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Jimenez-Labaig P, Aymerich C, Braña I, Rullan A, Cacicedo J, González-Torres MÁ, Harrington KJ, Catalan A. A comprehensive examination of mental health in patients with head and neck cancer: systematic review and meta-analysis. JNCI Cancer Spectr 2024; 8:pkae031. [PMID: 38702757 PMCID: PMC11149920 DOI: 10.1093/jncics/pkae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/04/2024] [Accepted: 04/18/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Patients with head and neck cancer present particularly considerable levels of emotional distress. However, the actual rates of clinically relevant mental health symptoms and disorders among this population remain unknown. METHODS A Preferred Reporting Items for Systematic Review and Meta-Analyses and Meta-analyses of Observational Studies in Epidemiology-compliant systematic review and quantitative random-effects meta-analysis was performed to determine suicide incidence and the prevalence of depression, anxiety, distress, posttraumatic stress, and insomnia in this population. MEDLINE, Web of Science, Cochrane Central Register, KCI Korean Journal database, SciELO, Russian Science Citation Index, and Ovid-PsycINFO databases were searched from database inception to August 1, 2023 (PROSPERO: CRD42023441432). Subgroup analyses and meta-regressions were performed to investigate the effect of clinical, therapeutical, and methodological factors. RESULTS A total of 208 studies (n = 654 413; median age = 60.7 years; 25.5% women) were identified. Among the patients, 19.5% reported depressive symptoms (95% confidence interval [CI] = 17% to 21%), 17.8% anxiety symptoms (95% CI = 14% to 21%), 34.3% distress (95% CI = 29% to 39%), 17.7% posttraumatic symptoms (95% CI = 6% to 41%), and 43.8% insomnia symptoms (95% CI = 35% to 52%). Diagnostic criteria assessments revealed lower prevalence of disorders: 10.3% depression (95% CI = 7% to 13%), 5.6% anxiety (95% CI = 2% to 10%), 9.6% insomnia (95% CI = 1% to 40%), and 1% posttraumatic stress (95% CI = 0% to 84.5%). Suicide pooled incidence was 161.16 per 100 000 individuals per year (95% CI = 82 to 239). Meta-regressions found a statistically significant higher prevalence of anxiety in patients undergoing primary chemoradiation compared with surgery and increased distress in smokers and advanced tumor staging. European samples exhibited lower prevalence of distress. CONCLUSIONS Patients with head and neck cancer presented notable prevalence of mental health concerns in all domains. Suicide remains a highly relevant concern. The prevalence of criteria-meeting disorders is significantly lower than clinically relevant symptoms. Investigating the effectiveness of targeted assessments for disorders in highly symptomatic patients is essential.
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Affiliation(s)
- Pablo Jimenez-Labaig
- Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London, UK
- The Institute of Cancer Research, National Institute of Health Research Biomedical Research Centre, London, UK
| | - Claudia Aymerich
- Psychiatry Department, Basurto University Hospital. Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, OSI Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Irene Braña
- Lung and Head & Neck Tumors Unit. Medical Oncology Department, Vall d‘Hebron University Hospital, Barcelona, Spain
- Vall d’Hebron Institute of Oncology (VHIO), Barcelona, Spain
| | - Antonio Rullan
- Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London, UK
- The Institute of Cancer Research, National Institute of Health Research Biomedical Research Centre, London, UK
| | - Jon Cacicedo
- Radiotherapy Department, Cruces University Hospital, Barakaldo, Spain
- Biobizkaia Health Research Institute, OSI Ezkerraldea Enkarterri Cruces, Barakaldo, Spain
- Faculty of Medicine, University of the Basque Country, Leioa, Spain
| | - Miguel Ángel González-Torres
- Psychiatry Department, Basurto University Hospital. Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, OSI Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Kevin J Harrington
- Head and Neck Unit, The Royal Marsden NHS Foundation Trust, London, UK
- The Institute of Cancer Research, National Institute of Health Research Biomedical Research Centre, London, UK
| | - Ana Catalan
- Psychiatry Department, Basurto University Hospital. Osakidetza, Basque Health Service, Bilbao, Spain
- Biobizkaia Health Research Institute, OSI Bilbao-Basurto, Bilbao, Spain
- Centro de Investigación en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Neuroscience Department, University of the Basque Country (UPV/EHU), Leioa, Spain
- Department of Psychiatry, University of Oxford, Oxford, UK
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Grobman B, Mansur A, Babalola D, Srinivasan AP, Antonio JM, Lu CY. Suicide among Cancer Patients: Current Knowledge and Directions for Observational Research. J Clin Med 2023; 12:6563. [PMID: 37892700 PMCID: PMC10607431 DOI: 10.3390/jcm12206563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/03/2023] [Accepted: 10/13/2023] [Indexed: 10/29/2023] Open
Abstract
Cancer is a major public health concern associated with an increased risk of psychosocial distress and suicide. The reasons for this increased risk are still being characterized. The purpose of this study is to highlight existing observational studies on cancer-related suicides in the United States and identify gaps for future research. This work helps inform clinical and policy decision-making on suicide prevention interventions and ongoing research on the detection and quantification of suicide risk among cancer patients. We identified 73 peer-reviewed studies (2010-2022) that examined the intersection of cancer and suicide using searches of PubMed and Embase. Overall, the reviewed studies showed that cancer patients have an elevated risk of suicide when compared to the general population. In general, the risk was higher among White, male, and older cancer patients, as well as among patients living in rural areas and with lower socioeconomic status. Future studies should further investigate the psychosocial aspects of receiving a diagnosis of cancer on patients' mental health as well as the impact of new treatments and their availability on suicide risk and disparities among cancer patients to better inform policies.
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Affiliation(s)
- Ben Grobman
- Harvard Medical School, Boston, MA 02115, USA; (B.G.); (A.M.)
| | - Arian Mansur
- Harvard Medical School, Boston, MA 02115, USA; (B.G.); (A.M.)
| | - Dolapo Babalola
- College of Medicine, University of Ibadan, Ibadan 200285, Nigeria;
| | | | | | - Christine Y. Lu
- Harvard Pilgrim Health Care Institute, Harvard Medical School, Boston, MA 02215, USA
- Faculty of Medicine and Health, School of Pharmacy, The University of Sydney, Sydney, NSW 2050, Australia
- Kolling Institute, Faculty of Medicine and Health, The University of Sydney, The Northern Sydney Local Health District, Sydney, NSW 2064, Australia
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Brahmbhatt S, Chao HH, Verma S, Gupta S. Does ADT Influence the Risk of Suicidal Ideation among US Veteran Prostate Cancer Patients Pre-Exposed to PTSD? Cancers (Basel) 2023; 15:2739. [PMID: 37345076 DOI: 10.3390/cancers15102739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/11/2023] [Indexed: 06/23/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is defined as a mental health disease that has a high probability of developing among individuals who have experienced traumatic events [...].
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Affiliation(s)
- Smit Brahmbhatt
- College of Arts and Sciences, Case Western Reserve University, Cleveland, OH 44016, USA
| | - Herta H Chao
- Department of Medicine & Yale Comprehensive Cancer Center, Yale University School of Medicine, New Haven, CT 06510, USA
- Yale Comprehensive Cancer Center & VA Connecticut Healthcare System, West Haven, CT 06516, USA
| | - Shiv Verma
- Department of Urology, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- The Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
| | - Sanjay Gupta
- Department of Urology, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
- The Urology Institute, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
- Department of Pharmacology, Case Western Reserve University, Cleveland, OH 44016, USA
- Department of Pathology, Case Western Reserve University, Cleveland, OH 44016, USA
- Department of Nutrition, Case Western Reserve University, Cleveland, OH 44016, USA
- Division of General Medical Sciences, Case Comprehensive Cancer Center, Cleveland, OH 44106, USA
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