Hendi M, Zhang B, Lv JM, Cai XJ. Factors influencing anxiety and depression in advanced hepatocellular carcinoma patients and their impact on quality of life. World J Psychiatry 2025; 15(5): 104995 [DOI: 10.5498/wjp.v15.i5.104995]
Corresponding Author of This Article
Xiu-Jun Cai, FACS, FRCS, MD, PhD, Professor, Department of General Surgery, Zhejiang University School of Medicine, Sir Run Run Shaw Hospital, No. 3 East Qingchun Road, Hangzhou 310016, Zhejiang Province, China. srrs_cxj@163.com
Research Domain of This Article
Psychiatry
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatry. May 19, 2025; 15(5): 104995 Published online May 19, 2025. doi: 10.5498/wjp.v15.i5.104995
Factors influencing anxiety and depression in advanced hepatocellular carcinoma patients and their impact on quality of life
Maher Hendi, Bin Zhang, Jie-Min Lv, Xiu-Jun Cai
Maher Hendi, Bin Zhang, Jie-Min Lv, Xiu-Jun Cai, Department of General Surgery, Zhejiang University School of Medicine, Sir Run Run Shaw Hospital, Hangzhou 310016, Zhejiang Province, China
Author contributions: Hendi M and Cai XJ drafted the manuscript and gave final approval of the version to be published; Hendi M, Zhang B, Lv JM, and Cai XJ designed this study, collected and analyzed the data; and all authors thoroughly reviewed and endorsed the final manuscript.
Institutional review board statement: This study was approved by the ethic institutional review board of the Zhejiang University School of Medicine, Sir Run Run Shaw Hospital, approval No. 2024-013-01.
Informed consent statement: The informed consent was waived by the ethic institutional review board of the Zhejiang University School of Medicine, Sir Run Run Shaw Hospital.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: All the data were generated and analyzed by the authors, and further inquiries can be directed to the corresponding author.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xiu-Jun Cai, FACS, FRCS, MD, PhD, Professor, Department of General Surgery, Zhejiang University School of Medicine, Sir Run Run Shaw Hospital, No. 3 East Qingchun Road, Hangzhou 310016, Zhejiang Province, China. srrs_cxj@163.com
Received: January 10, 2025 Revised: February 19, 2025 Accepted: April 8, 2025 Published online: May 19, 2025 Processing time: 110 Days and 1 Hours
Abstract
BACKGROUND
Patients with middle and advanced hepatocellular carcinoma (HCC) frequently experience significant anxiety and depression, severely affecting their quality of life.
AIM
To examine the anxiety and depression status of patients with middle and advanced HCC, the influencing factors, and the correlation between these psychological factors and quality of life.
METHODS
We collected baseline data from 100 patients with HCC, assessing anxiety and depression levels using the Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD). Quality of life was evaluated with the Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire. Multivariate logistic regression analyzed clinical and psychosocial factors affecting anxiety and depression, while Pearson correlation assessed relationships among HAMA, HAMD, and Functional Assessment of Cancer Therapy-Hepatobiliary Questionnaire scores.
RESULTS
Results indicated that 64% of patients exhibited anxiety and 65% showed depression symptoms. Key influencing factors included Barcelona Clinic Liver Cancer C stage, multiple tumors, social support, prior treatments (such as liver resection and transcatheter arterial chemoembolization/hepatic artery infusion chemotherapy), as well as HAMA and HAMD scores. Anxiety and depression correlated negatively with quality of life, with coefficients of -0.671 and -0.575 for HAMA and HAMD, respectively.
CONCLUSION
Anxiety and depression are prevalent among patients with middle and advanced HCC, impacting quality of life. This underscores the need for psychological health considerations in liver cancer treatment and establishing psychological interventions is essential.
Core Tip: Patients middle and advanced hepatocellular carcinoma (HCC) often experience significant anxiety and depression, which may severely affect their quality of life. This study assessed the anxiety and depression status of patients middle and advanced HCC and their influencing factors, analyzing the correlation between these psychological factors and quality of life. According to the results, a large number of advanced HCC patients suffer from depression and anxiety, which are negatively associated with social support and a high quality of life. Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale scores, prior liver resection, Barcelona Clinic Liver Cancer C stage, and multiple tumors are risk factors for depression in advanced HCC patients. Meanwhile, Karnofsky performance scores are negatively correlated with anxiety, and independent risk factors for anxiety include age over 60, a history of alcohol consumption, Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale scores, prior liver resection, Barcelona Clinic Liver Cancer C stage, and multiple tumors. Anxiety and depression scores in liver cancer patients are negatively correlated with quality of life.
