiety's impact on glioma patient survival lacks consensus. Understanding these effects can highlight the importance of identifying depression and anxiety in glioma patients, and inform future treatments. This systematic review and meta-analysis aims to clarify the impact of depression and anxiety on glioma patient survival. METHODS We conducted a systematic literature search of major databases, including PubMed, Embase, Web of Science Core Collection, Cochrane Library, and PsycINFO, from inception to June 2023, to identify relevant studies. Eligible studies were those that examined the association between depression, anxiety, or both, and survival outcomes in glioma patients. Data were extracted and analyzed using fixed-effects meta-analysis models to calculate pooled hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS A total of 15 studies met the inclusion criteria, encompassing a diverse range of glioma patients across different clinical settings and stages. The meta-analysis revealed a statistically significant association between depression and reduced overall survival in glioma patients, with a pooled HR of 1.65 (95% CI: 1.41-1.83, 11 studies). The preliminary univariate meta-regression results indicate no impact of individual study characteristics on the effect size. Likewise, anxiety was associated with worse overall survival, with a pooled HR of 1.65 (95% CI: 1.18-2.31, 5 studies). CONCLUSIONS This meta-analysis underscores the vital need to identify and treat depression and anxiety in glioma patients. Future research should explore the underlying mechanisms, aiding the creation of interventions enhancing both mental health and clinical outcomes for this vulnerable group.
Collapse
Affiliation(s)
- Jiahan Dong
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Qiannan Chen
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Shimeng Weng
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Lingyu Liu
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Jiangwei Wang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Shengyu Fang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 119, the Western Road of the Southern 4th Ring Road, Beijing, 100070, China.
| | - Xing Fan
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
| | - Tao Jiang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China.
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 119, the Western Road of the Southern 4th Ring Road, Beijing, 100070, China.
- Research Unit of Accurate Diagnosis, Treatment, and Translational Medicine of Brain Tumors, Chinese Academy of Medical Sciences, Beijing, China.
| |
Collapse
|
|
6
|
Knabbe J, Kowalski T, Seliger C. Pharmacological treatment of depression in patients with brain tumors. Int J Cancer 2024; 155:1533-1543. [PMID: 38943227 DOI: 10.1002/ijc.35058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 04/23/2024] [Accepted: 05/15/2024] [Indexed: 07/01/2024]
Abstract
Patients with brain tumors suffer from intense psychosocial distress. Although the prevalence of depressive symptoms in patients with brain tumors is high, the pharmacological antidepressant treatment of those patients is not well defined and results from clinical trials are largely missing. In this review, we describe the current standard of evidence and clinical guidelines for the pharmacological treatment of depression in brain tumor patients. We present specific side effects and interactions that should guide treatment decisions. Furthermore, we provide evidence for the diagnosis, screening and risk factors for depression in brain tumor patients and we elaborate on potential antineoplastic effects of antidepressant drugs and ongoing clinical trials. Antidepressant drugs should not be withheld from patients with brain tumors. Future clinical trials should explore the effectiveness and side effects of antidepressants in this specific patient population.
Collapse
Affiliation(s)
- Johannes Knabbe
- Department of Psychiatry and Psychotherapy, University Hospital Heidelberg, Heidelberg, Germany
| | - Thomas Kowalski
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany
| | - Corinna Seliger
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Bochum, Germany
| |
Collapse
|
|
7
|
Yu WZ, Wang HF, Huda N, Yen Y, Liu YL, Li CS, Ho YC, Chang HJ. Prevalence and Correlates of Depressive Symptoms among Patients with Cancer: A Cross-Sectional Study. Curr Oncol 2024; 31:5802-5820. [PMID: 39451735 PMCID: PMC11506764 DOI: 10.3390/curroncol31100431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 08/27/2024] [Accepted: 09/20/2024] [Indexed: 10/26/2024] Open
Abstract
The purpose of this study was to identify the correlates of depressive symptoms and the prevalence of depression, distress, and demoralization among patients with cancer in Taiwan in relation to their sociodemographics. A cross-sectional study design with convenience sampling was used to recruit 191 consecutive patients with cancer from the Cancer Center of a teaching hospital in northern Taiwan. Multiple linear regression was applied to analyze the determinants of depressive symptoms. The prevalence rates of depression (including suspected cases), distress, and demoralization were 17.8%, 36.1%, and 32.5%, respectively. The regression model explained 42.2% of the total variance, with significant predictors including marital status, life dependence, comorbidity, demoralization, and distress. The results demonstrated that higher levels of distress and demoralization were associated with more depressive symptoms. Demoralization and distress played vital roles in moderating depressive symptoms among patients with cancer. Nursing interventions should integrate appropriate mental health services, such as alleviating distress and demoralization, to prevent the occurrence of depression in patients with cancer.
Collapse
Affiliation(s)
- Wei-Zhen Yu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei 110301, Taiwan;
- Nursing Department, Min-Sheng General Hospital, Taoyuan 330056, Taiwan
| | - Hsin-Fang Wang
- Cancer Medical Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265501, Taiwan;
| | - Nurul Huda
- Nursing Faculty, Universitas Riau, Pekanbaru 28131, Indonesia;
| | - Yun Yen
- Program for Cancer Biology and Drug Discovery, College of Medical Science and Technology, Taipei Medical University, Taipei 110301, Taiwan;
| | - Yen-Lin Liu
- Taipei Cancer Center, Taipei Medical University, Taipei 110301, Taiwan;
- Pediatric Oncology, Department of Pediatrics, Taipei Medical University Hospital, Taipei 110301, Taiwan
- Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Chia-Sui Li
- Department of Community Medicine, En Chu Kong Hospital, New Taipei City 237414, Taiwan;
| | - Yen-Chung Ho
- Department of Nursing & Graduate Institute of Nursing, College of Nursing, Asia University, Taichung 413305, Taiwan;
| | - Hsiu-Ju Chang
- College of Nursing, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
- Efficient Smart Care Research Center, College of Nursing, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
| |
Collapse
|
|
8
|
Rafiei S, Pashazadeh Kan F, Raoofi S, Shafiee F, Masoumi M, Bagheribayati F, Javan Biparva A, Noorani Mejareh Z, Sanaei M, Dolati Y, Abdollahi B, Khani S, Parnian E, Nosrati Sanjabad E, Ghashghaee A. Global Prevalence of Suicide in Patients With Cancer: A Systematic Review and Meta-Analysis. Arch Suicide Res 2024; 28:723-736. [PMID: 37578189 DOI: 10.1080/13811118.2023.2240870] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
AIM Given that patients with cancer may commit suicide due to physical and mental problems, the present study objectives were to identify particular risk factors of different subgroup of patients including type of cancer, gender, age, type and time of suicide, and geographical region to facilitate early care and psychosocial support. METHODS A comprehensive review of databases including Embase, Scopus, PubMed, and Web of Science was conducted for original articles published in English from January 2000 to March 2022. It is based on the PRISMA checklist. RESULTS After reviewing 69 articles selected from 15 countries, the total prevalence rate of suicide among 34,157,856 patients with cancer was estimated 67,169, at 0.013 (95% CI, 0.008-0.021). The highest suicide prevalence was related to gastrointestinal cancer, estimated at 0.204 (95% CI, 0.161-0.255). A gender-based meta-analysis showed that the prevalence of suicide/suicidal ideation was higher among men, estimated at 0.013 (95% CI, 0.008-0.023) compared with women, at 0.006 (95% CI, 0.002-0.017). CONCLUSION Based on study results, suicide-prevention strategies should be aimed at patients younger than 40 years of age to effectively resolve their mental health disorders and promote their self-efficacy in successful management of the disease.
Collapse
|
|
9
|
Mishra E, Nanjaiya SB, Ghoshal S, Grover S. Does the prevalence of depression in patients with malignancies vary with the diagnostic approach: A study comparing the four diagnostic approaches. Indian J Psychiatry 2024; 66:566-571. [PMID: 39100376 PMCID: PMC11293776 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_149_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 05/22/2024] [Accepted: 06/05/2024] [Indexed: 08/06/2024] Open
Abstract
Background Very few studies have compared different diagnostic approaches to diagnose depression in patients with cancers. Aim To compare the different diagnostic approaches used for diagnosing depression in patients with cancers. Methodology This cross-sectional study included 200 patients (diagnosed with cancer at least 3 months prior to recruitment) attending the outpatient services who were assessed on diagnostic and statistical manual, fifth edition (DSM-5) criteria for depression. Additionally, these patients were also assessed using the inclusive, exclusive, and substitutive criteria for depression using a semistructured interview. Patients completed Patient Health Questionnaire-9 (PHQ-9). Results The mean age of the patients was 50.28 years (S.D. M14.11). Females outnumbered males. The mean age of onset of malignancy was 47 years (S.D 14.03), and the mean time since diagnosis of cancer was 35.45 years (S.D 36.87). The prevalence of depression was the highest (38.5%) when estimated using the PHQ-9 and was the lowest (21.5%) when assessed using exclusive criteria for depression. All approaches had high degree of concordance with the DSM-5 criteria for depression. Conclusion A significant proportion of patients with cancer suffer from depression, and the prevalence is influenced by the diagnostic method.
Collapse
Affiliation(s)
- Eepsita Mishra
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Sushmita Ghoshal
- Department of Radiotherapy, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sandeeep Grover
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
|
10
|
Zhang X, Perry RJ. Metabolic underpinnings of cancer-related fatigue. Am J Physiol Endocrinol Metab 2024; 326:E290-E307. [PMID: 38294698 PMCID: PMC11901342 DOI: 10.1152/ajpendo.00378.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/01/2024]
Abstract
Cancer-related fatigue (CRF) is one of the most prevalent and detrimental complications of cancer. Emerging evidence suggests that obesity and insulin resistance are associated with CRF occurrence and severity in cancer patients and survivors. In this narrative review, we analyzed recent studies including both preclinical and clinical research on the relationship between obesity and/or insulin resistance and CRF. We also describe potential mechanisms for these relationships, though with the caveat that because the mechanisms underlying CRF are incompletely understood, the mechanisms mediating the association between obesity/insulin resistance and CRF are similarly incompletely delineated. The data suggest that, in addition to their effects to worsen CRF by directly promoting tumor growth and metastasis, obesity and insulin resistance may also contribute to CRF by inducing chronic inflammation, neuroendocrinological disturbance, and metabolic alterations. Furthermore, studies suggest that patients with obesity and insulin resistance experience more cancer-induced pain and are at more risk of emotional and behavioral disruptions correlated with CRF. However, other studies implied a potentially paradoxical impact of obesity and insulin resistance to reduce CRF symptoms. Despite the need for further investigation utilizing interventions to directly elucidate the mechanisms of cancer-related fatigue, current evidence demonstrates a correlation between obesity and/or insulin resistance and CRF, and suggests potential therapeutics for CRF by targeting obesity and/or obesity-related mediators.
Collapse
Affiliation(s)
- Xinyi Zhang
- Departments of Cellular & Molecular Physiology and Medicine (Endocrinology), Yale University School of Medicine, New Haven, Connecticut, United States
| | - Rachel J Perry
- Departments of Cellular & Molecular Physiology and Medicine (Endocrinology), Yale University School of Medicine, New Haven, Connecticut, United States
| |
Collapse
|
|
11
|
Liao J, Xu J, Huang S, Jiang J, Hu N, Zhang W, Shi L, Deng M, Tang X, Yan Q. Cause of death among gastric cancer survivors in the United States from 2000 to 2020. Medicine (Baltimore) 2024; 103:e37219. [PMID: 38394549 PMCID: PMC11309694 DOI: 10.1097/md.0000000000037219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/18/2024] [Indexed: 02/25/2024] Open
Abstract
A number of studies have been conducted to explore the survival of gastric cancer (GC) patients, while studies about non-cancer causes of death in patients with GC are not well-conducted. The aim of this study was to deeply investigate the causes of death (COD) in GC patients, especially non-cancer ones. The Surveillance, Epidemiology and End Results (SEER) database was used to extract information including demographics, tumor characteristics and causes of death of GC patients meeting the inclusion criteria. The patients were stratified by demographic and clinical parameters. Standardized mortality ratios (SMRs) were calculated for all causes of death at different follow-up periods. A total of 116,437 patients with GC diagnosed between 2000 and 2020 were retrieved from the SEER database. Of these, 85,827 deaths occurred during the follow-up period, most of which occurred within 1 year after GC diagnosis. GC (n = 49,746; 58%) was the leading COD, followed by other cancer (n = 21,135; 25%) and non-cancer causes (n = 14,946; 17%). Diseases of heart were the most common non-cancer cause of death, accounting for 30%, followed by cerebrovascular diseases (n = 917; 6%) and chronic obstructive pulmonary disease (n = 900; 6%). Although gastric cancer remains the most common cause of death in gastric cancer patients, it should not be ignored that the risk of non-cancer causes tends to increase with the length of the latency period. These findings may provide important insights into the healthcare management of gastric cancer patients at various follow-up intervals.
Collapse
Affiliation(s)
- Jingyuan Liao
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Jia Xu
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Shu Huang
- Department of Gastroenterology, Lianshui County People’ Hospital, Huaian, China
- Department of Gastroenterology, Lianshui People’ Hospital of Kangda College Affiliated to Nanjing Medical University, Huaian, China
| | - Jiao Jiang
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Nan Hu
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Wei Zhang
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Lei Shi
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Mingming Deng
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Xiaowei Tang
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| | - Qiong Yan
- Department of Gastroenterology, the Affiliated Hospital of Southwest Medical University, Luzhou, China
- Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Luzhou, China
| |
Collapse
|
|
12
|
Knabbe J, Kowalski T, Seliger C. [Rational treatment of depressive syndromes in brain tumor patients]. DER NERVENARZT 2024; 95:125-132. [PMID: 37861698 DOI: 10.1007/s00115-023-01558-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Brain tumors represent a disease that causes both physical and psychological distress for those affected. The pharmacological treatment of depressive symptoms in particular has not been sufficiently researched in these patients. Depression can severely affect the quality of life and has an impact on the course of the disease. OBJECTIVE The aim of this work is to describe the diagnosis and treatment of depressive symptoms in brain tumor patients. MATERIAL AND METHODS For this work a comprehensive literature search was conducted to identify relevant studies addressing the topic of depressive symptoms in brain tumors. The included studies were critically appraised to ensure their quality and relevance. RESULTS The review of the literature revealed that depressive symptoms are a common complication in brain tumor patients. It was found that there are no studies to date on the efficacy of antidepressant medications in brain tumor patients. DISCUSSION The results of this work highlight the need to pay increased attention to mental health in brain tumor patients. It is important that healthcare professionals identify depression in these patients at an early stage and provide appropriate interventions to improve their quality of life. Future research should focus on further exploring the mechanisms behind the association between brain tumors and depression in order to develop targeted and effective intervention options.
Collapse
Affiliation(s)
- Johannes Knabbe
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - Thomas Kowalski
- Klinik für Neurologie, Universitätsklinikum Knappschaftskrankenhaus Bochum, Bochum, Deutschland
| | - Corinna Seliger
- Klinik für Neurologie, Universitätsklinikum Knappschaftskrankenhaus Bochum, Bochum, Deutschland.
- Klinik für Neurologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland.
| |
Collapse
|
|
13
|
Otten D, Ernst M, Werner AM, Tibubos AN, Reiner I, Brähler E, Wiltink J, Michal M, Nagler M, Wild PS, Münzel T, König J, Lackner KJ, Peiffer N, Beutel ME. Depressive symptoms predict the incidence of common chronic diseases in women and men in a representative community sample. Psychol Med 2023; 53:4172-4180. [PMID: 35443907 PMCID: PMC10317822 DOI: 10.1017/s0033291722000861] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 02/28/2022] [Accepted: 03/16/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Depression, the most frequent and harmful mental disorder, has been associated with specific somatic diseases as the leading cause of death. The purposes of this prospective study were to predict incident chronic diseases based on baseline depressive symptoms and to test sex-dependent effects. METHODS In a representative German community sample of over 12 000 participants, baseline depressive symptoms (assessed using the Patient Health Questionnaire-9) were tested as a predictor of new onset of cardiovascular disease (CVD), chronic obstructive lung disease, diabetes, cancer, and migraine at 5-year follow-up. To study disease incidence, we created subsamples for each chronic disease by excluding participants who already had the respective disease at baseline. Potential confounders were included in logistic regression models and sex-specific analyses were performed. RESULTS Controlling for demographic characteristics and loneliness, in men and women, baseline depressive symptoms were predictive of CVD, chronic obstructive lung disease, diabetes, and migraine, but not of cancer. When we additionally adjusted for metabolic and lifestyle risk factors, there was an 8% increase of chronic obstructive lung disease and migraine per point of depressive symptoms. There was a trend for CVD (4%; p = 0.053). Sex-sensitive analyses revealed trends for the relevance of depressive symptoms for CVD in men (p = 0.065), and for diabetes in women (p = 0.077). CONCLUSIONS These findings underscore the need to implement screening for depression in the treatment of major somatic illnesses. At the same time, depressed patients should be screened for metabolic and lifestyle risk factors and for somatic diseases and offered lifestyle interventions.
Collapse
Affiliation(s)
- Daniëlle Otten
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Antonia M. Werner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Ana N. Tibubos
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Iris Reiner
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jörg Wiltink
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Matthias Michal
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Markus Nagler
- Preventive Cardiology and Preventive Medicine – Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philipp S. Wild
- Preventive Cardiology and Preventive Medicine – Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Thomas Münzel
- Department of Cardiology – Cardiology I, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Jochem König
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Karl J. Lackner
- Institute of Clinical Chemistry and Laboratory Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany
| | - Norbert Peiffer
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Manfred E. Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| |
Collapse
|
|
14
|
Association between GHQ-12, Duke-UNC-11, Physical Activity, and Self-Perceived Health in Spanish Adults with Cancerous Tumours: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:healthcare11020192. [PMID: 36673560 PMCID: PMC9858809 DOI: 10.3390/healthcare11020192] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/02/2023] [Accepted: 01/06/2023] [Indexed: 01/11/2023] Open
Abstract
Background: In Spain, people who have overcome some type of cancer have significantly worse self-perceived health (SPH) and higher rates of depression than people who have never suffered any type of cancer. Objective: to explore the relationships among physical activity levels (PAL), perceived social support (PSS), and SPH in terms of mental health and its dimensions in Spanish adults with cancerous tumours. Methods: A correlational study rooted in the National Health Survey 2017 for adults was carried out, including 627 Spanish residents who reported having malignant tumours. Results: A dependent association was found between PAL and SPH (p < 0.001). The mental health mean score decreased as PAL increased for the total sample and for both sexes, separately (p < 0.001). Low reverse associations were also observed between PAL and mental health (rho: −0.274; p < 0.001), successful coping (rho: −0.239; p < 0.001) and self-confidence (rho: −0.264; p <0.001). Moreover, PSS weakly and inversely correlates with mental health (r: −0.225; p < 0.001), successful coping (r: −0.218; p < 0.001) and self-confidence (r: −0.231; p < 0.001). A binary logistic model showed that active and very active people presented less threat of poor SPH, as did people with higher PSS (p < 0.001). Conclusions: Greater levels of physical activity are associated with larger mean scores in the three dimensions of mental health, perceived social support and self-perceived health in people with cancerous tumours.
Collapse
|
|
15
|
Jung JY, Yun YH. Different effects between the current capability of and changes in self-management strategies on improving health behavior and psychological health after 6 months: evidence from a prospective cohort study of patients with cancer. Qual Life Res 2022; 32:1107-1117. [PMID: 36515757 DOI: 10.1007/s11136-022-03320-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE We aimed to examine different effects of the current capability of and changes in self-management strategies on improving health behavior and psychological health (satisfaction of life, depression, and anxiety) after 6 months in cancer patients. METHODS A prospective cohort study was conducted, including 540 cancer patients. We measured cancer patients' self-management strategies' capability with Smart Management Strategies for Health (SMASH) Assessment Tool (SAT) baseline scores and changes with SMASH change scores based on a clinically meaningful 10% change of the scores. We conducted adjusted multivariate multiple logistic regression analyses using the stepwise selection method between SMASH baseline and health behavior, satisfaction with life (SWL), depression, and anxiety and between SMASH changes and health behavior, SWL, depression, and anxiety. RESULTS 256 cancer patients completed both the first and second surveys. While various SMASH capabilities positively affected each health behavior, SWL, depression, and anxiety, the positive-reframing strategy at baseline only affected all health behavior, SWL, and depression. However, based on SMASH changes, using the positive-reframing strategy a lot for 6 months adversely affected some physical health behaviors' practice (balanced diet and stop smoking and drinking). Changes in the life value pursuing strategy only positively affected HB (proactive living) and anxiety. CONCLUSION SMASH baseline and change scores were generally associated with practicing cancer patients' health behaviors, lower depression, and anxiety. However, it is necessary to consider that excessively using the positive-reframing strategy would interfere with practicing a balanced diet and stopping smoking and drinking behaviors.
Collapse
Affiliation(s)
- Ju Youn Jung
- Department of Biomedical Science, Seoul National University College of Medicine and Hospital, 103 Daehak-Ro, Jongno-Gu, Seoul, South Korea
| | - Young Ho Yun
- Department of Family Medicine, Seoul National University College of Medicine and Hospital, 103 Daehak-Ro, Jongno-Gu, Seoul, 110-799, South Korea.
| |
Collapse
|
|
16
|
Su K, Din ZU, Cui B, Peng F, Zhou Y, Wang C, Zhang X, Lu J, Luo H, He B, Kelley KW, Liu Q. A broken circadian clock: The emerging neuro-immune link connecting depression to cancer. Brain Behav Immun Health 2022; 26:100533. [PMID: 36281466 PMCID: PMC9587523 DOI: 10.1016/j.bbih.2022.100533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 09/26/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022] Open
Abstract
Circadian clocks orchestrate daily rhythms in many organisms and are essential for optimal health. Circadian rhythm disrupting events, such as jet-lag, shift-work, night-light exposure and clock gene alterations, give rise to pathologic conditions that include cancer and clinical depression. This review systemically describes the fundamental mechanisms of circadian clocks and the interacting relationships among a broken circadian clock, cancer and depression. We propose that this broken clock is an emerging link that connects depression and cancer development. Importantly, broken circadian clocks, cancer and depression form a vicious feedback loop that threatens systemic fitness. Arresting this harmful loop by restoring normal circadian rhythms is a potential therapeutic strategy for treating both cancer and depression.
Collapse
Affiliation(s)
- Keyu Su
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Zaheer Ud Din
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Bai Cui
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China,State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, 651 Dongfeng East Road, Guangzhou, Guangdong Province, 510060, China,Corresponding author. Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China.
| | - Fei Peng
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Yuzhao Zhou
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Cenxin Wang
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Xiaoyu Zhang
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Jinxin Lu
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Huandong Luo
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Bin He
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Keith W. Kelley
- Department of Animal Sciences, College of ACES, University of Illinois at Urbana-Champaign, 212 Edward R. Madigan Laboratory, 1201 West Gregory Drive, Urbana, Il, 61801, USA
| | - Quentin Liu
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China,State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, 651 Dongfeng East Road, Guangzhou, Guangdong Province, 510060, China,Corresponding author. Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China.
| |
Collapse
|
|
17
|
Angelakis I, Huggett C, Gooding P, Panagioti M, Hodkinson A. Effectiveness of cognitive-behavioural therapies of varying complexity in reducing depression in adults: systematic review and network meta-analysis. Br J Psychiatry 2022; 221:459-467. [PMID: 35346407 DOI: 10.1192/bjp.2022.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Cognitive-behavioural therapy (CBT) is frequently used as an umbrella term to include a variety of psychological interventions. It remains unclear whether more complex CBT contributes to greater depression reduction. AIMS To (a) compare the effectiveness of core, complex and ultra-complex CBT against other psychological intervention, medication, treatment-as-usual and no treatment in reducing depression at post-treatment and in the long term and (b) explore important factors that could moderate the effectiveness of these interventions. METHOD MEDLINE, PsycInfo, Embase, Web of Science and the Cochrane Register of Controlled Trials were searched to November 2021. Only randomised controlled trials were eligible for the subsequent network meta-analysis. RESULTS We included 107 studies based on 15 248 participants. Core (s.m.d. = -1.14, 95% credible interval (CrI) -1.72 to -0.55 [m.d. = -8.44]), complex (s.m.d. = -1.24, 95% CrI -1.85 to -0.64 [m.d. = -9.18]) and ultra-complex CBT (s.m.d. = -1.45, 95% CrI -1.88 to -1.02 [m.d. = -10.73]) were all significant in reducing depression up to 6 months from treatment onset. The significant benefits of the ultra-complex (s.m.d. = -1.09, 95% CrI -1.61 to -0.56 [m.d. = -8.07]) and complex CBT (s.m.d. = -0.73, 95% CrI -1.36 to -0.11 [m.d. = -5.40]) extended beyond 6 months. Ultra-complex CBT was most effective in individuals presenting comorbid mental health problems and when delivered by non-mental health specialists. Ultra-complex and complex CBT were more effective for people younger than 59 years. CONCLUSIONS For people without comorbid conditions healthcare and policy organisations should invest in core CBT. For people <59 years of age with comorbid conditions investments should focus on ultra-complex and complex CBT delivered without the help of mental health professionals.
Collapse
Affiliation(s)
- Ioannis Angelakis
- PhD, National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, University of Manchester, UK; and School of Psychology, University of South Wales, Pontypridd, UK
| | - Charlotte Huggett
- MSc, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, UK; and Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, UK
| | - Patricia Gooding
- PhD, Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, UK
| | - Maria Panagioti
- PhD, National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, University of Manchester, UK; and National Institute for Health Research School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, University of Manchester, UK
| | - Alexander Hodkinson
- PhD, National Institute for Health Research Greater Manchester Patient Safety Translational Research Centre, Division of Population Health, Health Services Research and Primary Care, University of Manchester, UK; and National Institute for Health Research School for Primary Care Research, Division of Population Health, Health Services Research and Primary Care, University of Manchester, UK
| |
Collapse
|
|
18
|
Ye Y, Zheng Y, Miao Q, Ruan H, Zhang X. Causes of Death Among Prostate Cancer Patients Aged 40 Years and Older in the United States. Front Oncol 2022; 12:914875. [PMID: 35847902 PMCID: PMC9286245 DOI: 10.3389/fonc.2022.914875] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/07/2022] [Indexed: 11/15/2022] Open
Abstract
Purpose Little is known about the detailed spectrum of the cause of death associated with prostate cancer (PCa). This study systematically characterized the cause of death among patients with PCa. Methods Patients aged 40 years and older with primary PCa were identified from the Surveillance, Epidemiology, and End Results program. Mortality rates were estimated. Standardized mortality ratios (SMRs) of non-cancer deaths were calculated to evaluate the risk of death and to compare with the cancer-free population. Results This study included 1,170,489 patients with PCa. There were 501,262 deaths, of which 27.4% were due to PCa and 57.0% were due to non-cancer causes. Non-cancer deaths increased over time from 1975 to 2016, and index cancer death decreased continually. The risk of non-cancer deaths was 1.45 times (SMR, 1.45; 95% confidence interval [CI], 1.45-1.46) that of the general population. Cardiovascular disease was the most common non-cancer cause of death, accounting for 30.2% of all deaths among PCa patients. Alzheimer's disease (SMR, 3.92; 95% CI, 3.85-4.00) had the highest risk of death. The mortality rate and SMR of non-cancer deaths increased with increased follow-up after diagnosis. Conclusion Instead of the index cancer, non-cancer comorbidities were the leading cause of death among patients with PCa, and the risk of non-cancer deaths was much higher than among the general population. Clinicians and researchers should be aware of this trend to conduct timely and targeted interventions.
Collapse
Affiliation(s)
- Yuzhong Ye
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yongqiang Zheng
- State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Qi Miao
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hailong Ruan
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoping Zhang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
|
19
|
Ayalew M, Deribe B, Duko B, Geleta D, Bogale N, Gemechu L, Gebretsadik A, Bedaso A. Prevalence of depression and anxiety symptoms and their determinant factors among patients with cancer in southern Ethiopia: a cross-sectional study. BMJ Open 2022; 12:e051317. [PMID: 35063957 PMCID: PMC8785168 DOI: 10.1136/bmjopen-2021-051317] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE The study was aimed to assess the prevalence of depression and anxiety symptoms and their determinant factors among patients with cancer attending follow-up at Hawassa University Comprehensive Specialized Hospital cancer treatment centre, Ethiopia. DESIGN Institution-based cross-sectional study design was implemented. SETTING Patients with cancer at Hawassa University Comprehensive Specialized Hospital cancer treatment centre from October 2019 to December 2019. PARTICIPANTS Randomly selected 415 patients with cancer who had follow-up at cancer treatment centre. MAIN OUTCOME MEASURES Anxiety and depression symptoms were assessed using Hospital Anxiety and Depression Scale. RESULT The prevalence rates of depression and anxiety symptoms were found to be 244 (58.8%) and 249 (60.0%), respectively. Older age (>50 years) (AOR (adjusted OR)=2.24, 95% CI=1.14 to 4.40), being unemployed (AOR=1.96, 95% CI=1.08 to 3.56), advanced stage of cancer such as stage III (AOR=5.37, 95% CI=1.34 to 21.45) and stage IV (AOR=4.55, 95% CI=1.12 to 18.44), comorbid psychotic symptoms (AOR=1.67, 95% CI=1.07 to 2.61) and eating problem in the past 2 weeks (AOR=6.16, 95% CI=1.98 to 19.11) were independent factors significantly associated with depressive symptoms. In addition, cancer stage such as stage II (AOR=3.92, 95% CI=1.07 to 14.36) and stage IV (AOR=5.04, 95% CI=1.44 to 17.59) and comorbid psychotic symptoms (AOR=1.73, 95% CI=1.12 to 2.66) were significantly associated with anxiety symptoms. CONCLUSION Depression and anxiety symptoms among patients with cancer were considerably high. Age, occupation, cancer stage, comorbid psychotic symptoms and eating problem were determinant factors of depressive symptoms among patients with cancer. Moreover, cancer stage and comorbid psychosis were determinants of anxiety symptoms. Healthcare professionals working in the oncology unity need to conduct routine screening and treatment of depression and anxiety symptoms for patients with cancer.
Collapse
Affiliation(s)
- Mohammed Ayalew
- School of Nursing, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Bedilu Deribe
- School of Nursing, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Bereket Duko
- School of Nursing, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
- Curtin School of Population Health, Curtin University, Bentley, Perth, Australia
| | - Dereje Geleta
- School of Public Health, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Netsanet Bogale
- Faculty of Medicine, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Lalisa Gemechu
- Environmental Health, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Achamyelesh Gebretsadik
- School of Public Health, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
| | - Asres Bedaso
- School of Nursing, Hawassa University College of Medicine and Health Sciences, Hawassa, Ethiopia
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| |
Collapse
|
|
20
|
Akechi T, Mishiro I, Fujimoto S. Risk of Major Depressive Disorder in Adolescent and Young Adult Cancer Patients in Japan. Psychooncology 2022; 31:929-937. [PMID: 35001472 PMCID: PMC9305902 DOI: 10.1002/pon.5881] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 12/16/2021] [Accepted: 12/22/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To estimate the risk of major depressive disorder (MDD) in adolescent and young adult (AYA) patients with cancer in Japan and identify risk factors for MDD among these patients. METHODS This was a matched cohort study using a large claims database in Japan. Included patients were aged 15-39 years, newly diagnosed with cancer during 2012-2017 and assessable for a follow-up period of 12 months. Kaplan-Meier estimates and Cox proportional hazards models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for MDD in the AYA patients with cancer versus age-, sex- and working status-matched cancer-free controls. A subgroups analysis of the AYA patients with cancer was performed to explore MDD risk factors. RESULTS A total of 3,559 AYA patients with cancer and 35,590 matched controls were included in the analysis. AYA patients with cancer had a 3-fold higher risk for MDD compared with cancer-free controls (HR, 3.12; 95% CI, 2.64-3.70). Among cancer categories with >100 patients, patients with multiple cancer categories, including those with metastatic cancer (HR, 6.73, 95% CI, 3.65-12.40) and leukemia (HR, 6.30; 95% CI, 3.75-10.58), had the greatest MDD risk versus matched controls. Patients who received inpatient chemotherapy as initial treatment had a higher risk for MDD than patients without chemotherapy (HR, 0.43; 95% CI, 0.30-0.62). CONCLUSIONS AYA patients in Japan with cancer are at high risk for MDD. Particularly, those with multiple cancer categories, leukemia, and those who receive aggressive anticancer treatments should be monitored closely for symptoms of MDD. This article is protected by copyright. All rights reserved.
Collapse
Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Izumi Mishiro
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - Shinji Fujimoto
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
| |
Collapse
|
|
21
|
Madl M, Lieb M, Schieber K, Erim Y. The influence of patient-related factors on the frequency and duration of psycho-oncological sessions in a university cancer center. J Psychosoc Oncol 2021; 40:380-396. [PMID: 34860144 DOI: 10.1080/07347332.2021.1964013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The present study aimed at identifying factors that are associated with the frequency and duration of psycho-oncological sessions. DESIGN In a retrospective single-center study, data of all patients who made use of the psycho-oncological service (POS) at the University Hospital Erlangen from April 2017 - March 2018 were registered. SAMPLE Over the course of one year, N = 1601 patients made use of the POS. METHODS In the hospital's digital documentation system, relevant data such as frequency of sessions, duration of sessions, gender, age, family status, preexisting mental disorder, prior psychotherapy, cancer entity (type of cancer) and treatment modality were recorded. Socio-demographic and clinical parameters were analyzed to predict frequency and duration of the psycho-oncology sessions. FINDINGS Regression analyses revealed that among POS users, women, younger patients, patients with a longer hospital stay and those with a preexisting mental disorder attended significantly more sessions than other patients (p < .001). Patients with skin cancer had significantly fewer POS sessions than those with a hematological diagnosis. Also, patients who had undergone surgery had significantly fewer sessions than patients with pharmacological treatment. Younger age and a longer hospital stay significantly predicted longer sessions (p < .001). In the regression model, patients with brain tumors and lung cancer had significantly longer sessions than patients with skin cancer. IMPLICATIONS With the identification of specific risk groups that require more and longer sessions, we can provide the basis for more patient-tailored intervention approaches and better scheduling according to the patients' needs. However, our results also suggest that the frequency and duration of POS sessions also depend on illness- and treatment-related criteria, e.g. the length of the hospital stay.
Collapse
Affiliation(s)
- Martina Madl
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Marietta Lieb
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Katharina Schieber
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
| |
Collapse
|
|
22
|
Korhonen K, Moustgaard H, Tarkiainen L, Östergren O, Costa G, Urhoj SK, Martikainen P. Contributions of specific causes of death by age to the shorter life expectancy in depression: a register-based observational study from Denmark, Finland, Sweden and Italy. J Affect Disord 2021; 295:831-838. [PMID: 34706453 DOI: 10.1016/j.jad.2021.08.076] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 08/12/2021] [Accepted: 08/25/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The reasons for the shorter life expectancy of people with depression may vary by age. We quantified the contributions of specific causes of death by age to the life-expectancy gap in four European countries. METHODS Using register-based cohort data, we calculated annual mortality rates in between 1993 and 2007 for psychiatric inpatients with depression identified from hospital-care registers in Denmark, Finland and Sweden, and between 2000 and 2007 for antidepressant-treated outpatients identified from medication registers in Finland and Turin, Italy. We decomposed the life-expectancy gap at age 15 years by age and cause of death. RESULTS The life-expectancy gap was especially large for psychiatric inpatients (12.1 to 21.0 years) but substantial also for antidepressant-treated outpatients (6.3 to 14.2 years). Among psychiatric inpatients, the gap was largely attributable to unnatural deaths below age 55 years. The overall contribution was largest for suicide in Sweden (43 to 45%) and Finland (37 to 40%). In Denmark, 'other diseases' (25 to 34%) and alcohol-attributable causes (10 to 18%) had especially large contributions. Among antidepressant-treated outpatients, largest contributions were observed for suicide (18% for men) and circulatory deaths (23% for women) in Finland, and cancer deaths in Turin (29 to 36%). Natural deaths were concentrated at ages above 65 years. LIMITATIONS The indication of antidepressant prescription could not be ascertained from the medication registers. CONCLUSIONS Interventions should be directed to self-harm and substance use problems among younger psychiatric inpatients and antidepressant-treated young men. Rigorous monitoring and treatment of comorbid somatic conditions and disease risk factors may increase life expectancy for antidepressant-treated outpatients, especially women.
Collapse
Affiliation(s)
- Kaarina Korhonen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland, P.O. Box 18, 00014 Helsinki, Finland.
| | - Heta Moustgaard
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland, P.O. Box 18, 00014 Helsinki, Finland; Helsinki Institute of Urban and Regional Studies (URBARIA), University of Helsinki, Helsinki, Finland, Yliopistonkatu 3, 00100 Helsinki, Finland
| | - Lasse Tarkiainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland, P.O. Box 18, 00014 Helsinki, Finland; Helsinki Institute of Urban and Regional Studies (URBARIA), University of Helsinki, Helsinki, Finland, Yliopistonkatu 3, 00100 Helsinki, Finland
| | - Olof Östergren
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden, SE - 106 91 Stockholm, Sweden; Aging Research Center, Karolinska Institutet, Solna, Sweden, Tomtebodavägen 18a, SE-171 65 Solna, Sweden
| | - Giuseppe Costa
- Epidemiology Unit, Regional Health Service ASL TO3, Turin, Italy, Via Sabaudia 164, Grugliasco (TO), Italy
| | - Stine Kjaer Urhoj
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark, Oster Farimagsgade 5, P.O. Box 2099, 1014 København K, Denmark
| | - Pekka Martikainen
- Population Research Unit, Faculty of Social Sciences, University of Helsinki, Helsinki, Finland, P.O. Box 18, 00014 Helsinki, Finland; Department of Public Health Sciences, Stockholm University, Stockholm, Sweden, SE - 106 91 Stockholm, Sweden; Laboratory of Population Health, Max Planck Institute for Demographic Research, Rostock, Germany, Konrad-Zuse-Str. 1, 18057 Rostock, Germany
| |
Collapse
|
|
23
|
Efendioglu EM, Cigiloglu A, Turkbeyler IH. Malnutrition and Depressive Symptoms in Elderly Palliative Care Patients. J Palliat Care 2021; 37:503-509. [PMID: 34647838 DOI: 10.1177/08258597211045500] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Objective: The aim of this study is to determine the prevalence of and relationship between malnutrition and depressive symptoms in older palliative care inpatients. Methods: One hundred and thirty-six older adults were included in the study. The Geriatric Depression Scale, Mini Nutritional Assessment Short Form, Mini Mental State Examination, Barthel index, and Lawton & Brody index were used to evaluate the mood, nutrition status, mental status, and activities of daily living of the patients. Results: The mean age of the patients was 74.88 ± 8.82 years, and 63.2% of the patients were female. According to the nutritional assessment, 39.7% of the patients suffered from malnutrition, while 47.1% were at risk for it, and depressive symptoms were detected in 79.4% of the patients. A strong negative correlation was found between the scores for nutritional and depressive symptoms (r = -.750, 95% CI = -.834 to -.668). Conclusion: Malnutrition, risk of malnutrition, and depressive symptoms were found to occur often among the patients, and the relationship between them was statistically significant. Our results highlight that the quality of life of palliative care patients could be improved by providing adequate nutrition and psychological support.
Collapse
Affiliation(s)
| | | | - Ibrahim H Turkbeyler
- Gaziantep Dr Ersin Arslan Education Research Hospital, Sahinbey, Gaziantep, Turkey
| |
Collapse
|
|
24
|
Argano C, Catalano N, Natoli G, Monaco ML, Corrao S. GDS score as screening tool to assess the risk of impact of chronic conditions and depression on quality of life in hospitalized elderly patients in internal medicine wards. Medicine (Baltimore) 2021; 100:e26346. [PMID: 34190152 PMCID: PMC8257896 DOI: 10.1097/md.0000000000026346] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 06/01/2021] [Indexed: 01/04/2023] Open
Abstract
Aging of population is characterized by multiple chronic conditions in the same individual. Health-related quality of life (HR-QOL) reflects the multidimensional impact of chronic disease on population and it is increasingly analysed as outcomes.The aim of this study was the evaluation of the predictors of quality of life among elderly patients hospitalized in internal medicine ward, investigating the effect of comorbidities on health-related quality of life.Data collected in this cross-sectional study were analysed. Socio-demographic, clinical characteristics, disease distribution and quality of life by the 12-Item Short Form Health Survey (SF-12) were evaluated.Of 240 inpatients, subjects with Barthel Index (BI)≤40 were 23.7%, 55% had a Geriatric Depression Scale (GDS)≥2. After categorizing mental component score (MCS) and physical component score (PCS) in five classes, we found that diabetics and patients with cancer were more frequent in the first class of MCS while patients with NYHA III-IV are significantly more frequent in the first class of PCS. When we classified patients according to GDS≥2 or < 2, subjects with GDS≥2 had BI and MCS significantly lower. In the multivariate analysis GDS score ≥2 was independently associated with first MCS class [16.32 (3.77-70.68)] while NYHA III-IV class and claudicatio intermittents were strong predictors of the worst PCS class [9.54 (1.97-47.40), 2.53 (1.16-5.49), respectively]. Liver disease was independently associated with GDS≥2 [5.26 (1.13-24.39)].Our study highlighted the impact of chronic diseases on health-related quality of life in elderly subjects hospitalized in an internal medicine ward pointing out the importance of taking into account patient's needs and perception and the setting up of a personalised health-care. Patients with diabetes and liver disease along with persons affected by cancer need psychological support to improve their quality of life. A GDS score ≥ 2 is a strong predictor of poor quality of life and should trigger an in-depth assessment of mental health in this kind of patients.
Collapse
Affiliation(s)
- Christiano Argano
- Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli
| | - Nicola Catalano
- Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli
| | - Giuseppe Natoli
- Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli
| | - Marika Lo Monaco
- Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli
| | - Salvatore Corrao
- Department of Internal Medicine, National Relevance and High Specialization Hospital Trust ARNAS Civico, Di Cristina, Benfratelli
- Dipartimento di Promozione della Salute, Materno Infantile, Medicina Interna e Specialistica di Eccellenza “G. D’Alessandro”, PROMISE, University of Palermo, Palermo, Italy
| |
Collapse
|
|
25
|
Fatehi Hassanabad A, Bahrami N, Novick RJ, Ali IS. Delirium and depression in cardiac surgery: A comprehensive review of risk factors, pathophysiology, and management. J Card Surg 2021; 36:2876-2889. [PMID: 34120376 DOI: 10.1111/jocs.15610] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/17/2021] [Accepted: 04/19/2021] [Indexed: 01/06/2023]
Abstract
BACKGROUND Mental health and wellbeing continue to gain more attention as they are inextricably associated with clinical outcomes, particularly quality of life. Many medical ailments and major surgeries affect patients' mental health, including depression and delirium. AIMS The objective of this manuscript was to comprehensively review and critically examine the literature pertaining to cardiac surgery, depression, and delirium. METHODS This is a narrative review article. We performed our search analysis by using the following key words: "Cardiac Surgery", "Depression", "Delirium", "Clinical outcomes", and "Mental Health". Search analysis was done on MedLine PubMed, accessing indexed peer-reviewed publications. RESULTS Cardiac Surgery is a life-altering intervention indicated to improve morbidity and mortality in patients with cardiovascular diseases. Psychiatric conditions before and after cardiac surgery worsen patient prognosis and increase mortality rate. Specifically, preoperative depression increases postoperative depression and is associated with impaired functional status, slow physical recovery, and an increased readmission rate. DISCUSSION Although the exact pathophysiology between depression and cardiovascular disease (CVD) is unknown, several pathways have been implicated. Unmanaged depression can also lead to other psychological conditions such as delirium. Like depression, the exact association between delirium and CVD is not well understood, but believed to be multifactorial. CONCLUSION Herein, we provide a comprehensive review of the links between depression, delirium, and cardiovascular surgery. We critically examine the current data that pertains to the pathophysiology of these debilitating mental health issues in the context of cardiac surgery. Finally, we summarize the various treatment options available for managing depression and delirium in the cardiac surgery patient population.
Collapse
Affiliation(s)
- Ali Fatehi Hassanabad
- Section of Cardiac Surgery, Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, Calgary, Alberta, Canada
| | - Nabila Bahrami
- Department of Medicine, Department of Medicine, Cumming School of Medicine, Calgary, Alberta, Canada
| | - Richard J Novick
- Section of Cardiac Surgery, Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, Calgary, Alberta, Canada
| | - Imtiaz S Ali
- Section of Cardiac Surgery, Department of Cardiac Sciences, Cumming School of Medicine, Libin Cardiovascular Institute, Calgary, Alberta, Canada
| |
Collapse
|
|
26
|
Li Y, Ran G, Chen K, Shen X. Preoperative Psychological Burdens in Patients with Vestibular Schwannoma. Ann Otol Rhinol Laryngol 2021; 131:239-243. [PMID: 34032139 DOI: 10.1177/00034894211018915] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To assess preoperative psychological burden in patients with vestibular schwannoma (VS). METHODS A total of 100 patients undergoing VS resection between September 2019 and June 2020 completed preoperative psychological screening. The Hospital Anxiety and Depression Scale (HADS) was applied the day before surgery, and a score >14 was considered clinically important. Univariate and multivariate logistic regression analyzes were used to identify risk factors associated with increased preoperative psychological stress. RESULTS Of the 100 patients who underwent VS resection, 44% were male, with a mean age of 45.9 years. Twenty-two (22%) had HADS scores >14. For the univariate analysis, risk factors associated with elevated psychological burden included time since diagnosis, number of symptoms, headache, vertigo, and nausea and/or vomiting. In the regression analysis, the number of symptoms and greater time from diagnosis to treatment correlated with higher preoperative psychological stress. CONCLUSION Nearly 1 in 4 patients with VS experienced clinically significant emotional burden preoperatively. Number of symptoms and greater time from diagnosis to treatment contributed to this psychological burden.
Collapse
Affiliation(s)
- Yufeng Li
- Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Guo Ran
- Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Kaizheng Chen
- Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai, China
| | - Xia Shen
- Department of Anesthesiology, Eye & ENT Hospital, Fudan University, Shanghai, China
| |
Collapse
|
|
27
|
Mendes MVDC, Santos SLD, Ceballos AGDCD, Furtado BMASM, Bonfim CVD. Risk factors for suicide in individuals with cancer: an integrative literature review. Rev Bras Enferm 2021; 74:e20190889. [PMID: 34037173 DOI: 10.1590/0034-7167-2019-0889] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 10/31/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to develop an integrative literature review on risk factors for suicide in individuals with cancer. METHOD searching for articles was conducted in the Scientific Electronic Library Online, Medicinal Literature Analysis and Retrieval System Online, Latin American & Caribbean Literature in Health Sciences, Cumulative Index to Nursing and Allied Health Literature and SciVerse Scopus databases, using the descriptors "suicide" and "cancer". RESULTS eighteen articles were selected. Lung, bladder and colorectal cancers are the types of highest risk for suicide. Male, white and over 60 years of age are demographic factors with higher risk for suicide in individuals with cancer. CONCLUSION this review made it possible to verify that cancer may be a risk factor for suicide. This evidence can be useful for planning preventive actions in order to reduce the risk of suicide.
Collapse
|
|
28
|
Pertz M, Kowalski T, Schlegel U, Thoma P. Mental time travel in patients "cured" from primary central nervous system lymphoma. J Clin Exp Neuropsychol 2021; 43:264-275. [PMID: 33881382 DOI: 10.1080/13803395.2021.1912299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Significant advances in neuro-oncological treatment led to considering neurocognitive functioning and everyday functional needs in patients with long-term survival. Since a potentially lethal disease interrupts normal life and represents a threat to physical and psychological integrity, patients have to cope with the new challenges. Long-term survival and even "cure" is possible in primary central nervous system lymphoma (PCNSL), however, suffering from a life-threatening disease may affect patients´ cognitive processing of past and future (i.e., the generation of personal past memories and generation of personal future events). Therefore, the present study aimed to assess how PCNSL long-term survivors remember their past and anticipate their future.Methods: Recall of past and anticipation of future events (i.e., mental time travel), both positive and negative, was assessed in 39 PCNSL patients with ongoing complete remission to therapy for at least 1 year in an adapted verbal fluency paradigm. A group of 39 healthy controls matched for age, gender and education was assessed with the same paradigm evaluating retrospective and prospective cognitions.Results: Concerning the generation of personal future events PCNSL patients anticipated significantly fewer negative events for the distant future as compared to healthy controls. At trend level, patients also reported fewer negative events regarding their recent past.Conclusions: The results provide support for an altered generation of personal future events (i.e., future-directed assumptions) in PCNSL patients with ongoing complete remission. Being "cured" after experiencing a threat to life might induce cognitive reappraisal processes and lead people to reexamine their priorities and principles in life, resulting in a less negative evaluation of (future) life (i.e., "optimism bias") after facing death. Clinicians should be aware of these possible cognitive and affective processes and of chronic psychological disturbances in cancer survivors. Possible adaptive strategies ought to be promoted in supportive (neuro)psychological therapy.
Collapse
Affiliation(s)
- Milena Pertz
- Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
| | - Thomas Kowalski
- Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
| | - Uwe Schlegel
- Department of Neurology, University Hospital Knappschaftskrankenhaus, Ruhr University Bochum, Bochum, Germany
| | - Patrizia Thoma
- Neuropsychological Therapy Centre (NTC)/Clinical Neuropsychology, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| |
Collapse
|
|
29
|
Naser AY, Hameed AN, Mustafa N, Alwafi H, Dahmash EZ, Alyami HS, Khalil H. Depression and Anxiety in Patients With Cancer: A Cross-Sectional Study. Front Psychol 2021; 12:585534. [PMID: 33935849 PMCID: PMC8081978 DOI: 10.3389/fpsyg.2021.585534] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 03/11/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives Depression and anxiety persist in cancer patients, creating an additional burden during treatment and making it more challenging in terms of management and control. Studies on the prevalence of depression and anxiety among cancer patients in the Middle East are limited and include many limitations such as their small sample sizes and restriction to a specific type of cancer in specific clinical settings. This study aimed to describe the prevalence and risk factors of depression and anxiety among cancer patients in the inpatient and outpatient settings. Materials and Methods A total of 1,011 patients (399 inpatients and 612 outpatients) formed the study sample. Patients’ psychological status was assessed using the Hospital Anxiety and Depression Scale (HADS), the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The prevalence rate of depressive and anxious symptomatology was estimated by dividing the number of patients who exceeded the borderline score: 10 or more for each subscale of the HADS scale, 15 or more for the GAD-7 scale, and 15 or more in the PHQ-9 by the total number of the patients. Risk factors were identified using logistic regression. Results The prevalence of depressive and anxious symptomatology among all patients was 23.4% and 19.1–19.9%, respectively. Depressive symptomatology was more prevalent across patients who were hospitalized (37.1%) compared with patients in the outpatient setting (14.5%) (p < 0.001). Similarly, anxious symptomatology was more prevalent in the inpatient setting (p < 0.001). In the inpatient setting, depressive symptomatology was more prevalent among patients with bladder cancer, while severe anxious symptomatology was more prevalent across patients with lung cancer. In the outpatient setting, depressive and anxious symptomatology was more prevalent among breast and prostate cancer patients, respectively. Despite that, around 42.7% and 24.8% of the patients, respectively, reported that they feel anxious and depressed, and only 15.5% of them were using medications to manage their conditions. Conclusion Our study findings demonstrated a higher prevalence of depressive and anxious symptomatology in the inpatient setting and advanced disease stages. In addition, the underutilization of antidepressant therapy was observed. There is a need to consider mental disorders as part of the treatment protocol for cancer patients. Enhanced clinical monitoring and treatment of depression and anxiety of cancer patients are required.
Collapse
Affiliation(s)
| | | | - Nour Mustafa
- Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
| | - Hassan Alwafi
- Department of Pharmacology and Toxicology, College of Medicine, Umm Al-Qura University, Mecca, Saudi Arabia
| | | | - Hamad S Alyami
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran, Saudi Arabia
| | - Haya Khalil
- Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan
| |
Collapse
|
|
30
|
Ross S, Agin-Liebes G, Lo S, Zeifman RJ, Ghazal L, Benville J, Franco Corso S, Bjerre Real C, Guss J, Bossis A, Mennenga SE. Acute and Sustained Reductions in Loss of Meaning and Suicidal Ideation Following Psilocybin-Assisted Psychotherapy for Psychiatric and Existential Distress in Life-Threatening Cancer. ACS Pharmacol Transl Sci 2021; 4:553-562. [PMID: 33860185 PMCID: PMC8033770 DOI: 10.1021/acsptsci.1c00020] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Indexed: 12/13/2022]
Abstract
People with advanced cancer are at heightened risk of desire for hastened death (DHD), suicidal ideation (SI), and completed suicide. Loss of Meaning (LoM), a component of demoralization, can be elevated by a cancer diagnosis and predicts DHD and SI in this population. We completed a randomized controlled trial in which psilocybin-assisted psychotherapy (PAP) produced rapid and sustained improvements in depression, demoralization, and hopelessness in people with cancer. Converging epidemiologic and clinical trial findings suggests a potential antisuicidal effect of this treatment. To probe our hypothesis that PAP relieves SI through its beneficial impacts on depression and demoralization (LoM in particular), we performed secondary analyses assessing within- and between-group differences with regard to LoM and an SI composite score. Among participants with elevated SI at baseline, PAP was associated with within-group reductions in SI that were apparent as early as 8 h and persisted for 6.5 months postdosing. PAP also produced large reductions in LoM from baseline that were apparent 2 weeks after treatment and remained significant and robust at the 6.5 month and 3.2 and 4.5 year follow-ups. Exploratory analyses support our hypothesis and suggest that PAP may be an effective antisuicidal intervention following a cancer diagnosis due to its positive impact on hopelessness and demoralization and its effects on meaning-making in particular. These preliminary results implicate psilocybin treatment as a potentially effective alternative to existing antidepressant medications in patients with cancer that are also suicidal, and warrant further investigation in participants with elevated levels of depression and suicidality.
Collapse
Affiliation(s)
- Stephen Ross
- NYU Langone Health Center for Psychedelic Medicine, 462 First Avenue, New York, New York, 10016, United States.,NYU Grossman School of Medicine Department of PsychiatryNew York, New York, 10016, United States.,Bellevue Hospital Center, New York, New York, 10016, United States
| | - Gabrielle Agin-Liebes
- University of California, San Francisco, Department of Psychiatry & Behavioral Sciences, San Francisco, California, 94110, United States.,Zuckerberg San Francisco General Hospital, San Francisco, California, 94110, United States
| | - Sharon Lo
- Pacific University College of Health Professions, Hillsboro, Oregon 97123-4218, United States
| | | | - Leila Ghazal
- NYU Langone Health Center for Psychedelic Medicine, 462 First Avenue, New York, New York, 10016, United States.,NYU Grossman School of Medicine Department of PsychiatryNew York, New York, 10016, United States
| | - Julia Benville
- NYU Langone Health Center for Psychedelic Medicine, 462 First Avenue, New York, New York, 10016, United States.,NYU Grossman School of Medicine Department of PsychiatryNew York, New York, 10016, United States
| | - Silvia Franco Corso
- Columbia University, Department of Psychiatry, New York State Psychiatric Institute, New York, New York, 10032-3784, United States
| | - Christian Bjerre Real
- Memorial Sloan Kettering Cancer Center, New York, New York, 10065-6007, United States
| | - Jeffrey Guss
- NYU Langone Health Center for Psychedelic Medicine, 462 First Avenue, New York, New York, 10016, United States.,NYU Grossman School of Medicine Department of PsychiatryNew York, New York, 10016, United States.,Bellevue Hospital Center, New York, New York, 10016, United States
| | - Anthony Bossis
- NYU Langone Health Center for Psychedelic Medicine, 462 First Avenue, New York, New York, 10016, United States.,NYU Grossman School of Medicine Department of PsychiatryNew York, New York, 10016, United States.,Bellevue Hospital Center, New York, New York, 10016, United States
| | - Sarah E Mennenga
- NYU Langone Health Center for Psychedelic Medicine, 462 First Avenue, New York, New York, 10016, United States.,NYU Grossman School of Medicine Department of PsychiatryNew York, New York, 10016, United States
| |
Collapse
|
|
31
|
Exploring the problems faced by patients living with advanced cancer in Bengaluru, India. Heliyon 2021; 7:e06686. [PMID: 33898822 PMCID: PMC8056401 DOI: 10.1016/j.heliyon.2021.e06686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/18/2021] [Accepted: 03/30/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose Cancer is a key influence on psychosocial and emotional distress among patients. Problems that advanced cancer patients in the western world face have been widely explored, but these findings may not be applicable in the non-western world due to the cultural differences. Exploring the problems of advanced cancer patients will help professionals plan appropriate therapeutic interventions to take care of the patients' physical, emotional, social and practical needs. Hence, this study aims to explore the psychosocial and emotional problems of advanced cancer patients in India. Methods Data were collected from 10 advanced cancer patients from Bengaluru, using purposive sampling and semi-structured interviews. The interviews were audio-recorded and transcribed. Themes were generated using thematic analysis. Results The prevalent themes were financial instability, hopelessness, family anguish, self-blame, helplessness, anger, stress, and suicidal thoughts. Conclusion This research has highlighted that advanced cancer patients have several issues, indicating the importance of using a holistic approach while handling this vulnerable population by focusing more on the patient rather than the disease.
Collapse
|
|
32
|
Xuyi W, Seow H, Sutradhar R. Artificial neural networks for simultaneously predicting the risk of multiple co-occurring symptoms among patients with cancer. Cancer Med 2021; 10:989-998. [PMID: 33350595 PMCID: PMC7897969 DOI: 10.1002/cam4.3685] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 11/11/2022] Open
Abstract
Patients with cancer often exhibit multiple co-occurring symptoms which can impact the type of treatment received, recovery, and long-term health. We aim to simultaneously predict the risk of three symptoms: severe pain, moderate-severe depression, and poor well-being in order to flag patients who may benefit from pre-emptive early symptom management. This was a retrospective population-based cohort study of adults diagnosed with cancer between 2008 and 2015. We developed and tested an Artificial Neural Network (ANN) model to predict the risk of multiple co-occurring symptoms within 6 months after diagnosis. The ANN model derived from a training cohort was assessed on an independent test cohort for model performance based on sensitivity, specificity, accuracy, AUC, and calibration. The mutually exclusive training and test cohorts consisted of 35,606 and 10,498 patients, respectively. The area under the curve for the risk of experiencing severe pain, moderate-severe depression, and poor well-being were 71%, 73%, and 70%, respectively. Patient characteristics at highest risk of simultaneously experiencing these three symptoms included: those with lung cancer, late stage cancer, existing chronic conditions such as osteoarthritis, mood disorder, hypertension, diabetes, and coronary disease. Patients with over a 40% risk of severe pain also had over a 70% risk of depression, and over a 55% risk of poor well-being. Our ANN model was able to simultaneously predict the risk of pain, depression, and lack of well-being. Accurate prediction of future symptom burden can serve as an early indicator tool so that providers can implement timely interventions for symptom management, ultimately improving cancer care and quality of life.
Collapse
Affiliation(s)
- Wenhui Xuyi
- Division of BiostatisticsDalla Lana School of Public HealthUniversity of TorontoTorontoONUSA
| | - Hsien Seow
- ICESTorontoONUSA
- Department of OncologyMcMaster UniversityHamiltonONCanada
| | - Rinku Sutradhar
- Division of BiostatisticsDalla Lana School of Public HealthUniversity of TorontoTorontoONUSA
- ICESTorontoONUSA
- Institute of Health Policy, Management and EvaluationUniversity of TorontoTorontoONUSA
| |
Collapse
|
|
33
|
Ketamine as augmentation for the treatment of major depression and suicidal risk in advanced cancer: Case report. Palliat Support Care 2020; 18:110-112. [PMID: 31397251 DOI: 10.1017/s1478951519000580] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Major depressive disorder (MDD) is common in patients diagnosed with advanced cancer (AC), with a prevalence of 16.5%. It is associated with great disability and worsened quality of life, increased number and intensity of physical symptoms, and lower survival. It is the main factor for the presence of suicidal ideation. Antidepressants show modest efficacy, and response requires several weeks. Ketamine has demonstrated a fast and robust antidepressant effect in subanesthetic doses. This effect may prove useful in patients with AC, MDD, and suicidal risk. METHOD We report a case of a patient with advanced cervical cancer who presented with uncontrollable pain, MDD, and a suicide attempt. RESULT A 39-year-old woman diagnosed with cervical cancer stage IVB presented to the Emergency Department after a suicide attempt by hanging. Upon evaluation by the palliative care psychiatrist, she reported intense pain, unresponsive to analgesics, and had a history of persistent suicidal ideation. Antidepressant treatment was started (sertraline 50mg/d) after a single dose of ketamine hydrochloride IV (0.5 mg/kg) was administered. Treatment response was measured using the Brief Edinburgh Depression Scale before and after the intervention. The depressive symptoms decreased by 17% on day 1, 39% on day 3, and 72% on day 17. SIGNIFICANCE OF RESULTS This case report shows ketamine's efficacy as an augmentation agent alongside conventional antidepressant treatment in patients with AC. Moreover, it shows rapid response in suicidal ideation that has not been achieved with treatment as usual. More clinical trials are needed to support the potential benefit and safety of ketamine in patients with AC, MDD, and persisting suicidal ideation.
Collapse
|
|
34
|
Zhai M, Tang C, Li M, Chen X, Jin Y, Ying X, Tang Z, Wang X, Wu Y, Sun C, Chen K, Guo X. Short-term mortality risks among patients with non-metastatic bladder cancer. BMC Cancer 2020; 20:1148. [PMID: 33238972 PMCID: PMC7691110 DOI: 10.1186/s12885-020-07655-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/17/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Population-based analysis for the short-term non-bladder cancer related mortality among patients with non-metastatic bladder cancer is currently lacking. The objective of the current study was to assess and quantify cause of death after bladder cancer diagnosis. METHODS The custom Surveillance, Epidemiology, and End Results (SEER) dataset for standardized mortality ratios (SMRs) was utilized to identify 24,074 patients who were diagnosed with nonmetastatic (M0) bladder cancer from 2014 to 2015. SMRs for causes of death were calculated. Risk factors for bladder cancer-specific mortality, competing mortality, second-cancer mortality, and noncancer mortality were determined using either multivariable Cox or competing risk regression models. RESULTS Among all the 4179 (17.4%) deaths occurred during the follow-up period, almost half of them (44.2%) were attributed to non-bladder cancer cause, including second non-bladder cancer (10%) and other non-cancer causes (34.2%). The most common noncancer causes of death were heart diseases followed by chronic obstructive pulmonary disease. Patients had a higher risk of death from second malignancies (SMR, 1.59; 95% CI, 1.47-1.74) compared with death from first malignancies in the US general population, and also had higher risks of death from heart diseases (SMR, 1.29; 95% CI, 1.18-1.40) and chronic obstructive pulmonary disease (SMR, 1.52; 95% CI, 1.29-1.79) compared with the US general population. Additionally, some risk factors for competing second malignancies or noncancer mortality were determined, such as age, gender, marital status and treatment modalities. CONCLUSIONS Death from non-bladder cancer cause contributed to almost half of all deaths in bladder cancer survivors during the short-term follow-up period. These findings can inform medical management and assist clinicians in counseling those survivors regarding their short-term health risks.
Collapse
Affiliation(s)
- Menghe Zhai
- Department of Urology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, People's Republic of China
| | - Chenye Tang
- Department of Urology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, People's Republic of China
| | - Ming Li
- Department of Urology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, People's Republic of China
| | - Xin Chen
- Department of Urology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, People's Republic of China
| | - Yigang Jin
- Department of Urology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, People's Republic of China
| | - Xiangjun Ying
- Department of Urology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, People's Republic of China
| | - Zhiling Tang
- Department of Urology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, People's Republic of China
| | - Xiao Wang
- Department of Urology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, People's Republic of China
| | - Yuntao Wu
- Department of Urology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, People's Republic of China
| | - Chun Sun
- Department of Urology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, People's Republic of China
| | - Kean Chen
- Department of Urology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, People's Republic of China
| | - Xiao Guo
- Department of Urology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang Province, People's Republic of China.
| |
Collapse
|
|
35
|
Goebel S, Knuth C, Damm M, Linden D, Coburger J, Ringel F, Tabatabai G, Mehdorn M, Renovanz M. Towards the targeted assessment of relevant problems: Optimization of the distress Thermometer for adult neuro-oncological patients. Psychooncology 2020; 29:2057-2066. [PMID: 33002245 DOI: 10.1002/pon.5564] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 08/31/2020] [Accepted: 09/23/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Generic psychosocial screening tools may not reflect the unique symptom profile of brain tumour patients (BTPs). The aim was to adapt the problem list of the distress thermometer (DT) for BTPs. METHODS First, items of low relevance for BTPs were identified on basis of retrospective analyses. Second, relevant yet missing problems were identified via an extensive literature search, qualitative interviews with BTPs and experts, as well as an online expert survey. The resulting raw version of the adapted problem list in BTPs was subsequently pretested. RESULTS In the first part, data of n = 657 BTPs were analysed. Twelve items (20%) were excluded in this step as they proved to be less relevant for BTPs (i.e., items were endorsed by less than 10% and without significant correlations to patients' DT score). In the second part, qualitative interviews and the online survey with 102 professionals led to the addition of 21 new and the modification and condensation of 17 relevant problems specific for BTPs. This adapted list was than successfully pretested in n = 19 patients, leading to the 'distress thermometer brain tumour problem list' (DT-BT), consisting of 42 relevant problems. CONCLUSION The adapted problem list for the DT particularly reflects the neurological and psychosocial burden of an intracranial tumour and allows for the targeted assessment of the specific burdens and needs of BTPs. Our revised version of the DTs problem list (DT-BT) should in the next step be widely validated in multinational samples.
Collapse
Affiliation(s)
- Simone Goebel
- Department of Psychology, University Kiel, Kiel, Germany
| | - Carina Knuth
- Department of Psychology, University Kiel, Kiel, Germany
| | - Matthias Damm
- Department of Neurology & Interdisciplinary Neuro-Oncology, Hertie Institute for Clinical Brain Research, University Hospital Tuebingen, Tuebingen, Germany
| | - Daniel Linden
- Department of Neurology & Interdisciplinary Neuro-Oncology, Hertie Institute for Clinical Brain Research, University Hospital Tuebingen, Tuebingen, Germany
| | - Jan Coburger
- Department of Neurosurgery, University Medical Center, Ulm, Germany
| | - Florian Ringel
- Department of Neurosurgery, University Medical Center, Mainz, Germany
| | - Ghazaleh Tabatabai
- Department of Neurology & Interdisciplinary Neuro-Oncology, Hertie Institute for Clinical Brain Research, University Hospital Tuebingen, Tuebingen, Germany
| | | | - Mirjam Renovanz
- Department of Neurology & Interdisciplinary Neuro-Oncology, Hertie Institute for Clinical Brain Research, University Hospital Tuebingen, Tuebingen, Germany.,Department of Neurosurgery, University Medical Center, Tuebingen, Germany
| |
Collapse
|
|
36
|
Kim J, Kim J, Williams RD, Han A. The Association of Social Support and Leisure Time Physical Activity With Mental Health Among Individuals With Cancer. Am J Health Promot 2020; 35:362-368. [PMID: 32996323 DOI: 10.1177/0890117120961321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
PURPOSE This study examined the relationship among social support, leisure time physical activity (LTPA), and mental health among people with cancer. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS Using the 2017 Health Information National Trends Survey, we extracted data of 504 respondents who had been diagnosed with any of the 22 types of cancer listed in the survey questionnaire. MEASURES As independent variables, we assessed 3 different types of support: emotional, informational, and tangible support. As mediating and outcome variables, we measured LTPA and mental health, respectively. ANALYSIS Using AMOS version 22, a path analysis was conducted to measure model fit. A mediation test was then conducted using bootstrapping procedures. RESULTS The hypothesized model provided an acceptable fit to the data. Specifically, emotional support (b = .15, p = .005), informational support (b = .13, p = .008), tangible support (b = .12, p = .010), and LTPA (b = .14, p = .001) were significantly associated with mental health. We revealed a significant mediating effect of LPTA on the relationship between emotional support and mental health (Estimate = .037, 95% CI = .001-.098, p < .05). CONCLUSION Social support and LTPA played a significant role in promoting mental health among people with cancer. In particular, the results confirmed that individuals with cancer who reported receiving emotional support tended to engage in LTPA and thus reported better mental health.
Collapse
Affiliation(s)
- Jaehyun Kim
- Department of Recreation, Therapeutic Recreation, and Tourism, 7174College at Brockport, State University of New York, Brockport, NY, USA
| | - Junhyoung Kim
- Department of Health and Wellness Design, 1771Indiana University, Bloomington, IN, USA
| | - Ronald D Williams
- Department of Health and Human Performance, 7174Texas State University, San Marcos, TX, USA
| | - Areum Han
- Department of Health and Human Performance, 7174Texas State University, San Marcos, TX, USA
| |
Collapse
|
|
37
|
Ribeiro-Carvalho F, Gonçalves-Pinho M, Bergantim R, Freitas A, Fernandes L. Trend of depression and its association with sociodemographic and clinical factors among multiple myeloma hospitalizations: A Portuguese nationwide study from 2000 to 2015. Psychooncology 2020; 29:1587-1594. [PMID: 32658348 DOI: 10.1002/pon.5469] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/15/2020] [Accepted: 07/01/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Patients hospitalized with multiple myeloma (MM) are particularly vulnerable to depression. The present study aims to determine the frequency of depression among MM hospitalized patients, in order to assess the possible differences between those with and without depression in relation to sociodemographic and clinical variables and to measure the impact of depression on hospitalization outcomes. METHODS An observational retrospective study was performed using an administrative data set of all hospitalizations with a primary diagnosis of MM between 2000 and 2015 in Portuguese mainland public hospitals. Codes related to depressive disorders were grouped to generate the dichotomous variable of depression (yes/no). A multivariate analysis was conducted and adjusted odd ratios (aOR) calculated between different variables and depression. RESULTS Of a total of 14.575 MM hospitalizations studied, a concurrent code of depression was registered in 666 patients (4.6%). A greater odds of depression was observed in female patients (aOR = 2.26; 95%CI = 1.91-2.66), transplanted patients (aOR = 1.78; 95%CI = 1.44-2.20), patients with plasma cell leukemia (aOR = 1.79; 95%CI = 1.22-2.64) and patients with a higher Charlson Comorbidity Index (CCI) (aOR = 1.10; 95%CI = 1.05-1.15). Length of stay was longer in patients with a registered diagnosis of depression (aOR = 1.01; 95%CI = 1.01-1.02) while the odds of in-hospital mortality were lower in these patients (aOR = 0.53; 95%CI = 0.41-0.68). CONCLUSIONS These results may help identify MM inpatients at higher risk of presenting depression (female gender, younger age, high CCI, plasma cell leukemia, transplant procedure). This will enable timely psychological assessment and treatment to prevent worse outcomes and higher healthcare costs associated with depression.
Collapse
Affiliation(s)
| | - Manuel Gonçalves-Pinho
- Department of Psychiatry and Mental Health, Centro Hospitalar do Tâmega e Sousa, Penafiel, Portugal.,Center for Health Technology and Services Research (CINTESIS), FMUP, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), FMUP, Porto, Portugal
| | - Rui Bergantim
- Hematology Department, Centro Hospitalar Universitário de São João (CHUSJ), Porto, Portugal.,i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,Cancer Drug Resistance Group, IPATIMUP-Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal
| | - Alberto Freitas
- Center for Health Technology and Services Research (CINTESIS), FMUP, Porto, Portugal.,Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), FMUP, Porto, Portugal
| | - Lia Fernandes
- Center for Health Technology and Services Research (CINTESIS), FMUP, Porto, Portugal.,Department of Clinical Neurosciences and Mental Health, FMUP, Porto, Portugal.,Psychiatry Service, CHUSJ, Porto, Portugal
| |
Collapse
|
|
38
|
Mravec B, Tibensky M, Horvathova L. Stress and cancer. Part II: Therapeutic implications for oncology. J Neuroimmunol 2020; 346:577312. [PMID: 32652364 DOI: 10.1016/j.jneuroim.2020.577312] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 02/06/2023]
Abstract
Accumulated evidence has confirmed the ability of stress to promote the induction and progression of cancer (for review see Stress and cancer. Part I: Mechanisms mediating the effect of stressors on cancer). In support of this, data from clinical trials utilizing approaches that reduce stress-related signaling have shown prolonged survival of cancer patients. Therefore, the question has arisen as to how we can utilize this knowledge in the daily treatment of cancer patients. The main aim of this review is to critically analyze data from studies utilizing psychotherapy or treatment by β-blockers on the survival of cancer patients. Because these approaches, especially treatment by β-blockers, have been routinely used in clinical practice for decades in the treatment of non-cancer patients, their wider introduction into oncology might be realized in the near future.
Collapse
Affiliation(s)
- Boris Mravec
- Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, Slovakia; Biomedical Research Center, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia.
| | - Miroslav Tibensky
- Institute of Physiology, Faculty of Medicine, Comenius University in Bratislava, Slovakia
| | - Lubica Horvathova
- Biomedical Research Center, Institute of Experimental Endocrinology, Slovak Academy of Sciences, Bratislava, Slovakia
| |
Collapse
|
|
39
|
Trejnowska A, Goodall K, Rush R, Ellison M, McVittie C. The relationship between adult attachment and coping with brain tumour: the mediating role of social support. Psychooncology 2020; 29:729-736. [PMID: 31876067 DOI: 10.1002/pon.5325] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 12/17/2019] [Accepted: 12/23/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE A primary brain tumour diagnosis is known to elicit higher distress than other forms of cancer and is related to high depressive symptomatology. Using a cross-sectional design, the present study explored how individuals cope with this diagnosis using an attachment theory framework. Attachment anxiety and attachment avoidance were hypothesised to be positively related to helplessness/hopelessness, anxious preoccupation, and cognitive avoidance; and negatively related to fighting spirit and fatalism coping. We proposed perceived social support to play a mediating role in those associations. METHODS Four hundred and eighty participants diagnosed with primary brain tumours completed the Mini-Mental Adjustment to Cancer Scale (Mini-MAC), the Experiences in Close Relationships Questionnaire-Revised (ECR-R), and the modified Medical Outcomes Study-Social Support Scale (mMOS-SSS) online. RESULTS Lower perceived social support mediated the positive associations between both higher attachment anxiety and avoidance and higher helpless/hopeless coping. Attachment anxiety was also positively associated with anxious preoccupation. This relationship was not mediated by perceived social support. Cognitive avoidance was unrelated to both attachment dimensions and social support. CONCLUSIONS The findings highlight that the differences in coping repertoire are associated with social relatedness factors, specifically attachment security and its relationship to perceived social support. Implications of the findings are discussed.
Collapse
Affiliation(s)
- Anna Trejnowska
- Division of Psychology, Sociology and Education, Queen Margaret University, Edinburgh, UK
| | - Karen Goodall
- Department of Clinical Psychology, University of Edinburgh, Edinburgh, UK
| | - Robert Rush
- Division of Psychology, Sociology and Education, Queen Margaret University, Edinburgh, UK
| | - Marion Ellison
- Division of Psychology, Sociology and Education, Queen Margaret University, Edinburgh, UK
| | - Chris McVittie
- Division of Psychology, Sociology and Education, Queen Margaret University, Edinburgh, UK
| |
Collapse
|
|
40
|
Rosenblat JD, Kurdyak P, Cosci F, Berk M, Maes M, Brunoni AR, Li M, Rodin G, McIntyre RS, Carvalho AF. Depression in the medically ill. Aust N Z J Psychiatry 2020; 54:346-366. [PMID: 31749372 DOI: 10.1177/0004867419888576] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Depressive disorders are significantly more common in the medically ill compared to the general population. Depression is associated with worsening of physical symptoms, greater healthcare utilization and poorer treatment adherence. The present paper provides a critical review on the assessment and management of depression in the medically ill. METHODS Relevant articles pertaining to depression in the medically ill were identified, reviewed and synthesized qualitatively. A systematic review was not performed due to the large breadth of this topic, making a meaningful summary of all published and unpublished studies not feasible. Notable studies were reviewed and synthesized by a diverse set of experts to provide a balanced summary. RESULTS Depression is frequently under-recognized in medical settings. Differential diagnoses include delirium, personality disorders and depressive disorders secondary to substances, medications or another medical condition. Depressive symptoms in the context of an adjustment disorder should be initially managed by supportive psychological approaches. Once a mild to moderate major depressive episode is identified, a stepped care approach should be implemented, starting with general psychoeducation, psychosocial interventions and ongoing monitoring. For moderate to severe symptoms, or mild symptoms that are not responding to low-intensity interventions, the use of antidepressants or higher intensity psychotherapeutic interventions should be considered. Psychotherapeutic interventions have demonstrated benefits with small to moderate effect sizes. Antidepressant medications have also demonstrated benefits with moderate effect sizes; however, special caution is needed in evaluating side effects, drug-drug interactions as well as dose adjustments due to impairment in hepatic metabolism and/or renal clearance. Novel interventions for the treatment of depression and other illness-related psychological symptoms (e.g. death anxiety, loss of dignity) are under investigation. LIMITATIONS Non-systematic review of the literature. CONCLUSION Replicated evidence has demonstrated a bidirectional interaction between depression and medical illness. Screening and stepped care using pharmacological and non-pharmacological interventions is merited.
Collapse
Affiliation(s)
- Joshua D Rosenblat
- Mood Disorder Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Paul Kurdyak
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences (ICES), Toronto, ON, Canada
| | - Fiammetta Cosci
- Department of Health Sciences, University of Florence, Florence, Italy.,Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Michael Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, VIC, Australia.,The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Parkville, VIC, Australia.,Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Royal Melbourne Hospital, Parkville, VIC, Australia.,Centre of Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia
| | - Michael Maes
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, VIC, Australia.,Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Andre R Brunoni
- Service of Interdisciplinary Neuromodulation (SIN), Laboratory of Neuroscience (LIM27) and National Institute of Biomarkers in Neuropsychiatry (INBioN), Department and Institute of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil.,Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany
| | - Madeline Li
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Gary Rodin
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Department of Supportive Care, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorder Psychopharmacology Unit, University Health Network, Toronto, ON, Canada.,Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Andre F Carvalho
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada
| |
Collapse
|
|
41
|
Patterns of Postdiagnosis Depression Among Late-Stage Cancer Patients: Do Racial/Ethnic and Sex Disparities Exist? Am J Clin Oncol 2020; 42:675-681. [PMID: 31305288 DOI: 10.1097/coc.0000000000000569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES The incidence of depression after a late-stage cancer diagnosis is poorly understood and has not been the subject of intense investigation. We used population-based data to examine trends in postdiagnosis depression incidence among racial/ethnic and sexual groups. METHODS We identified 123,066 patients diagnosed with late-stage breast, prostate, lung, or colorectal cancer from 2001 to 2013 in the Surveillance Epidemiology and End Results Medicare-linked database. The primary outcome was the incidence of postdiagnosis depression after a late-stage cancer diagnosis. Trend analysis was performed using the Cochran-Armitage test. Stratified incidence rates were calculated for the racial/ethnic and sexual groups. RESULTS The incidence of depression after cancer diagnosis increased from 15.3% in 2001 to 24.1% in 2013, P trend<0.0001. About 50% of depression was reported in the first 3 months of stage IV cancer diagnosis. A total of 19,775 (20.0%) non-Hispanic whites, 1937 (15.9%) non-Hispanic blacks, and 657 (12.7%) Hispanics were diagnosed with depression during a mean follow-up of 2.7 months (interquartile range: 0.9 to 10.2 mo). The incidence of depression is significantly higher among females than males, 22.7% versus 16.3%, P<0.0001. In the multivariable logistic regression, non-Hispanic whites and females were still independent predictors of higher risk of postdiagnosis depression. CONCLUSIONS There are significant differences in the incidence of postdiagnosis depression among racial/ethnic and sexual groups in the United States. The consideration of racial/ethnic in depression prevention and diagnosis among cancer patients should be discussed as a matter of importance to ensure that there is no diagnosis bias among non-Hispanic blacks and Hispanics.
Collapse
|
|
42
|
Chen R, Ryan P, Natarajan K, Falconer T, Crew KD, Reich CG, Vashisht R, Randhawa G, Shah NH, Hripcsak G. Treatment Patterns for Chronic Comorbid Conditions in Patients With Cancer Using a Large-Scale Observational Data Network. JCO Clin Cancer Inform 2020; 4:171-183. [PMID: 32134687 PMCID: PMC7113074 DOI: 10.1200/cci.19.00107] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2020] [Indexed: 12/24/2022] Open
Abstract
PURPOSE Patients with cancer are predisposed to developing chronic, comorbid conditions that affect prognosis, quality of life, and mortality. While treatment guidelines and care variations for these comorbidities have been described for the general noncancer population, less is known about real-world treatment patterns in patients with cancer. We sought to characterize the prevalence and distribution of initial treatment patterns across a large-scale data network for depression, hypertension, and type II diabetes mellitus (T2DM) among patients with cancer. METHODS We used the Observational Health Data Sciences and Informatics network, an international collaborative implementing the Observational Medical Outcomes Partnership Common Data Model to standardize more than 2 billion patient records. For this study, we used 8 databases across 3 countries-the United States, France, and Germany-with 295,529,655 patient records. We identified patients with cancer using SNOMED (Systematized Nomenclature of Medicine) codes validated via manual review. We then characterized the treatment patterns of these patients initiating treatment of depression, hypertension, or T2DM with persistent treatment and at least 365 days of observation. RESULTS Across databases, wide variations exist in treatment patterns for depression (n = 1,145,510), hypertension (n = 3,178,944), and T2DM (n = 886,766). When limited to 6-node (6-drug) sequences, we identified 61,052 unique sequences for depression, 346,067 sequences for hypertension, and 40,629 sequences for T2DM. These variations persisted across sites, databases, countries, and conditions, with the exception of metformin (73.8%) being the most common initial T2DM treatment. The most common initial medications were sertraline (17.5%) and escitalopram (17.5%) for depression and hydrochlorothiazide (20.5%) and lisinopril (19.6%) for hypertension. CONCLUSION We identified wide variations in the treatment of common comorbidities in patients with cancer, similar to the general population, and demonstrate the feasibility of conducting research on patients with cancer across a large-scale observational data network using a common data model.
Collapse
Affiliation(s)
- Ruijun Chen
- Department of Biomedical Informatics, Columbia University, New York, NY
- Observational Health Data Sciences and Informatics, New York, NY
- Department of Medicine, Weill Cornell Medical College, New York, NY
| | - Patrick Ryan
- Department of Biomedical Informatics, Columbia University, New York, NY
- Observational Health Data Sciences and Informatics, New York, NY
- Epidemiology Analytics, Janssen Research and Development, Titusville, NJ
| | - Karthik Natarajan
- Department of Biomedical Informatics, Columbia University, New York, NY
- Observational Health Data Sciences and Informatics, New York, NY
| | - Thomas Falconer
- Department of Biomedical Informatics, Columbia University, New York, NY
- Observational Health Data Sciences and Informatics, New York, NY
| | - Katherine D. Crew
- Department of Medicine and the Herbert Irving Comprehensive Cancer Center, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Christian G. Reich
- Observational Health Data Sciences and Informatics, New York, NY
- IQVIA, Cambridge, MA
| | - Rohit Vashisht
- Observational Health Data Sciences and Informatics, New York, NY
- Center for Biomedical Informatics Research, Stanford University, Palo Alto, CA
| | - Gurvaneet Randhawa
- Health Systems and Interventions Research Branch, Healthcare Delivery Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD
| | - Nigam H. Shah
- Observational Health Data Sciences and Informatics, New York, NY
- Center for Biomedical Informatics Research, Stanford University, Palo Alto, CA
| | - George Hripcsak
- Department of Biomedical Informatics, Columbia University, New York, NY
- Observational Health Data Sciences and Informatics, New York, NY
- Medical Informatics Services, New York-Presbyterian Hospital, New York, NY
| |
Collapse
|
|
43
|
Unmarried men have worse oncologic outcomes after radical cystectomy for nonmetastatic urothelial bladder cancer. Urol Oncol 2020; 38:76.e1-76.e9. [DOI: 10.1016/j.urolonc.2019.10.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/22/2019] [Accepted: 10/29/2019] [Indexed: 02/08/2023]
|
|
44
|
Jia Y, Zhang W, You S, Li M, Lei L, Chen L. A nomogram for predicting depression in patients with hepatocellular carcinoma: an observational cross-sectional study. Int J Psychiatry Clin Pract 2019; 23:273-280. [PMID: 31124729 DOI: 10.1080/13651501.2019.1619777] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Objectives: Depression is common in hepatocellular carcinoma patients. Predicting depression is critical for managing hepatocellular carcinoma patients. The aim of this study was to establish a comprehensive visual predictive nomogram for calculating a probabilistic estimate of depression in hepatocellular carcinoma patients.Methods: Two-hundred and sixty-nine patients diagnosed with hepatocellular carcinoma were included. The demographic and clinical information was collected from medical records. A nomogram was constructed based on the results of a multivariate regression analysis. Discrimination and calibration were used to assess its performance. A decision curve analysis was used to assess its clinical utility.Results: One hundred and thirty-four (49.82%) hepatocellular carcinoma patients with depression were identified. The education level, social support, pain intensity, disclosure of the cancer diagnosis to the patient and Child-Pugh class were included in the nomogram. The AUC was 0.828, indicating good discrimination. The nomogram demonstrated calibration curves with slight deviation from the ideal predictions and a high net benefit in the decision curve analysis.Conclusions: We proposed a nomogram for the individualised prediction of depression in hepatocellular carcinoma patients with satisfactory performance and clinical utility.Key points/highlightsA visual, comprehensive and convenient nomogram was established for the prediction of depression in patients with hepatocellular carcinoma.The proposed nomogram showed satisfactory validity, discrimination and clinical utility, indicating good performance for predicting depression.The variables found to be sufficiently informative and predictive to warrant inclusion in the nomogram were the patient education level, pain intensity, social support, disclosure of the hepatocellular carcinoma diagnosis to the patient and Child-Pugh class.
Collapse
Affiliation(s)
- Yong Jia
- School of Nursing, Jilin University, Changchun, China
| | - Wenlei Zhang
- Invasive Technology Department, The First Hospital Jilin University, Changchun, China
| | - Simiao You
- Department of Nursing Welfare, College of Health and Welfare, College of Humanities and Sciences of Northeast, Normal University, Changchun, China
| | - Min Li
- Invasive Technology Department, The First Hospital Jilin University, Changchun, China
| | - Lin Lei
- Pediatric Department, The Second Hospital Jilin University, Changchun, China
| | - Li Chen
- School of Nursing, Jilin University, Changchun, China.,Department of Pharmacology, College of Basic Medical Sciences, Jilin University, Changchun, China
| |
Collapse
|
|
45
|
Defining a new model of interdisciplinary cancer cachexia care in regional Victoria, Australia. Support Care Cancer 2019; 28:3041-3049. [DOI: 10.1007/s00520-019-05072-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 09/05/2019] [Indexed: 12/24/2022]
|
|
46
|
Köhler M, Steinmann E, Maximilian Mehdorn H, Pedersen A, Goebel S. The importance of social relationships for brain tumor patients' quality of life: A case for the inclusion of the concept of disclosure in psycho-oncological care. J Psychosoc Oncol 2019; 38:310-327. [PMID: 31347472 DOI: 10.1080/07347332.2019.1642283] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: Interpersonal factors are of major importance for cancer patients' physical and mental health. Brain tumor patients rank amongst those cancer patients with the highest psychosocial burden. Changes in language, cognition, and personality pose specific risk factors for impeding interpersonal functioning in this patient group. Despite this, role and relevance of social support including both supportive (e.g., emotional support) and detrimental interactions causing distress (e.g., critical remarks) are not well understood. Aims of this study were thus (1) to investigate the association of social support and patients' Health Related Quality of Life (HRQoL) and (2) to assess whether this relationship is mediated by the patients' disclosure behavior.Methods: Seventy-four ambulatory brain tumor patients (mean age 54 years; 58% women) completed the following self-report questionnaires: Illness-specific Social Support Scale (SSUK) for assessment of positive support and detrimental interactions, the Disclosure of Trauma Questionnaire (DTQ) for assessment of patients' disclosure behavior, and the Short-Form Health Survey (SF-8) for assessment of QoL.Findings: Detrimental social interactions were significantly related to patients' mental and physical well-being while positive support was not. Our results support a model in which patients perceiving detrimental social interactions show more difficulties in talking about illness-specific contents in a functional manner. This, in turn, was associated with a lower physical and mental HRQoL.Conclusions: This was the first study in which the close associations of detrimental social interactions, brain tumor patients' dysfunctional disclosure behavior and patients' mental as well as physical well-being were empiricially validated. Thus, dysfunctional disclosure behavior might pose a relevant therapeutic target when offering psycho-oncological support for brain tumor patients and their families.
Collapse
Affiliation(s)
- Martina Köhler
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Kiel, Kiel, Germany
| | - Elisabeth Steinmann
- Department of Neurosurgery, University Hospital Schleswig-Holstein, Kiel, Germany
| | | | - Anya Pedersen
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Kiel, Kiel, Germany
| | - Simone Goebel
- Clinical Psychology and Psychotherapy, Department of Psychology, University of Kiel, Kiel, Germany
| |
Collapse
|
|
47
|
Huynh-Le MP, Karunamuni R, Moiseenko V, Farid N, McDonald CR, Hattangadi-Gluth JA, Seibert TM. Dose-dependent atrophy of the amygdala after radiotherapy. Radiother Oncol 2019; 136:44-49. [PMID: 31015128 PMCID: PMC7041546 DOI: 10.1016/j.radonc.2019.03.024] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 03/20/2019] [Accepted: 03/26/2019] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND PURPOSE The amygdalae are deep brain nuclei critical to emotional processing and the creation and storage of memory. It is not known whether the amygdalae are affected by brain radiotherapy (RT). We sought to quantify dose-dependent amygdala change one year after brain RT. MATERIALS AND METHODS 52 patients with primary brain tumors were retrospectively identified. Study patients underwent high-resolution, volumetric magnetic resonance imaging before RT and 1 year afterward. Images were processed using FDA-cleared software for automated segmentation of amygdala volume. Tumor, surgical changes, and segmentation errors were manually censored. Mean amygdala RT dose was tested for correlation with amygdala volume change 1 year after RT via the Pearson correlation coefficient. A linear mixed-effects model was constructed to evaluate potential predictors of amygdala volume change, including age, tumor hemisphere, sex, seizure history, and bevacizumab treatment during the study period. As 51 of 52 patients received chemotherapy, possible chemotherapy effects could not be studied. A two-tailed p-value <0.05 was considered statistically significant. RESULTS Mean amygdala RT dose (r = -0.28, p = 0.01) was significantly correlated with volume loss. On multivariable analysis, the only significant predictor of amygdala atrophy was radiation dose. The final linear mixed-effects model estimated amygdala volume loss of 0.17% for every 1 Gy increase in mean amygdala RT dose (p = 0.008). CONCLUSIONS The amygdala demonstrates dose-dependent atrophy one year after radiotherapy for brain tumors. Amygdala atrophy may mediate neuropsychological effects seen after brain RT.
Collapse
Affiliation(s)
- Minh-Phuong Huynh-Le
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, United States
| | - Roshan Karunamuni
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, United States
| | - Vitali Moiseenko
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, United States
| | - Nikdokht Farid
- Department of Radiology, University of California San Diego, La Jolla, CA, United States
| | - Carrie R McDonald
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, United States; Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Jona A Hattangadi-Gluth
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, United States
| | - Tyler M Seibert
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, United States; Department of Bioengineering, University of California San Diego, La Jolla, CA, United States.
| |
Collapse
|
|
48
|
Erim DO, Bensen JT, Mohler JL, Fontham ETH, Song L, Farnan L, Delacroix SE, Peters ES, Erim TN, Chen RC, Gaynes BN. Prevalence and predictors of probable depression in prostate cancer survivors. Cancer 2019; 125:3418-3427. [PMID: 31246284 DOI: 10.1002/cncr.32338] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/12/2019] [Accepted: 05/14/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The early diagnosis and treatment of depression are cancer care priorities. These priorities are critical for prostate cancer survivors because men rarely seek mental health care. However, little is known about the epidemiology of depression in this patient population. The goal of this study was to describe the prevalence and predictors of probable depression in prostate cancer survivors. METHODS The data were from a population-based cohort of North Carolinian prostate cancer survivors who were enrolled from 2004 to 2007 in the North Carolina-Louisiana Prostate Cancer Project (n = 1031) and were prospectively followed annually from 2008 to 2011 in the Health Care Access and Prostate Cancer Treatment in North Carolina study (n = 805). Generalized estimating equations were used to evaluate an indicator of probable depression (Short Form 12 mental composite score ≤48.9; measured at enrollment and during the annual follow-up) as a function of individual-level characteristics within the longitudinal data set. RESULTS The prevalence of probable depression fell from 38% in the year of the cancer diagnosis to 20% 6 to 7 years later. Risk factors for probable depression throughout the study were African American race, unemployment, low annual income, younger age, recency of cancer diagnosis, past depression, comorbidities, treatment decisional regret, and nonadherence to exercise recommendations. CONCLUSIONS Depression is a major challenge for prostate cancer survivors, particularly in the first 5 years after the cancer diagnosis. To the authors' knowledge, this is the first study to demonstrate an association between treatment decisional regret and probable depression.
Collapse
Affiliation(s)
- Daniel O Erim
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,RTI International, Research Triangle Park, North Carolina
| | - Jeannette T Bensen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.,Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - James L Mohler
- Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Elizabeth T H Fontham
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Lixin Song
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Laura Farnan
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Scott E Delacroix
- Department of Urology, Louisiana State University, New Orleans, Louisiana
| | - Edward S Peters
- School of Public Health, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | | | - Ronald C Chen
- Lineberger Comprehensive Cancer Center, School of Medicine, University of North Carolina, Chapel Hill, North Carolina.,Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina
| | - Bradley N Gaynes
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
| |
Collapse
|
|
49
|
Emerging therapeutic potential of anti-psychotic drugs in the management of human glioma: A comprehensive review. Oncotarget 2019; 10:3952-3977. [PMID: 31231472 PMCID: PMC6570463 DOI: 10.18632/oncotarget.26994] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 05/13/2019] [Indexed: 12/12/2022] Open
Abstract
Despite numerous advancements in the last decade, human gliomas such as astrocytoma and glioblastoma multiforme have the worst prognoses among all cancers. Anti-psychotic drugs are commonly prescribed to treat mental disorders among cancer patients, and growing empirical evidence has revealed their antitumor, anti-metastatic, anti-angiogenic, anti-proliferative, chemo-preventive, and neo-adjuvant efficacies in various in vitro, in vivo, and clinical glioma models. Anti-psychotic drugs have drawn the attention of physicians and researchers owing to their beneficial effects in the prevention and treatment of gliomas. This review highlights data on the therapeutic potential of various anti-psychotic drugs as anti-proliferative, chemopreventive, and anti-angiogenic agents in various glioma models via the modulation of upstream and downstream molecular targets involved in apoptosis, autophagy, oxidative stress, inflammation, and the cell cycle in in vitro and in vivo preclinical and clinical stages among glioma patients. The ability of anti-psychotic drugs to modulate various signaling pathways and multidrug resistance-conferring proteins that enhance the efficacy of chemotherapeutic drugs with low side-effects exemplifies their great potential as neo-adjuvants and potential chemotherapeutics in single or multimodal treatment approach. Moreover, anti-psychotic drugs confer the ability to induce glioma into oligodendrocyte-like cells and neuronal-like phenotype cells with reversal of epigenetic alterations through inhibition of histone deacetylase further rationalize their use in glioma treatment. The improved understanding of anti-psychotic drugs as potential chemotherapeutic drugs or as neo-adjuvants will provide better information for their use globally as affordable, well-tolerated, and effective anticancer agents for human glioma.
Collapse
|
|
50
|
Malloch YZ, Taylor LD. Emotional Self-Disclosure in Online Breast Cancer Support Groups: Examining Theme, Reciprocity, and Linguistic Style Matching. HEALTH COMMUNICATION 2019; 34:764-773. [PMID: 29400555 DOI: 10.1080/10410236.2018.1434737] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The present study investigated emotional self-disclosure (ESD) patterns and their effects in online support groups specific to different stages of breast cancer. Linguistic features of messages posted to an online breast cancer support group were analyzed. ESD was common, and was consistent across four stage forums. Emotional talk was linked to a variety of themes, but most prominently in the context of discussions about social connections rather than health or death. Linguistic style matching mediated the relationship between ESD in posts and reciprocal ESD in comments, suggesting a key role for mutual understanding and engagement between posters and commenters. Implications for health communication theory and practice were discussed.
Collapse
|