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Kuczmarski TM, Roemer L, Odejide OO. Depression in patients with hematologic malignancies: The current landscape and future directions. Blood Rev 2024; 65:101182. [PMID: 38402023 DOI: 10.1016/j.blre.2024.101182] [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: 12/29/2023] [Revised: 02/08/2024] [Accepted: 02/12/2024] [Indexed: 02/26/2024]
Abstract
Patients with hematologic malignancies experience high rates of depression. These patients are vulnerable to depression throughout the disease trajectory, from diagnosis to survivorship, and at the end of life. In addition to the distressing nature of depression, it has substantial downstream effects including poor quality of life, increased risk of treatment complications, and worse survival. Therefore, systematic screening for depression and integration of robust psychological interventions for affected patients is crucial. Although depression has been historically studied mostly in patients with solid malignancies, research focusing on patients with hematologic malignancies is growing. In this article, we describe what is known about depression in patients with hematologic malignancies, including its assessment, prevalence, risk factors, and implications. We also describe interventions to ameliorate depression in this population. Future research is needed to test effective and scalable interventions to reduce the burden of depression among patients with blood cancers.
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Affiliation(s)
| | - Lizabeth Roemer
- Department of Psychology, University of Massachusetts Boston, USA
| | - Oreofe O Odejide
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, USA; Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, USA.
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2
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Gulbrandsen MS, Nøding AS, Smeland KB, Eikeland SA, Kiserud CE, Hjermstad MJ, Fosså A. Health-related quality of life, depressive symptoms, and chronic fatigue in long-term survivors of Hodgkin lymphoma. Leuk Lymphoma 2023:1-12. [PMID: 37144290 DOI: 10.1080/10428194.2023.2198053] [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: 05/06/2023]
Abstract
High-dose chemotherapy with autologous stem cell transplantation (HDT-ASCT) is the preferred treatment option in relapsed or refractory Hodgkin lymphoma (HL). We analyzed the association between treatment intensity and health-related quality of life (HRQoL), depressive symptoms, and chronic fatigue (CF) in long-term survivors of HL (HLS), identified in two population-based national cross-sectional studies on late adverse effects. We included 375 HLS treated between 1987 and 2006, 264 with conventional therapy only, and 111 with HDT-ASCT. Despite similar differences to the matched general population, when controlling for other imbalances between the groups, use of HDT-ASCT was not associated with poorer outcome in multivariable analysis. However, work participation, family income, comorbidities, and lifestyle factors had stronger associations with aspects of HRQoL, depressive symptoms, and CF. Our data suggest that better rehabilitation to work participation and adequate income as well as follow-up for comorbidities may reduce differences in long-term outcome after treatment for HL.
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Affiliation(s)
| | - Ane S Nøding
- Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Knut B Smeland
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Siri A Eikeland
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Cecilie E Kiserud
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- National Advisory Unit on Late Effects after Cancer Treatment, Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Marianne J Hjermstad
- Regional Advisory Unit for Palliative Care, Department of Oncology, Oslo University Hospital, Oslo, Norway
- European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital, Oslo, Norway
| | - Alexander Fosså
- Department of Oncology, Oslo University Hospital, Oslo, Norway
- EuKG Jebsen Centre for B-cell malignancies, University of Oslo, Oslo, Norway
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Øvlisen AK, Jakobsen LH, Kragholm KH, Nielsen RE, Nully Brown P, Dahl‐Sørensen RB, Frederiksen H, Mannering N, Josefsson PL, Ludvigsen Al‐Mashhadi A, Jørgensen JM, Dessau‐Arp A, Clausen MR, Pedersen RS, Torp‐Pedersen C, Severinsen MT, El‐Galaly TC. Mental health among patients with non-Hodgkin lymphoma: A Danish nationwide study of psychotropic drug use in 8750 patients and 43 750 matched comparators. Am J Hematol 2022; 97:749-761. [PMID: 35298039 PMCID: PMC9310853 DOI: 10.1002/ajh.26538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/21/2022] [Accepted: 03/07/2022] [Indexed: 11/12/2022]
Abstract
Psychological distress following cancer diagnosis may lead to mental health complications including depression and anxiety. Non-Hodgkin lymphomas (NHLs) include indolent and aggressive subtypes for which treatment and prognosis differ widely. Incident use of psychotropic drugs (PDs-antidepressants, antipsychotics, and anxiolytics) and its correlation to lymphoma types can give insights into the psychological distress these patients endure. In this prospective matched cohort study, we used nationwide population-based registries to investigate the cumulative risk of PD use in NHL patients compared to a sex- and age-matched cohort from the Danish background population. In addition, contact patterns to psychiatric departments and incident intentional self-harm or completed suicide were explored. In total, 8750 NHL patients and 43 750 matched comparators were included (median age 68; male:female ratio 1.6). Median follow-up was 7.1 years. Two-year cumulative risk of PD use was higher in NHL patients (16.4%) as compared to the matched comparators (5.1%, p < .01); patients with aggressive NHL subtypes had the highest incidence. Prescription rates were higher in the first years after diagnosis but approached the rate of the matched population 5 years into survivorship in aggressive NHLs, whereas patients with indolent subtypes continued to be at higher risk. NHL patients had a slightly higher two-year risk of suicide/intentional self-harm (0.3%) as compared to the matched comparators (0.2%, p = .01). These results demonstrate that mental health complications among NHL patients are frequent. Routine assessment for symptoms of depression and anxiety should be consider as part of standard follow-up of NHL patients.
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Affiliation(s)
- Andreas Kiesbye Øvlisen
- Department of Hematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
| | - Lasse Hjort Jakobsen
- Department of Hematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
| | - Kristian Hay Kragholm
- Unit of Epidemiology and Biostatistics Aalborg University Hospital Aalborg Denmark
- Department of Cardiology Aalborg University Hospital Aalborg Denmark
| | - René Ernst Nielsen
- Department of Clinical Medicine Aalborg University Aalborg Denmark
- Department of Psychiatry Aalborg University Hospital Aalborg Denmark
| | - Peter Nully Brown
- Department of Hematology, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
| | | | | | | | | | | | | | | | | | | | - Christian Torp‐Pedersen
- Unit of Epidemiology and Biostatistics Aalborg University Hospital Aalborg Denmark
- Department of Cardiology and Clinical Research Nordsjællands Hospital Hillerød Denmark
| | - Marianne Tang Severinsen
- Department of Hematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
- Clinical Cancer Research Unit Aalborg University Hospital Aalborg Denmark
| | - Tarec Christoffer El‐Galaly
- Department of Hematology Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
- Clinical Cancer Research Unit Aalborg University Hospital Aalborg Denmark
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Agostinelli G, Muzzatti B, Serpentini S, Spina M, Annunziata MA. Cancer-Related Psychological Distress in Lymphoma Survivor: An Italian Cross-Sectional Study. Front Psychol 2022; 13:872329. [PMID: 35558708 PMCID: PMC9088809 DOI: 10.3389/fpsyg.2022.872329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/18/2022] [Indexed: 11/16/2022] Open
Abstract
Cancer is becoming a chronic disease, and the number of cancer survivors continues to increase. Lymphoma survivors are also increasing in numbers, and anxiety and depression are among the consequences they face. This study aimed to explore psychological distress in a sample of 212 lymphoma survivors. Information through a socio-demographic form and the compilation of questionnaires to assess anxiety, depression, quality of life, and the impact of cancer on lymphoma survivors was collected and analyzed. In the sample examined, 17% of lymphoma survivors were anxiety caseness, and 12.3% were depression caseness, and of these, 8% presented with concomitant anxiety depression. This study identified some variables associated with psychological distress in lymphoma survivors: female sex; living as a couple; a diagnosis of Hodgkin lymphoma; systematic treatment and/or radiotherapy; sleep disorders; no regular physical activity; and present or past use of psychiatric drugs. Our cross-sectional study results suggest that some of the variables investigated may be useful in identifying lymphoma survivors who are more likely to report psychological distress. It is important to monitor psychological distress along the entire trajectory of survivorship in order to identify early the presence of anxiety and depression and to provide timely psychological support.
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Affiliation(s)
- Giulia Agostinelli
- Unit of Oncological Psychology - Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | - Barbara Muzzatti
- Unit of Oncological Psychology - Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
| | | | - Michele Spina
- Unit of Oncological Medicine - Centro di Riferimento Oncologico di Aviano (CRO), IRCCS, Aviano, Italy
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Jensen O, Øvlisen AK, Jakobsen LH, Roug AS, Nielsen RE, Marcher CW, Ebbesen LH, Theilgaard-Mönch K, Møller P, Schöllkopf C, Torp-Pedersen C, El-Galaly TC, Severinsen MT. Psychotropic Drug Use in Acute Myeloid Leukaemia (AML) and Myelodysplastic Syndrome (MDS): A Danish Nationwide Matched Cohort Study of 2404 AML and 1307 MDS Patients. Clin Epidemiol 2022; 14:225-237. [PMID: 35241936 PMCID: PMC8887140 DOI: 10.2147/clep.s336115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 12/25/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction The diagnosis of a life-threatening disease can lead to depression and anxiety resulting in pharmacological treatment. However, use of psychotropic drugs (antidepressants, anxiolytics, and antipsychotics) in acute myeloid leukaemia (AML) and myelodysplastic syndrome (MDS) is undetermined. Methods Prescription of psychotropic drugs in Danish AML and MDS patients was compared to a cohort matched on age, sex, and country of origin from the Danish background population using national population-based registries. Results In total, 2404 AML patients (median age 69 years) and 1307 MDS patients (median age 75 years) were included and each matched to five comparators from the background population. Two-year cumulative incidences showed that AML (20.6%) and MDS (21.2%) patients had a high risk of redemption of a psychotropic drug prescription compared to the background population (7.0% and 7.9%). High age, low educational level, and Charlson Comorbidity Index score ≥1 was associated with a higher risk in AML and MDS patients. Furthermore, non-curative treatment intent and performance status in AML patients, and high risk MDS were associated with elevated risk of psychotropic drug prescription. Conclusion In conclusion, diagnoses of AML and MDS were associated with a higher rate of psychotropic drugs prescription compared to the background population.
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Affiliation(s)
- Oda Jensen
- Department of Haematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Andreas Kiesbye Øvlisen
- Department of Haematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Lasse Hjort Jakobsen
- Department of Haematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Anne Stidsholt Roug
- Department of Haematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - René Ernst Nielsen
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark
| | | | | | | | - Peter Møller
- Department of Haematology, Roskilde Sygehus, Roskilde, Denmark
| | | | - Christian Torp-Pedersen
- Unit of Clinical Biostatistics and Epidemiology, Aalborg University Hospital, Aalborg, Denmark
- Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark
| | - Tarec Christoffer El-Galaly
- Department of Haematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Marianne Tang Severinsen
- Department of Haematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Correspondence: Marianne Tang Severinsen, Department of Haematology, Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark, Email
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Patients in complete remission after R-CHOP(-like) therapy for diffuse large B-cell lymphoma have limited excess use of health care services in Denmark. Blood Cancer J 2022; 12:16. [PMID: 35087026 PMCID: PMC8795387 DOI: 10.1038/s41408-022-00614-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/07/2022] [Accepted: 01/13/2022] [Indexed: 11/12/2022] Open
Abstract
For most patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL), R-CHOP immunochemotherapy leads to complete remission and 60-70% of patients remain progression-free after 5 years. Given a median age of 65, it is relevant to disentangle how DLBCL and DLBCL therapy influence health care use among the survivors. In this nationwide study, the health care use among Danish DLBCL patients diagnosed in 2007-2015, who achieved complete remission after R-CHOP(-like) therapy, was explored and compared to matched comparators from the Danish general population. The post-remission 5-year risk of hospitalization was significantly higher among DLBCL survivors (55%) compared to matched comparators (49%, P < 0.001). DLBCL survivors had on average 10.3 (9.3-11.3) inpatient bed days within 5 years of response evaluation, whereas matched comparators had 8.4 (7.9-8.8). The rate of outpatient visits was also significantly higher(excluding routine follow-up visits, incidence rate ratio, 1.3, P < 0.001), but translated into only a very small absolute difference of <1 outpatient visits within 5 years between DLBCL survivors (4.2 visits, 95% CI, 4.0-4.4) and matched comparators (3.8 visits, 95% CI, 3.7-3.9). In conclusion, DLBCL survivors have an increased incidence of hospital visits due to a wide range of conditions, but in absolute terms the excess use of health care services in DLBCL survivors was small.
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Burden of depression and anxiety disorders per disease codes in patients with lymphoma in Germany. Support Care Cancer 2021; 30:2387-2395. [PMID: 34761297 PMCID: PMC8795002 DOI: 10.1007/s00520-021-06677-w] [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: 08/25/2021] [Accepted: 11/02/2021] [Indexed: 11/06/2022]
Abstract
Purpose The aim of this study was to explore the incidence of depression and anxiety disorder diagnoses in a large German cohort of patients with Hodgkin lymphoma (HL) and non-Hodgkin lymphoma (NHL) diagnoses in comparison to patients without cancer over a 10-year time frame. Methods Patients with HL (n=687) and NHL (n=4130) were matched to cohorts without a cancer diagnosis (n=687 and 4130) by age, sex, and yearly consultation frequency. The primary outcome of the study was the incidence of depression and anxiety disorders. The relationship between lymphoma, separated into HL and NHL, and both depression and anxiety disorders was investigated using Cox regression models. Results We compared 687 patients with HL with 687 matched non-cancer individuals and 4130 patients with NHL with 4130 matched non-cancer individuals. Within 10 years of the index date, 24.0% of patients with HL and 22.3% of patients with NHL were diagnosed with depression. Anxiety disorders were diagnosed in 6.7% and 5.3% of patients with HL and NHL, respectively. On regression analyses, HL (HR 2.30, 95% CI 1.65–3.21, p<0.001) and NHL (HR 2.09, 95% CI 1.81–2.41, p<0.001) were positively associated with incident depression. The HR for anxiety disorders was 1.64 (95% CI 1.24–2.16, p<0.001) in patients with NHL, while HL was not associated with incident anxiety disorders (HR 1.21, 95% CI 0.71–2.07, p<0.478). Conclusion Lymphoma constitutes a risk factor for emerging depression and anxiety disorders. Following the diagnosis of lymphoma, screening and strategies to prevent the occurrence of these diseases seem warranted.
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Sommer M, Nielsen LK, Nielsen LB, Brøndum RF, Nielsen MM, Rytter AS, Vesteghem C, Severinsen MT, El-Galaly TC, Bøgsted M, Grønkjær M, Jørgensen L. Patient-reported outcomes in patients with hematological relapse or progressive disease: a longitudinal observational study. Health Qual Life Outcomes 2021; 19:251. [PMID: 34736479 PMCID: PMC8567661 DOI: 10.1186/s12955-021-01887-6] [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: 06/07/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022] Open
Abstract
Background Patients with hematological cancer who experience relapse or progressive disease often face yet another line of treatment and continued mortality risk that could increase their physical and emotional trauma and worsen their health-related quality of life. Healthcare professionals who use patient-reported outcomes to identify who will have specific sensitivities in particular health-related quality of life domains may be able to individualize and target treatment and supportive care, both features of precision medicine. Here, in a cohort of patients with relapsed or progressive hematological cancer, we sought to identify health-related quality of life domains in which they experienced deterioration after relapse treatment and to investigate health-related quality of life patterns.
Method Patients were recruited in connection with a precision medicine study at the Department of Hematology, Aalborg University Hospital. They completed the European Organization for Research and Treatment of Cancer questionnaire and the Hospital Anxiety and Depression Scale at baseline and at 3, 6, 9, and 12 months after the relapse diagnosis or progressive cancer. Modes of completion were electronically or on paper. Clinically relevant changes from baseline to 12 months were interpreted according to Cocks’ guidelines. We quantified the number of patients with moderate or severe symptoms and functional problems and the number who experienced improvements or deterioration from baseline to 12 months. Results A total of 104 patients were included, of whom 90 (87%) completed baseline questionnaires and 50 (56%) completed the 12-month assessments. The three symptoms that patients most often reported as deteriorating were fatigue (18%), insomnia (18%), and diarrhea (18%). The three functions that patients most often reported as deteriorating were role (16%) and emotional (16%) and cognitive (16%) functioning. Conclusion In this study, patient-reported outcome data were useful for identifying negatively affected health-related quality of life domains in patients with relapsed or progressive hematological cancer. We identified patients experiencing deterioration in health-related quality of life during treatment and characterized a potential role for patient-reported outcomes in precision medicine to target treatment and supportive care in this patient group. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01887-6.
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Affiliation(s)
- Mia Sommer
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark. .,Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark. .,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark. .,Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark. .,University College Northern Denmark, Aalborg, Denmark.
| | - Lene Kongsgaard Nielsen
- Quality of Life Research Centre, Department of Hematology, Odense University Hospital, Odense, Denmark.,Department of Internal Medicine and Cardiology, Regional Hospital Viborg, Viborg, Denmark
| | | | - Rasmus Froberg Brøndum
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | | | | | - Charles Vesteghem
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Marianne Tang Severinsen
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Tarec Christoffer El-Galaly
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Martin Bøgsted
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Mette Grønkjær
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Lone Jørgensen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinic for Surgery and Cancer Treatment, Aalborg University Hospital, Aalborg, Denmark
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Rogowski A, Krowicka-Wasyl M, Chotkowska E, Kluz T, Wróbel A, Berent D, Mierzejewski P, Sienkiewicz-Jarosz H, Wichniak A, Wojnar M, Samochowiec J, Kilis-Pstrusinska K, Bienkowski P. Psychiatric History and Overactive Bladder Symptom Severity in Ambulatory Urogynecological Patients. J Clin Med 2021; 10:jcm10173988. [PMID: 34501436 PMCID: PMC8432447 DOI: 10.3390/jcm10173988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 08/27/2021] [Accepted: 08/31/2021] [Indexed: 12/05/2022] Open
Abstract
Introduction and hypothesis: A link between psychiatric comorbidities and overactive bladder symptomatology has been suggested by preclinical and clinical studies. Given this, we hypothesized that a psychiatric history and current treatment with psychotropic medications could be related to the severity of overactive bladder and incontinence symptoms in patients referred to a tertiary care urogynecological center. Methods: One hundred and twenty-seven female patients diagnosed with an overactive bladder were screened for a lifetime history of psychiatric disorders and the type and number of psychotropic medications currently taken. The overall severity of overactive bladder symptoms was assessed using the Indevus Urgency Severity Scale. The severity and impact of urinary incontinence on the quality of life were quantified with the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form. Urinary incontinence was further quantified with the aid of the Urinary Distress Inventory-6. The patients were screened for stress urinary incontinence using the Stamey Incontinence Score. Results: A psychiatric history, as well as current use of at least two psychotropic medications, was associated with increased severity of overactive bladder symptoms. A history of depression and current treatment with any selective serotonin reuptake inhibitor was associated with increased severity of stress urinary incontinence symptoms. Current treatment with other psychotropic medications, including sedative-hypnotics and drugs with anticholinergic properties was not related to the severity of overactive bladder and incontinence symptoms.
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Affiliation(s)
- Artur Rogowski
- Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warsaw, Poland
- Department of Obstetrics and Gynecology, Mother and Child Institute, 01-211 Warsaw, Poland; (M.K.-W.); (E.C.)
- Correspondence: ; Tel.: +48-604-060-090
| | - Maria Krowicka-Wasyl
- Department of Obstetrics and Gynecology, Mother and Child Institute, 01-211 Warsaw, Poland; (M.K.-W.); (E.C.)
| | - Ewa Chotkowska
- Department of Obstetrics and Gynecology, Mother and Child Institute, 01-211 Warsaw, Poland; (M.K.-W.); (E.C.)
| | - Tomasz Kluz
- Department of Gynecology and Obstetrics, Institute of Medical Sciences, Medical College of Rzeszow University, 35-310 Rzeszów, Poland;
| | - Andrzej Wróbel
- Second Department of Gynecology, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland;
| | - Dominika Berent
- Regional Psychiatric Hospital Drewnica, 05-091 Zabki, Poland;
| | - Paweł Mierzejewski
- Departments of Pharmacology, Institute of Psychiatry and Neurology, 02-957 Warsaw, Poland;
| | | | - Adam Wichniak
- Department of Psychiatry III, Institute of Psychiatry and Neurology, 02-957 Warsaw, Poland;
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.W.); (P.B.)
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, 70-111 Szczecin, Poland;
| | | | - Przemyslaw Bienkowski
- Department of Psychiatry, Medical University of Warsaw, 02-091 Warsaw, Poland; (M.W.); (P.B.)
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10
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El-Galaly TC, Øvlisen AK, Cheah CY. Routine imaging for disease surveillance in follicular lymphoma-To comfort the patients or their doctors? Cancer 2021; 127:3298-3301. [PMID: 34157785 DOI: 10.1002/cncr.33659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 04/07/2021] [Accepted: 05/01/2021] [Indexed: 11/08/2022]
Affiliation(s)
- Tarec Christoffer El-Galaly
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Andreas Kiesbye Øvlisen
- Department of Hematology, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Chan Yoon Cheah
- Department of Hematology, Sir Gairdner Hospital, Perth, Western Australia, Australia.,Medical School, University of Western Australia, Perth, Western Australia, Australia
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11
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Akechi T, Mishiro I, Fujimoto S, Murase K. Risk of major depressive disorder in Japanese cancer patients: A matched cohort study using employer-based health insurance claims data. Psychooncology 2020; 29:1686-1694. [PMID: 32779276 PMCID: PMC7589376 DOI: 10.1002/pon.5509] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 07/02/2020] [Accepted: 08/03/2020] [Indexed: 01/17/2023]
Abstract
Objective Patients with cancer are at high risk of depression. However, the risk of major depressive disorder (MDD) after cancer diagnosis has not been studied in a population setting in Japan. This cohort study used a Japanese medical claims database to examine time to MDD in cancer patients and the risk of MDD (hazard ratio; HR) compared with matched cancer‐free controls. Methods Primary endpoint was time to MDD (starting 6 months before cancer diagnosis) in adult (18–74 years) cancer patients; secondary endpoint was time to MDD (6 months before to 12 months after cancer diagnosis) in a matched cohort of cancer patients and cancer‐free controls. Multivariate analyses were performed to determine HRs for all cancers and for each cancer site. Results Of 35 008 cancer patients (mean age, 53.3 years), 2201 (6.3%) were diagnosed with MDD within 66 months. Matched cancer patients (n = 30 372) had an elevated risk of MDD compared with cancer‐free controls (n = 303 720; HR [95% confidence interval] 2.96 [2.77–3.16]). MDD risk was highest in patients with multiple cancers, pancreatic cancer, and brain cancer. Compared with middle‐aged patients, risk was higher in patients <40 years old and lower in patients ≥65 years old; risk tended to be higher in women than in men. Conclusions Compared with cancer‐free individuals, Japanese patients with cancer, mostly <65 years old, had an almost threefold higher risk of developing MDD within 12 months of cancer diagnosis. Physicians should watch for MDD in cancer patients and treat when necessary.
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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
| | - Katsuhito Murase
- Japan Medical Office, Takeda Pharmaceutical Company Limited, Tokyo, Japan
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12
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Øvlisen AK, Jakobsen LH, Kragholm KH, Nielsen RE, Hutchings M, Dahl‐Sørensen RB, Frederiksen H, Stoltenberg D, Bøgsted M, Østgård LSG, Severinsen MT, El‐Galaly TC. Depression and anxiety in Hodgkin lymphoma patients: A Danish nationwide cohort study of 945 patients. Cancer Med 2020; 9:4395-4404. [PMID: 32301251 PMCID: PMC7300408 DOI: 10.1002/cam4.2981] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 12/15/2022] Open
Abstract
Cancer-related psychological distress may lead to depression and anxiety among survivors. The vast majority of patients with Hodgkin lymphoma (HL) become long-term survivors, but the risk of mental health problems after HL is not well-characterized. Using national population-based registries, we investigated the cumulative incidence of psychotropic drug (antidepressants, antipsychotics, and anxiolytics) use (proxies for depression and anxiety) in HL patients as well as if an increased risk would normalize over time for patients in remission. The study included 945 HL patients aged 18-92 years and 4725 matched persons. In total, 215 HL patients (22.8%) received a prescription of any psychotropic drug (PD) at some point after date of diagnosis compared to 545 persons (11.5%) in the matched cohort. Cumulative incidences with death/relapse as competing risk confirmed that HL patients were at higher risk of receiving psychotropic drug prescriptions, but the increased risk was transient and normalized to the matched population 5 years into survivorship. Increased age, Eastern Cooperative Oncology Group performance status, and disease stage were associated with higher risk of psychotropic drug prescriptions. Given the increased rate of psychotropic drug prescriptions after HL diagnosis, screening for symptoms of depression and anxiety is warranted after HL diagnosis and first years into survivorship.
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Affiliation(s)
- Andreas K. Øvlisen
- Department of HaematologyAalborg University HospitalAalborgDenmark
- Department of Clinical MedicineAalborg UniversityAalborgDenmark
| | - Lasse H. Jakobsen
- Department of HaematologyAalborg University HospitalAalborgDenmark
- Department of Clinical MedicineAalborg UniversityAalborgDenmark
| | - Kristian H. Kragholm
- Department of CardiologyUnit of Epidemiology and BiostatisticsAalborg University HospitalAalborgDenmark
| | - René E. Nielsen
- Department of Clinical MedicineAalborg UniversityAalborgDenmark
- Department of PsychiatryAalborg University HospitalAalborgDenmark
| | - Martin Hutchings
- Department of HaematologyRigshospitaletCopenhagen University HospitalCopenhagenDenmark
| | | | | | - Danny Stoltenberg
- Department of HaematologyCopenhagen University HospitalHerlevDenmark
| | - Martin Bøgsted
- Department of HaematologyAalborg University HospitalAalborgDenmark
- Department of Clinical MedicineAalborg UniversityAalborgDenmark
| | | | - Marianne T. Severinsen
- Department of HaematologyAalborg University HospitalAalborgDenmark
- Department of Clinical MedicineAalborg UniversityAalborgDenmark
- Clinical Cancer Research UnitAalborg University HospitalAalborgDenmark
| | - Tarec C. El‐Galaly
- Department of HaematologyAalborg University HospitalAalborgDenmark
- Department of Clinical MedicineAalborg UniversityAalborgDenmark
- Clinical Cancer Research UnitAalborg University HospitalAalborgDenmark
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