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.

Cognitive and psychiatric problems are common in cancer patients, but literature on patients with neuroendocrine tumors (NET) is scarce. In a subset of these patients, the tumor produces serotonin, causing physical symptoms known as carcinoid syndrome. This peripheral overproduction of serotonin may cause central depletion of its precursor tryptophan, potentially resulting in cognitive and psychiatric problems. Therefore, we investigated cognitive and psychiatric function in patients with a serotonin overproduction and the association with this serotonin overproduction. Eighty-one patients with a serotonin-producing metastatic ileal NET underwent standardized neuropsychological and psychiatric assessment. Blood and urine samples were collected to determine concentrations of serotonin, its precursor tryptophan, and metabolite (5-HIAA). Multivariate normative comparison was applied to determine the prevalence of cognitive impairment. Separate linear regressions of serotonin, tryptophan, and 5-HIAA concentrations on cognitive function, depressive symptoms, and anxiety symptoms were performed, corrected for age, sex, education, and/or duration of illness. We found an 11% prevalence of cognitive impairment and a 20% prevalence of psychiatric disorders. Cognitive function was not related to measures of peripheral serotonin production. Unexpectedly, depressive symptoms were significantly associated with lower serum serotonin concentrations and elevated serum tryptophan concentrations. Cognitive symptoms of anxiety were also associated with elevated tryptophan concentrations. Concluding, cognitive or psychiatric problems occur in a minority of patients with NET and cannot be explained by tryptophan depletion following tumor-related serotonin production.

Nearly 60% of cancer survivors experience insomnia symptoms, which is 2-3 times higher than the general population. This study examined the efficacy, safety, and feasibility of repetitive transcranial magnetic stimulation (rTMS) for the treatment of insomnia in cancer survivors. Sixty-six cancer survivors with insomnia were randomly assigned to receive rTMS (n = 22), Sham-rTMS (n = 21), and CBT-I (n = 23) treatment for a 6-week period. Participants completed assessments at baseline, 3 weeks, and 6 weeks, respectively. The primary outcome was the change in Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) from baseline to 6 weeks. The secondary outcome included the change in Hospital Anxiety and Depression Scale (HADS) and Epworth Sleeping Scale (ESS). The generalized estimating equations (GEE) analysis showed a significant difference in reduced ISI (β = -4.58, 95% CI -8.25, -0.91, p = .009) and PSQI (β = -2.35, 95% CI -4.63, -0.07, p = .041) between intervention rTMS and Sham-rTMS, respectively. A significant between-group difference was also observed in reduced ESS (β = -4.65, 95% CI -8.24, -1.06, p = .006). However, the GEE analysis showed that there was no difference between rTMS and CBT-I for relieving insomnia symptoms and daytime sleepiness. After the 6-week treatment, rTMS, Sham-rTMS, and CBT-I demonstrated 60.0%, 28.6%, and 61.5% response rates for insomnia severity and 66.7%, 35.7%, and 53.8% for sleep quality improvement. The rate of adverse events was 9.1%, 0%, and 4.3% in the rTMS, Sham-rTMS, and CBT-I groups, respectively, and no serious adverse events were reported. Given the critical role of good sleep for cancer prognosis, there is an urgent need to increase access to evidence-based treatment for insomnia in cancer survivors. TMS offers an efficacy, safety, and feasibility therapy.

Breast cancer surgery is a critical intervention with potentially significant psychological impacts. This systematic review and meta-analysis investigate the effect of different surgical approaches on levels of depression and anxiety in breast cancer patients.

Following the PRISMA 2020 guidelines, we conducted a comprehensive search of international bibliometric databases including PubMed, Scopus, Web of Science, and Embase, up to March 21, 2024.

From 1576 identified articles, 13 studies were included after screening and eligibility assessments. Meta-analysis results indicated a significant reduction in depression (SMD: -0.14; 95% CI: -0.25 to -0.02) and anxiety (SMD: -0.42; 95% CI: -0.56 to -0.28) following breast cancer surgery. Subgroup analysis revealed that mastectomy patients experienced a notable decrease in both depression and anxiety, while results for breast-conserving surgery and reconstruction were more varied.

Breast cancer surgery is associated with a decrease in depression and anxiety, particularly following mastectomy. Further research should focus on long-term psychological effects and the development of tailored interventions for different surgical types.

According to the World Health Organization, cancer remains the primary cause of death of millions of individuals annually and the foremost cause of mortality worldwide. Cancer imposes substantial economic and mental challenges on patients and their families and strains healthcare systems. Depression, one of the most prevalent mental health conditions, affects approximately 3.8% of the global population and is a significant global health challenge. Research indicates increasing incidence rates of depression among patients with cancer. Depression also appears to influence cancer development and progression, worsening patient prognosis and quality of life, thereby creating additional challenges for clinical treatment. Correlation of depression and cancer is a complicated yet promising field with fast-paced progression and vital clinical values. Therefore, we discussed in this review the associations between depression and cancer and their potential mechanisms by analyzing the specific role of depression in the development and progression of tumors from the perspective of suppressing tumor immunity, inhibiting tumor cell apoptosis, inducing DNA damage, promoting tumor cell mesenchymal transition, enhancing tumor cell stemness, and promoting tumor angiogenesis. This review also discusses how tumors influence the development of depression via inflammatory factors and the significance of identifying and treating depression to enhance the quality of life and prognosis of patients with cancer. Promising biomarkers and effective treatments are also highlighted. Despite available data, limited research exists on how treating depression affects cancer prognosis, and whether timely treatment can reduce cancer risk remains unclear, which necessitates further investigation. This review summarizes the molecular mechanisms involved in the relationship between cancer and depression to help identify new biomarkers and provide precise medical care for patients with depression. We hope this review will lay the foundation for future research, advancing new biomarkers and therapies for early diagnosis of cancer and depression comorbidity.

Music and medicine interventions are recognised for their effects on emotional regulation and stress reduction. However, limited research exists on how these interventions affect anxiety based on personality types, particularly in breast cancer patients undergoing chemotherapy. This study aimed to evaluate the effects of music and medicine interventions on anxiety levels according to personality types in women with breast cancer receiving adjuvant chemotherapy. In a controlled, cross-sectional case-control study, 120 women were randomly assigned to two groups: an intervention group (music and medicine + chemotherapy) and a control group (chemotherapy only). The music playlist included classical, folk, and pop genres, and participants' anxiety levels were measured using the State-Trait Anxiety Inventory. Personality types were determined post-treatment using the Eysenck Personality Questionnaire - Revised Short Form. Serum C-reactive protein levels, blood pressure, and heart rate were also measured. Significant reductions were observed in anxiety levels, systolic blood pressure, heart rate, and serum C-reactive protein levels in the music intervention group compared to the control group. Neurotic individuals showed the most substantial improvement in anxiety, with reductions in systolic blood pressure and heart rate. Multivariate analysis revealed that both neurotic personality type and the music intervention were significant predictors of anxiety reduction. Music and medicine interventions provide notable benefits in reducing anxiety, particularly in neurotic individuals. Personalised music therapy based on personality types could enhance the quality of life for breast cancer patients undergoing chemotherapy. While this study focuses on the immediate effects of MMI during the first chemotherapy session, future research should explore the long-term impacts to better understand the sustained efficacy of such interventions in managing anxiety across multiple treatment cycles.

Cancer patients often suffer from depression, the presence of which promotes the deterioration of the cancer patient's condition and thus affects the patient's survival. However, the exact mechanisms underlying the relationship between depression and tumour progression remain unclear, and this complexity involves multi-system and multi-level interactions, with several key challenges remaining in current research. First, the extreme complexity of biological systems. Depression and tumors involve multiple pathways such as neuroendocrine, immune system, and metabolism, respectively, and there are nonlinear interactions between these pathways (e.g., HPA axis activation affects both immunosuppression and tumor angiogenesis), so it is difficult to isolate the predominant role of a single mechanism, and there are feedback loops (e.g., inflammatory factors (e.g., IL-6) can both induce depressive symptoms and promote tumor growth) form a "feedback loop between depression and tumors" that makes it difficult to determine the direction of causality. Second, the potential blind spot of mechanism research. There is insufficient direct evidence for the brain-tumor axis, and it is known that the vagus nerve or sympathetic nerves can directly modulate the tumor microenvironment (TME) (e.g., via β-adrenergic receptors), but there is a lack of technical support for in vivo imaging on how the CNS remotely affects tumors through the neural circuits; whereas depression-associated disturbances of the intestinal flora or in certain stages of tumor development (e.g., metastatic) or specific microenvironments (e.g., areas of hyper-infiltrating T-cells) may have long-term effects on the tumors, but such changes are difficult to capture in short-term experiments and cannot be precisely temporally resolved by existing technologies. However, there are limitations in current research methods. Existing studies have relied on mouse models of chronic stress (e.g., chronic unpredictable stress), but the "depression-like behaviour" of mice is fundamentally different from the clinical manifestations of depression in humans, and the TME (e.g., immune composition) is different from that of humans. Finally, for patients with cancer-associated depression, clinical treatment is usually a two-pronged strategy, but the combination of anticancer and antidepressant drugs has limitations, such as drug-drug interactions, safety issues, and the challenge of individualised treatment in clinical practice. Therefore, by elucidating the relationship between depression and tumour bidirectional effects, this review relatively clarifies how depression affects TME to promote tumour progression by influencing changes in immunosuppression, hormonal changes, glutamate/glutamate receptors, and intestinal flora. Further, some potential therapeutic strategies are proposed for the clinical treatment of this group of patients through the above pathological mechanism; at the same time, it was found that antidepressant drugs have potential antitumor activity, and their dual pharmacological effects may provide synergistic therapeutic benefits for patients with cancer-associated depressive disorders. This finding not only expands the choice of drugs for tumour therapy but also provides a new theoretical basis for comprehensive treatment strategies in the field of psycho-oncology.

Depression is a prevalent but often underrecognized comorbidity among cancer patients. Emerging evidence suggests that psychological distress may adversely impact cancer outcomes, but the magnitude of its effect on survival remains unclear. This meta-analysis evaluates the association between depression diagnosed after cancer diagnosis and cancer-specific and all-cause mortality across major cancer types. A systematic search of PubMed, Web of Science, Google Scholar, and the Cochrane Library was conducted to identify cohort studies examining the impact of depression on cancer mortality. Studies were included if they assessed clinically diagnosed depression or depressive symptoms using validated scales and reported hazard ratios (HRs) for mortality outcomes. A random-effects meta-analysis was performed to pool HR estimates, with heterogeneity assessed via Cochran's Q and I2 statistics. Funnel plots and Egger's test were used to evaluate publication bias. A total of 65 cohort studies were included. Depression was associated with significantly increased cancer-specific mortality in colorectal cancer (HR 1.83, 95% CI 1.47-2.28), breast cancer (HR 1.23, 95% CI 1.13-1.34), lung cancer (HR 1.59, 95% CI 1.36-1.86), and prostate cancer (HR 1.74, 95% CI 1.36-2.23). When considering mixed cancer types, depression was linked to a 38% increased risk of cancer mortality (HR 1.38, 95% CI 1.20-1.60). Significant heterogeneity was observed across studies (I2 range 56-98%), suggesting variations in study populations and methodologies. Sensitivity analyses confirmed the robustness of the findings, and trial sequential analysis indicated sufficient evidence for a conclusive association. Depression after cancer diagnosis is associated with a significantly increased risk of cancer-specific mortality across multiple cancer types. These findings highlight the urgent need for integrating routine mental health screening and interventions into oncology care. Future research should focus on mechanistic pathways and targeted interventions to mitigate the negative impact of depression on cancer survival.

Objective. Electroencephalographic neurofeedback (EEG NF) or its effects on event-related potentials (ERPs) in quantitative EEG have not yet been systematically studied in cancer patients. The aim of this study was to investigate the emotional arousal and valence effects on the event-related P300 in a visual oddball paradigm by an individualized EEG alpha and theta/beta NF intervention in cancer patients and survivors (N = 18, age between 31 and 73 years). Methods. ERPs to low and high arousal target stimuli with either emotional positive or negative content and depressive state were obtained in cancer patients before and after a five-week NF intervention in a waitlist paradigm, following the consensus on the reporting and experimental design of clinical and cognitive-behavioral NF studies (CRED-nf checklist). Results. Overall, P300 amplitudes decreased significantly (p < .05) from pre to post therapy. Effects concerning high arousal stimuli with negative and positive valences were on the border to significance. Moreover, patients achieved significant relief of depressive symptoms (p < .05). Especially younger participants (<55 yrs.) benefited. Conclusions. P300 observations could reflect a therapeutic effect on brain activity level. EEG NF alleviates depressive symptoms in cancer patients. Significance. Based on these findings, further studies are needed to investigate the effects on event-related potentials by NF therapy.

Clinically significant existential distress may impair quality of life and communication about illness. We investigated the presence of existential distress in the form of demoralization, death anxiety, and dignity-related distress, and its co-occurrence with mental disorders in patients with advanced cancer.

We conducted structured clinical interviews and administered self-report questionnaires to assess existential distress and mental disorders. We recruited patients with different Union for International Cancer Control (UICC) stage IV solid tumors from in- and outpatient oncology and palliative care settings.

A total of 671 patients completed assessments (55 % participation rate, 48 % female, primary tumor site: 28 % lung, 14 % prostate, 11 % breast). Clinically relevant levels of existential distress were present in 46.4 % (95 % CI, 41.7 % to 51.1 %), including demoralization, 12.5 % (95 % CI, 9.6 % to 15.9 %), death anxiety, 27.3 % (95 % CI, 23.2 % to 31.6 %), and dignity-related distress, 38.7 % (95 % CI, 34.2 % to 43.3 %). Frequent existential distress symptoms were sense of entrapment and fear of own and close others' suffering. Mental disorders occurred in 26.2 % (95 % CI, 22.2 % to 30.4 %), including major depression, 8.6 % (95 % CI, 6.2 % to 11.5 %), anxiety disorders, 8.4 % (95 % CI, 6.0 % to 11.3 %), and ICD-11-adjustment disorder, 10.5 % (95 % CI, 7.9 % to 13.7 %). Existential distress and mental disorders co-occurred in 20.0 % (95 % CI, 16.4 % to 24.0 %).

Existential distress is a common, clinically significant problem in patients with advanced cancer. Its recognition in multiprofessional clinical settings can contribute to improve quality of life. Most patients with a mental disorder show comorbid existential distress requiring treatment of both.

This meta-analysis aimed to evaluate the effectiveness of internet-based mindfulness interventions on anxiety and depression symptoms in patients with cancer.

Eight databases (Cochrane Library, PubMed, Embase, and PsycINFO CNKI, Wanfang, VIP, and CBM) were systematically searched from the inception of databases to August 2023 for randomized controlled trials (RCTs). Two independent reviewers rigorously assessed the risk of bias and extracted data using a pre-established form. The meta-analysis, conducted using Stata version 16, calculated pooled effect sizes and 95% confidence intervals (CIs). Sensitivity analysis was employed to find the source of heterogeneity, and potential publication bias was evaluated through funnel plot analysis and the Egger test.

This study included 10 studies, involving a total of 1314 patients. The results of the meta-analysis showed that Internet-based mindfulness interventions were effective in reducing anxiety [SMD = -0.38, 95% CI (-0.51, -0.25), P < 0.01] and depression [SMD = -0.36, 95% CI (-0.49, -0.23), P < 0.01], particularly when the duration of the program was within 8 weeks and each session lasted <45 min. Interventions guided by therapists proved to be more effective than those without therapist guidance in improving anxiety and depression in cancer patients, and synchronous online interaction with therapists were found to yield the most noticeable improvements in anxiety and depression.

Internet-based mindfulness interventions, especially synchronous online interaction with therapists, contribute to alleviating anxiety and depression symptoms in cancer patients. The effectiveness is more pronounced when the intervention duration per session is limited to 45 min and the overall intervention duration is within 8 weeks. The medium to long-term efficacy of the intervention needs further validation through more high-quality research.

Various exercise modalities have been demonstrated to be effective in alleviating anxiety and depression among individuals with cancer. However, it remains unclear which specific exercise intervention is the optimal choice. This study aimed to systematically evaluate the impact of different exercise intervention types on anxiety and depression in individuals with cancer.

Eligible randomized controlled trials were identified through searches of PubMed, Web of Science, and EBSCOHost, with the search period up to December 2024. Two researchers independently conducted the literature screening, data extraction, and assessment. Statistical analyses and visualizations were performed using Stata 15.0 software and RevMan5.4 software.

A total of 26 randomized controlled trials (involving 2118 individuals with cancer) examining three types of exercise interventions were included. Compared to usual care, mind-body exercise (SMD = -0.58, 95 % CI (-0.99, -0.17)), followed by resistance training (SMD = -0.52, 95 % CI (-1.12, 0.09)), and aerobic exercise (SMD = -0.51, 95 % CI (-0.89, -0.13)) significantly decreased depression levels among individuals with cancer. Additionally, resistance training (SMD = -0.66, 95 % CI (-1.59, 0.27)), followed by aerobic exercise (SMD = -0.59, 95 % CI (-1.08, -0.10)), and mind-body exercise (SMD = -0.48, 95 % CI (-0.96, 0.00)) significantly decreased anxiety levels among individuals with cancer compared to usual care.

The findings of this network meta-analysis suggest that mind-body exercise, resistance training, and aerobic exercise are all effective interventions for reducing anxiety and depression among individuals with cancer.

Life's Crucial 9 (LC9) is a recently proposed cardiovascular health (CVH) scoring system that integrates psychological well-being with Life's Essential 8 (LE8). However, its prognostic value remains unclear. This study aims to investigate the association between LC9 and outcomes among cancer survivors.

A total of 2,558 cancer survivors from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 were included in this study. LC9, representing a dimension of psychological health, was calculated as the average of the LE8 score and the depression score. Cox proportional hazards regression, restricted cubic spline (RCS) analysis, subgroup analysis, and Kaplan-Meier survival curves were employed to evaluate the association between LC9 and mortality risk, with adjustments for potential confounders.

During an average follow-up period of 80 months, 640 deaths occurred, including 205 from cancer and 128 from cardiovascular disease. After adjusting for all covariates using Cox regression, a 10-point increase in the LC9 score was associated with a 24% reduction in all-cause mortality (HR: 0.76; 95% CI: 0.68-0.84), a 19% reduction in cancer-specific mortality (HR: 0.81; 95% CI: 0.68-0.97), and a 28% reduction in cardiovascular mortality (HR: 0.72; 95% CI: 0.58-0.90). Kaplan-Meier survival curves indicated lower rates of all-cause, cancer-specific, and cardiovascular mortality among participants with higher LC9 scores. RCS analysis revealed a linear inverse association between LC9 and all-cause and cancer-specific mortality and a nonlinear inverse association with cardiovascular mortality.

Among cancer survivors in the United States, higher LC9 scores were independently associated with lower risks of all-cause, cancer-specific, and cardiovascular mortality. This finding highlights the potential link between cardiovascular health and survival outcomes in cancer survivors, suggesting that improving cardiovascular health may serve as an important preventive strategy to enhance survival rates in this population.

To examine the comprehensive health impacts of exercise on people with cancer by systematically summarising existing evidence and assessing the strength and reliability of the associations.

Umbrella review of meta-analyses.

PubMed, Embase, Cochrane and Web of Science databases were searched from their inception to 23 July 2024.

Meta-analyses of randomised controlled trials that investigated the associations between exercise and health outcomes among people with cancer.

This umbrella review identified 485 associations from 80 articles, all evaluated as moderate to high quality using A Measurement Tool to Assess Systematic Reviews (AMSTAR). Two hundred and sixty (53.6%) associations were statistically significant (p<0.05), 81/485 (16.7%) were supported by high-certainty evidence according to the Grading of Recommendations Assessment, Development, and Evaluation criteria. Compared with usual care or no exercise, moderate- to high-certainty evidence supported the view that exercise significantly mitigates adverse events associated with cancer and its treatments (eg, cardiac toxicity, chemotherapy-induced peripheral neuropathy, cognitive impairment and dyspnoea). Exercise also modulates body composition and biomarkers (eg, insulin, insulin-like growth factor-1, insulin-like growth factor-binding protein-1 and C-reactive protein) in people with cancer, and enhances sleep quality, psychological well-being, physiological functioning and social interaction, while improving overall quality of life.

Exercise reduces adverse events and enhances well-being through a range of health outcomes in people with cancer.

Cancer- or chemotherapy-related cognitive deficit is a common side effect occurring in patients with Hodgkin lymphoma. No previous study compared the influence of different types of treatment on the onset and development of chemotherapy cognitive impairment in longitudinal design. The aim of this study was to assess whether a more intensive form of chemotherapy causes greater cognitive impairment.

Forty-four patients at three different stages of the disease and with three different treatments (ABVD + 30 Gy, BEACOPPesc, or ABVD + 30 Gy plus BEACOPPesc) completed the neuropsychological battery and psychological measures of affective distress and quality of life. We compared their cognitive performance before, immediately after, and 6 months after the treatment.

Whether or not we divided the total number of people with Hodgkin lymphoma into two groups (mild and moderate disease versus severe disease) or three groups (mild, moderate, and advanced disease), we found no statistically significant difference between the groups in cognitive performance or other psychological factors or experienced quality of life.

Our results did not show that disease stage or treatment protocol had an effect on the depth of cognitive impairment in cancer or chemotherapy. We hypothesize that, in terms of brain health, intensive forms of chemotherapy (6 × BEA-COPPesc) do not pose a greater risk than milder forms (4 × ABVD + 30 Gy IF RT and 2 × BEACOPPesc + 4 × ABVD + 30 Gy IF RT) of cancer treatment for Hodgkin lymphoma. However, a limitation of our study is the small number of participants in the study, so it would be advisable to repeat the study on a larger sample of patients. Confirmation of our results could be beneficial in that neither patients nor physicians need to worry that intensive chemotherapy will worsen cognitive deficits.

Patients with cancer suffering from comorbid symptoms of depression need a psychotherapeutic treatment that is specifically tailored to the exceptional context of acute or chronic cancer treatment. The conceptualization of depression in Interpersonal Psychotherapy (IPT) is a promising framework for symptoms of depression in patients with cancer, because it focuses on coping with stressful life events, managing change and accessing social support.

The intervention was developed based on standard practice of group IPT for depression and adapted to the oncology setting by an expert panel. The IPT intervention comprises 10 weekly sessions of 60 minutes each. It is structured into modules incorporating IPT core themes: role transitions, grief, connection and interpersonal conflict. This feasibility study with an integrated qualitative study seeks to ascertain feasibility and acceptability of a larger trial of modified group IPT for adult patients with cancer within the context of a university clinics' outpatient treatment. In addition, the study will enable first evidence of the intervention's efficacy in reducing symptoms of depression and anxiety, and changes in interpersonal factors such as loneliness, thwarted sense of belonging, perceived burdensomeness, and perceived social support. Post-intervention semi-structured interviews will be recorded for qualitative content analysis.

Our findings will suggest whether investigating group IPT as proposed is an acceptable, feasible and safe approach to ameliorate symptoms of depression in patients with cancer. The study is innovative in that it provides a new treatment to patients of different cancer types and treatment stages, creating a setting that is naturalistic and realistic in the context of psycho-oncology services.

ObjectiveTo evaluate psilocybin's efficacy in reducing depressive and anxiety symptoms in cancer patients based on randomized controlled trials (RCTs).MethodsThis systematic review and network meta-analysis (NMA) followed PRISMA and Cochrane Handbook guidelines. PubMed, Embase and Cochrane Library data up to July 2024 were analyzed. Two RCTs met the inclusion criteria. Changes in Beck Depression Inventory (BDI) and State-Trait Anxiety Inventory (STAI) scores were assessed on day 1 and 2-week follow-up. The risk of bias was evaluated with the Cochrane Risk of Bias Tool 2.0.ResultsPsilocybin significantly reduced BDI scores at day 1 post-administration (MD = -2.26; P = 0.01), though effects were not sustained at 2 weeks. STAI state scores showed substantial reductions at both day 1 (MD = -11.52; P < 0.001) and 2 weeks (MD = -12.66; P < 0.001). STAI trait scores also improved on both day 1 and day 14. The highest psilocybin dose (0.3 mg/kg) was the most effective, with SUCRA values of 87.81% (BDI), 91.58% (STAI state), and 94.2% (STAI trait).ConclusionsFindings suggest psilocybin may rapidly reduce depressive and anxiety symptoms in cancer patients, but methodological limitations, including the small number of trials, necessitate cautious interpretation. Larger, high-quality RCTs are needed to verify its clinical potential.

Although research has highlighted the link between anxiety and cancer, studies on the relationship between the two have produced inconsistent findings. Therefore, we investigated this relationship and also examined which types of cancer are more likely to induce anxiety.

This retrospective longitudinal cohort study, conducted in Taiwan from 2003 to 2016, looked at the risk of cancer in 23,255 patients with anxiety disorder and the risk of anxiety in 33,334 patients with cancer diagnosed between 2003 and 2005. For both analyses, a comparison cohort was created using 1:4 case-control sampling. Cox proportional hazard regression models were used to analyze factors related to anxiety disorder or cancer.

Patients with anxiety were more likely to develop cancer (adjusted hazard ratio [AHR] = 1.29; 95% confidence interval [CI]: 1.23-1.35) compared to those in the comparison group. Particularly high risks were observed for thyroid cancer (AHR: 2.13, CI: 1.60-2.82), skin cancer (AHR: 2.10, CI: 1.63-2.71), and prostate cancer (AHR: 1.97, CI: 1.59-2.47). Patients with cancer were more likely to develop anxiety than those without cancer (AHR: 1.63, 95% CI: 1.56-1.71), with particularly high risks observed in those with nose cancer (AHR: 3.12, 95% CI: 2.41-4.03), leukemia (AHR: 2.54, 95% CI: 1.63-3.96), thyroid cancer (AHR: 2.34, 95% CI: 1.84-2.97), and oral cancer (AHR: 2.04, 95% CI: 1.65-2.52).

Our findings highlight a bidirectional link between cancer and anxiety disorder. Understanding this two-way connection can help healthcare providers develop effective strategies for managing cancer and anxiety disorders.

This study sought to translate and validate the Fear of Progression Questionnaire-Short Form (FoP-Q-SF) for use in assessing the FoP among Turkish cancer patients.

A sample of 185 cancer patients who were undergoing active treatment at Ege University Oncology Clinic participated in this study. The FoP-Q-SF was translated into Turkish and its psychometric properties were assessed. The questionnaire's reliability was evaluated using Cronbach's alpha and McDonald's omega, while its validity was tested via confirmatory factor analysis (CFA) and correlation with established measures such as the Hospital Anxiety and Depression Scale (HADS) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30).

The FoP-Q-SF demonstrated high internal consistency (Cronbach's alpha = 0.89, McDonald's omega = 0.89) and a strong unidimensional structure based on CFA (CFI = 0.987, TLI = 0.984, RMSEA = 0.078, SRMR = 0.076). Significant correlations were found between the FoP-Q-SF scores and related anxiety measures, including the HADS-D, HADS-A and EORTC QLQ-C30 emotional and total scores (0.395-0.578, p < 0.01). The known-groups validity analysis revealed that the FoP-Q-SF scores were higher among female cancer patients (p < 0.001), which was consistent with the findings of previous studies, while no significant associations were observed with cancer patients' age, marital status, perceived income, educational status or psychiatric history.

The FoP-Q-SF is a valid and reliable tool for assessing the FoP among Turkish cancer patients, which renders it suitable for clinical and research applications in this population.

HER2-positive metastatic breast cancer continues to have a significant impact on patients' lives. The HERmione project was conducted in France to identify patients' needs for support and information, understand services offered, and identify differences in the perception of burden between patients and oncologists.

Between July and October 2022, 273 patients with HER2-positive metastatic breast cancer and 40 oncologists were surveyed. The mean age of patients was 52 years, with most receiving treatment at specialized cancer centers (38%) or other public hospitals (34%).

The survey revealed a substantial burden of the disease and treatment in patients, perceptions that differed from those of oncologists. Both the physical and mental well-being of the patients were below average. Despite the burden of the disease, patients lacked access to many types of support, particularly support with sexual well-being. Additionally, 60% of patients did not have access to nursing support. Patients had high expectations regarding access to information but often did not know where to access this information. Despite this, they still exhibited treatment preferences.

These findings suggest that enhanced communication is critical to ensure that patients receive adequate support. Nursing support could improve patient-oncologist communication and thereby enhance patient well-being. Finally, to meet patient expectations regarding information access, a broader array of support tools should be offered.

To evaluate incidence of mental health disorder (MHD) diagnosis after orchiectomy in testicular cancer patients and identify factors associated with MHD.

Using claims from the IBM Marketscan database, we identified patients 18 years or older diagnosed with testicular cancer between 2009 and 2021 who underwent orchiectomy, had no prior MHD diagnoses, and maintained insurance coverage spanning 6months before and 12months after diagnosis. Chemotherapy and RPLND were defined as advanced treatments. We identified insurance claims associated with diagnoses of MHD at 12 and 36months after orchiectomy. Factors predicting the cumulative incidence of MHD were analyzed using multivariable regression. Male patients with no lifetime cancer diagnosis and 4years of continuous insurance coverage were identified as controls and matched by demographics.

Of all 5881 patients, 507 (8.6%) and 909 (13.9%) had a new diagnosis of MHD within 12 and 36months of orchiectomy, respectively. The cumulative incidence of MHD was significantly different among cases and controls over 12months (9.2% vs 2.2%, P<.0001) and 36months (14.8% vs 7.3%, P<.0001). In the multivariable regression, factors associated with new diagnosis of MHD were younger age, more recent year of diagnosis, higher CCI, and receipt of advanced treatment.

Testicular cancer patients have a higher incidence of developing MHD compared to age-matched controls. Physicians should counsel patients prior to orchiectomy regarding the risk of developing MHD, understand factors associated with likelihood of MHD incidence, and refer patients to receive appropriate interventions as needed postoperatively.

Optimism and pessimism are stable, overarching dispositions that influence mental health, especially in stressful life situations, such as cancer survival. They have been associated with more specific coping strategies. This study sought to investigate a theoretically-based model of their interplay in shaping depressive and anxiety symptoms to inform prevention and intervention efforts.

The registry-based study included 689 survivors of malignant melanoma. We assessed sociodemographic and disease-related variables, optimism/pessimism (LOT-R), coping strategies (BC), depressive (PHQ-9), and anxiety symptoms (GAD-7). A structural equation model was conducted to analyse the hypothesized associations, modelling coping strategies (denial/self-blame, seeking external support, active coping) as mediators of the relationship of optimism/pessimism with depressive and anxiety symptoms. As a sensitivity analysis, gender-stratified models were tested.

The proposed model fit the data well. In the full sample, optimism was directly related to depression and anxiety, and the effects of optimism and pessimism were mediated via denial/self-blame. This indirect effect accounted for 60.8% of the total effect of pessimism on depression, and for 79.55% on anxiety. Stratified analyses showed different patterns of associations by gender, in the sense that the mediation effect was more relevant among men.

This study shows the relevance and need of gender-sensitive psychosocial-care. Especially in men, psychosocial interventions should target maladaptive coping strategies. Within women, fostering optimism seems to be particularly important. As the model did not fit as well for women, more gender-sensitive research is needed to understand potentially different risk/protective factors and needs of support.

The association of globulin and albumin-globulin ratio (AGR) with depression in cancer and non-cancer populations remains understudied. Therefore, this study aims to investigate this association and potential differences, with a focus on cancer-specific pathophysiology.

This study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted from 2005 to 2016. The participants were divided into three tertiles of globulin and AGR to explore more detailed associations. Logistic regression, restricted cubic spline (RCS) curves, and subgroup analyses were conducted to assess the associations. Finally, receiver operating characteristic (ROC) curves were applied to evaluate the predictive performance of globulin and AGR for depression.

After adjusting for covariates, higher globulin levels were significantly associated with an increased incidence of depression in cancer patients (OR=2.53, 95% CI: 1.69-3.80), while a higher AGR was associated with a reduced incidence (OR=0.28, 95% CI: 0.14-0.58). In the non-cancer group, a similar but weaker association was observed: higher globulin levels (OR=1.16, 95% CI: 1.00-1.35) and lower AGR (OR=0.80, 95% CI: 0.62-1.05) were associated with depression. Subgroup analyses suggested that the associations were more stable in cancer populations, while in non-cancer populations, these associations might be influenced by drinking. AUC values indicated that the biomarkers demonstrated good predictive performance.

This study identifies globulin and AGR as novel, cost-effective biomarkers that integrate inflammation and nutrition, providing a convenient and robust means to predict depression, particularly in cancer patients. These findings also offer new perspectives for future dual clinical interventions targeting inflammation and nutrition, as well as experimental research on depression.

To describe patients' expectations prior to participating in a yoga intervention during cancer treatment and assess whether the outcomes experienced post-intervention align with these prior expectations.

A qualitative design was used, including participants from a quasi-experimental medical yoga intervention. Structured interviews (n = 20 in the online group yoga and n = 20 participating in the on-site group yoga) were conducted prior to and after 3-months yoga intervention, and were analyzed using thematic analysis employing a codebook approach.

Two themes were generated; individual holistic benefits of yoga, and collective benefits of group yoga. Participants expected yoga to be helpful in unwinding, learning breathing techniques for relaxation, gaining physical strength, feeling more energetic, and improving body control. However, emotional and mental benefits were more commonly described than the physical benefits after participating in the yoga sessions. Participants valued the sense of belonging to a group and the opportunity to exchange experiences related to practicing yoga and to their cancer diagnoses, which were often fulfilled. Additionally, participants valued guidance from instructors during group yoga sessions.

This study adds to the growing body of evidence supporting yoga-whether on-site or online-as a valuable intervention for patients undergoing cancer treatment. While it may not fulfil all physical fitness expectations, its mental and emotional benefits (which were both expected and experienced), along with the sense of community it fosters, could make yoga a worthwhile mind and body intervention for these patients.

Background/objectives: Depression is a common complication of cancer and is associated with distress and reduced participation in medical care. The prevalence is still uncertain in advanced cancer due to methodological problems. Our aim was to study depression in the last year of life and related variables. Methods: We used an administrative database and analyzed clinically verified diagnoses of depression during the last year of life for 27,343 persons (nursing home residents excluded) and related the data to age, sex, socioeconomic status on an area level (Mosaic system), and frailty risk as calculated by the Hospital Frailty Risk Score (HFRS). T-tests, chi-2 tests, and binary logistic regression models were used. Results: During the last year of life, a clinical diagnosis of depression was found in 1168/27,343 (4.3%) cases and more frequently seen in women (4.8% vs. 3.8%, p = 0.001), in the elderly aged 80 years or more, p = 0.03, and especially in persons with a frailty risk according to the HFRS, with rates of 3.3%, 5.3% and 7.8% in the low-risk, intermediate and high-risk groups, respectively (p < 0.001), whereas no differences were found based on socioeconomic status. In a multiple logistic regression model, being female (aOR 1.30, 95% CI 1.16-1.46) or having an intermediate (1.66, 1.46-1.88) or high frailty risk (2.57, 2.10-3.14) retained the predictive value (p < 0.001, respectively). Conclusions: Depression is more common in women and, above all, in people with multimorbidity. Depression affects the amount of health care needed, including the need for psychiatric care. Therefore, it should be included in clinical decision-making, especially as depression is associated with poorer prognosis in cancer.

To explore pre-hematopoietic stem cell transplant (HSCT) demographic, disease, and psychological factors predictive of future transplant regret and to determine post-HSCT variables associated with regret.

HSCT candidates participated in a prospective cohort study (June 2008-October 2013) examining health behaviors and HSCT outcomes, including completion of standardized surveys at pre-HSCT (baseline) and 1-year post-HSCT. Cases were participants that endorsed regret at 1-year post-HSCT follow-up, and controls were participants without regret at 1 year, matched on age, sex, and transplant type. For cases and controls, pre-HSCT psychosocial evaluations were abstracted from the electronic health record and coded to determine the Psychosocial Assessment of Candidates for Transplantation score, psychosocial stressors, and mental health diagnoses. The association of selected factors with regret was estimated with odds ratios and 95% confidence intervals from conditional logistic regression models.

At post-HSCT, 49 participants of 638 endorsed transplant regret (8%) and formed the case group; 98 controls were matched from remaining participants. Cases and controls were well matched on age (56.6 vs. 57.2 years), sex (both groups 34.7% female), and transplant type (both groups 81.6% autologous). After controlling for the number of hospitalizations and active treatment status, conditional logistic regression revealed that patients who endorsed regret were 3.7 times (95% CI = 1.37-9.69, p = 0.008) more likely to not be in remission compared to controls at 1-year post-HSCT.

Matched case-control analyses revealed that no pre-HSCT variables collected during the pre-HSCT evaluation period were predictive of transplant regret, while poorer outcomes at 1-year after transplant were associated with regret.

Social support is a crucial protective factor against psychological concerns in patients with cancer. However, there is limited knowledge regarding the differential impacts of social support on cancer worries and depressive symptoms in patients undergoing genetic counseling for hereditary cancer. The current study utilized a high-volume database from a multi-site cancer genetics clinic to assess the impact of perceived social support on depressive symptoms and cancer worries among patients of different age groups (young versus older patients) and diagnosis status (diagnosed survivors versus undiagnosed).

6,666 patients completed brief assessments of depressive symptoms, cancer worries, social support, and demographic questionnaires as part of routine clinical care between October 2016 and October 2020. Logistics and moderated regression were used to analyze the relationships between social support, depressive symptoms, and cancer worries.

Increased social support was associated with fewer depressive symptoms and fewer cancer worries across all patients. Social support mitigated depressive symptoms most significantly for young adult patients with and without cancer. Social support mitigated cancer worries most significantly for young adults with cancer and older adults without cancer.

While results were mixed, general findings upheld original hypotheses. Social support buffered depressive symptoms and cancer worries differentially for patients of different ages and different disease status.

Social support groups are beneficial for all patients and should be emphasized by cancer clinics. However, increasing patient-tailored and age-appropriate support networks will be crucial for managing depression and cancer worries for high-risk survivors: young adults with cancer.

Violent, abusive, and harmful behavior enacted by older adults upon their caregivers represents a distressing and frequently disregarded facet within the domain of caregiving. This qualitative study aims to (a) explore family caregivers' experiences of violent, abusive, and harmful behavior by the older person and (b) explore how violent, abusive, and harmful behavior by the older person affects family caregivers' mental health. This qualitative study encompassed 393 participants, with a diverse age range spanning from 40 to 72 years. All the interviews went through the process of content analysis. For the first objective, findings indicated six emerging themes: Frequent and extreme verbal violence (77.3%); feeling manipulated and controlled by older adults (74.7%); experiencing unpredictable illegal circumstances provoked by older adults (62.1%); experiencing damaging financial issues provoked by older adults (43.1%); experiencing physical violence (34.2.%); and experiencing sexual violence (31.1%). The second objective highlighted four themes: depression and anxiety (89.9 %), anger (81.2%), feeling morally isolated (78.3%), and emotional outbursts (65.1%). Brazilian participants mainly experienced frequent and extreme verbal violence (62.4%). Moreover, depression and anxiety were mainly verbalized by English participants (84.3%). These findings underscore the significant toll that older individuals' violent, abusive, and harmful behavior can have on the mental well-being of family caregivers. This study sheds light on the complex experiences faced by family caregivers and emphasizes the urgent need for targeted interventions to foster healthier caregiving environments. Older individuals' violent, abusive, and harmful behavior toward their caregivers has received limited attention in research and public discourse. The findings of this study call attention to the pressing need of addressing this issue, given its detrimental impact on the mental health of family carers. Recognizing the significance of this topic demands a comprehensive and targeted approach to ensure the well-being and safety of caregivers and older adults.

Anxiety is highly prevalent among cancer patients, significantly impacting their prognosis. Current cancer therapies typically lack anxiolytic properties and may even exacerbate anxiety. Here, a gasotransmitter-nanodonors (GND) system is presented that exerts dual anxiolytic and anti-tumor effects via a "tumor-brain axis" strategy. The GND, synthesized by co-embedding Fe2⁺ and S2⁻ ions along with glucose oxidase (GOx) within bovine serum albumin (BSA) nanoparticles (FSG@AB), enables the controlled release of the gasotransmitter hydrogen sulfide (H₂S) in the acidic tumor microenvironment. H₂S and GOx synergistically deplete tumor energy sources, resulting in robust anti-tumor effects. Meanwhile, H₂S generated at the tumor site is transported through the bloodstream to the anterior cingulate cortex (ACC) in the brain, where it modulates neuronal activity. Specifically, in the ACC, H₂S upregulates glutamate transporter 1 (GLT-1), which reduces extracellular glutamate levels and attenuates the hyperactivity of glutamatergic neurons, thereby alleviating anxiety-like behavior. This study proposes a GND system that targets both oncological and psychiatric dimensions of cancer through the "tumor-brain axis" strategy, resulting in improved therapeutic outcomes.

To identify trajectories of depressive symptoms in older breast cancer survivors and demographic, psychosocial, physical health, and cancer-related predictors of these trajectories.

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.

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.

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.

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.

Patients facing the diagnosis of cancer are confronted with high stress levels, which increase the risk of developing a mental disorder. Being in a relationship moderates patients' mental health and can have a risk-reducing effect. We aim to describe the influence of partnership status on the 4-week-prevalence of mental disorders in cancer patients and how it varies by gender.

As part of the secondary data analysis of a multicenter cross-sectional study, 1857 patients with cancer (51,6% women, age 18-75 years, Ø age 57 years, 79,7% in a partnership) were assessed using a written questionnaire and, for the diagnosis of psychological disorders (4-week prevalence), the CIDI-O interview. Frequency calculations and binary logistic analyses were carried out.

In the univariate analyses, the frequency of the presence of at least one mental disorder is significantly lower in patients who are in a relationship (25,4% vs. 35,3%, p<0,001). They are also less likely to simultaneously suffer from multiple mental disorders. These differences are also evident for individual classes of disorders. The multivariate gender-differentiated analysis confirms this trend. In addition to age and income as significant predictors, only men experience a significant protective effect of their relationship against the occurrence of a mental disorder (OR=2,5, p<0,001).

There has been very limited research on the links between partnership status, gender, and mental disorders in cancer patients. The results found in our analyses should be further explored, particularly regarding the protective role of partnership against developing mental disorders.

In the context of psycho-oncological care the status of living alone should be considered as a possible risk factor for developing mental disorders, especially in men.

Anxiety disorders and/or depressive disorders co-occurring with hematological cancer are an additional burden for patients. Experiential avoidance (EA; efforts to avoid negative emotions, thoughts, or memories) is an empirically evident transdiagnostic factor for the onset and maintenance of anxiety and depressive disorders in non-cancer populations. There is lack of evidence on the impact of EA in predicting anxiety and depression in cancer patients. A total of 291 patients with hematological cancer (60% male, mean age 55 years) were included in this cross-sectional observational study. Participants were assessed using the Structured Clinical Interview for DSM-5 mental disorders (SCID-5). EA was assessed via self-report using the Brief Experiential Avoidance Questionnaire (BEAQ). Hierarchical binomial logistic regression was conducted in order to estimate the impact of EA on anxiety and depressive disorders. A total of 38 patients (13.3%) met the diagnostic criteria for a current anxiety disorder, while 49 patients (17.2%) met the criteria for a current depressive disorder. In bivariate analyses, EA was significantly elevated in patients with an anxiety disorder in comparison to those without (54.4 vs. 48.9; p = 0.01). The same was true for depressive disorder (54.9 vs. 48.6; p < 0.01). After controlling for relevant sociodemographic and medical factors, EA did not predict anxiety or depressive disorder in separate regression models. The presence of an anxiety disorder was significantly predicted by female sex, younger age and elevated comorbidity burden. In contrast, the presence of a depressive disorder was predicted by comorbidity burden. Sociodemographic and medical predictors have greater predictive potential than EA regarding current anxiety and depressive disorder in hematological cancer patients.

Delay in gastric cancer diagnosis is associated with inferior outcomes. The effects of pre-existing mental health disorders (MHDs) on delays in gastric cancer diagnosis and treatment disparities are not well-understood. In this study, we evaluated the impact of MHDs on time to gastric cancer diagnosis and receipt of guideline-concordant treatment.

We performed a retrospective review of patients diagnosed with gastric adenocarcinoma between 2015 and 2022. Patients with pre-existing diagnoses of mood, affective, and substance use disorders were classified as having an MHD. Univariable and multivariable regression were used to analyze the association between MHDs and delay in diagnosis. The association between MHD and receipt of guideline-concordant care was also evaluated.

Overall, 460 patients diagnosed with gastric cancer were included in the analytic group. Seventy patients (15%) had an MHD prior to their cancer diagnosis, of whom 34 (49%) experienced a delay in diagnosis, compared with 109 (28%) without an MHD. On multivariable regression, patients with an MHD were more likely to experience a delay in diagnosis (odds ratio [OR] 2.84, 95% confidence interval [CI] 1.58-5.11; p < 0.001) and have more than one visit to a provider prior to diagnosis (OR 2.71, 95% CI 1.37-5.37; p = 0.004). Patients with an MHD were also less likely to receive guideline-concordant care for their gastric cancer (OR 0.29, 95% CI 0.12-0.67; p = 0.004).

MHD is a patient-level factor that negatively impacts gastric cancer care. Addressing provider knowledge gaps and increasing efforts to counter the social stigma and implicit bias associated with MHD may improve the time to diagnosis and receipt of guideline-concordant care in this at-risk population.

Depression and diet are both common modifiable factors related to mortality rates among individuals with cancer, but their combined effects remained underexplored. We aimed to comprehensively evaluate the independent and joint association of depressive symptoms and dietary patterns with mortality among cancer survivors.

A cohort of US cancer survivors (3,011 eligible participants, representing 20 million cancer patients) were collected from the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018. Depressive symptoms were assessed with the Patient Health Questionnaire (PHQ-9). Based on dietary data from 24-hour recall, several well-developed dietary pattern indices were calculated, including Healthy Eating Index-2020 (HEI-2020), Alternative Healthy Eating Index (AHEI), Alternate Mediterranean Diet Score (aMED), MED Index in serving sizes from the PREDIMED trial (MEDI), Dietary Approaches to Stop Hypertension Index (DASH), DASH Index in serving sizes from the DASH trial (DASHI), Dietary Inflammation Index (DII), and DII excluding alcohol (DII [No EtOH]). Kaplan-Meier curves and multivariable Cox proportional hazards regression models were conducted to investigate the relationships of independent and combined prognostic effects of PHQ-9 score and dietary pattern indices with survival among cancer survivors.

In joint analysis, combinations of lower PHQ-9 score with higher HEI-2020, AHEI, aMED or DASH were favorably linked to lower risks of overall and noncancer mortality. Representatively, cancer survivors with no to minimal depressive symptoms (PHQ-9 score: 0-4) and high adherence to the HEI-2020 had lower risk of all-cause (HR = 0.43, 95% CI: 0.24-0.75) and noncancer (HR = 0.29, 95% CI: 0.15-0.55) mortality, when compared to those with PHQ-9 score ≥ 10 and low adherence to the HEI-2020. Additionally, a combination of higher adherence to the MEDI and lower PHQ-9 scores was linked to a reduced risk of noncancer mortality.

The joints of depressive symptoms and certain dietary patterns were associated with risks of all-cause, cancer-specific, and noncancer mortality among cancer survivors. Early psychological counseling and individualized dietary strategies are crucial to reduce mortality risk and improve quality of life for this population.