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van Vliet NK, Atsma F, Boer TA, van den Brink B, Groenewoud AS. Correlations between the euthanasia and physician-assisted suicide rates and the non-assisted suicide rates at the municipal level in the Netherlands. DEATH STUDIES 2024:1-9. [PMID: 39093602 DOI: 10.1080/07481187.2024.2386059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
In the Netherlands, rates of euthanasia and physician-assisted suicide (henceforth "EPAS") display substantial variation at the municipal level. If a similar variation can be found in non-assisted suicide (henceforth "suicide"), this may enable us to establish a possible correlation between these variations. This cross-sectional study assessed proportions of suicide in the years 2013-2017 in The Netherlands. Negative binomial regression analysis was performed to identify potential explanatory variables and to calculate adjusted proportions. The magnitude of variation was calculated by ratios between the highest and lowest municipality proportions. Outliers were detected by Funnel Plots. A possible correlation between suicide and EPAS was calculated. From 2013-2017 the suicide rate between Dutch municipalities varied by a factor 6.7. This variation could only be partially explained by gender, political orientation, the availability of voluntary workers, and mobility limitations. No correlation was found with the variation in EPAS. A "waterbed effect" between suicides and EPAS-cases could not be confirmed. Advice for further research is given.
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Affiliation(s)
| | - Femke Atsma
- Scientific Institute for Quality in Health Care, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Theo A Boer
- Beliefs, Protestant Theological University, Utrecht, The Netherlands
| | - Bart van den Brink
- GGz Centraal, Amersfoort, The Netherlands
- Centre for Research and Innovation in Christian Mental Health Care (Kicg), Hoevelaken, The Netherlands
- Theological University of Apeldoorn, Apeldoorn, The Netherlands
| | - A Stef Groenewoud
- Scientific Institute for Quality in Health Care, Radboud University Medical Centre, Nijmegen, The Netherlands
- Theological University Utrecht, Utrecht, The Netherlands
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Schwinn T, Hirschmiller J, Brähler E, Merzenich H, Faber J, Wild PS, Beutel ME, Ernst M. A powerful safety net: Social support moderates the association of quality of life deficits with suicidal ideation in long-term childhood cancer survivors. J Psychosoc Oncol 2024:1-18. [PMID: 39083714 DOI: 10.1080/07347332.2024.2379827] [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: 08/02/2024]
Abstract
OBJECTIVES Cancer survivors are at risk for suicidality. We aimed to expand the knowledge about protective factors and their interplay with risk factors by testing social support as a modifier of the association of Quality of Life (QoL) deficits with suicidal ideation. RESEARCH APPROACH We surveyed N = 633 childhood cancer survivors (CCS) using validated questionnaires (EORTC Core Quality of Life questionnaire QLQ-C30, Patient Health Questionnaire PHQ-9). The interaction of QoL and social support was investigated using multiple linear regression analysis. FINDINGS CCS reporting suicide attempts and current suicidal ideation (SI) had lower QoL. CCS with SI reported less social support. QoL and social support were independently associated with SI and interacted: among CCS with less social support, low QoL was more strongly associated with SI. CONCLUSION The results highlight the need for interdisciplinary survivorship care, and to focus on risk and protective factors to strengthen suicide prevention.
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Affiliation(s)
- Tamara Schwinn
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Judith Hirschmiller
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Elmar Brähler
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Integrated Research and Treatment Center Adiposity Diseases, Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig Medical Center, Leipzig, Germany
| | - Hiltrud Merzenich
- Institute for Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Jörg Faber
- Department of Pediatric Hematology/Oncology/Hemostaseology, Center for Pediatric and Adolescent Medicine, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Philipp S Wild
- Preventive Cardiology and Preventive Medicine - Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Center for Thrombosis and Hemostasis, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- DZHK (German Center for Cardiovascular Research), Partner Site Rhine-Main, Mainz, Germany
| | - Manfred E Beutel
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Mareike Ernst
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany
- Department of Clinical Psychology, Psychotherapy and Psychoanalysis, Institute of Psychology, University of Klagenfurt, Klagenfurt am Wörthersee, Austria
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Roshid MM, Rahman MM, Sarker MHR, Rahman MJ, Prihanto JB, Alam MN, Eity KF, Masud MH, Kakehashi M, Okamura H. Assessment of psychological distress and its associated factors among patients with cancer undergoing chemotherapy in rural Bangladesh. J Family Med Prim Care 2024; 13:647-655. [PMID: 38605750 PMCID: PMC11006069 DOI: 10.4103/jfmpc.jfmpc_1102_23] [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: 07/05/2023] [Revised: 09/03/2023] [Accepted: 10/01/2023] [Indexed: 04/13/2024] Open
Abstract
Background Psychological distress may worsen during cancer treatment and affect well-being. Information on the prevalence of distress and its associated variables in cancer patients undergoing chemotherapy in rural Bangladesh has not been thoroughly explored. To address this, we aimed to assess psychological distress and its associated factors in patients with cancer undergoing chemotherapy. Methods This cross-sectional study was conducted at a tertiary care hospital in rural Bangladesh. Only adult patients with cancer who were receiving chemotherapy were enrolled in this study. The validated Depression Anxiety Stress Scale was used to assess psychological distress. Frequency and percentages were used in descriptive analysis, and logistic regression analysis was performed to investigate potential associated factors for depression, anxiety, and stress. Results Participants comprised 415 patients with a mean age of 46.3 years. The prevalence of depression, anxiety, and stress was 61.5%, 55.4%, and 22.0%, respectively. In the multivariate logistic regression analysis, patients with more than five family members and smokeless tobacco users had a significant association with depression, anxiety, and stress. In contrast, participants aged >60 years had a protective association with depression. Conclusions Our findings show that patients with cancer receiving chemotherapy experience a high prevalence of depression and anxiety and that the use of smokeless tobacco and having six or more family members are associated with psychological distress. These findings will aid health professionals and policymakers in establishing and implementing improved care programs to ensure the greater mental health of cancer survivors, particularly in resource-limited settings.
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Affiliation(s)
- Md Marufur Roshid
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Md Moshiur Rahman
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mohammad H. R. Sarker
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b), Dhaka, Bangladesh
| | - Md Jiaur Rahman
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Junaidi B. Prihanto
- Health Education, Health and Recreation, Sport Science Faculty, Universitas Negeri Surabaya, Indonesia
| | - Md Nazmul Alam
- Oncology Department, Khwaja Yunus Ali Medical College and Hospital, Sirajgonj, Bangladesh
| | - Kaniz F. Eity
- Oncology Department, Khwaja Yunus Ali Medical College and Hospital, Sirajgonj, Bangladesh
| | - Mehedee H. Masud
- Oncology Department, Khwaja Yunus Ali Medical College and Hospital, Sirajgonj, Bangladesh
| | - Masayuki Kakehashi
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Hitoshi Okamura
- Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Güth U, Junker C, Elger BS, Elfgen C, Montagna G, Schneeberger AR. Conventional and assisted suicide in Switzerland: Insights into a divergent development based on cancer-associated self-initiated deaths. Cancer Med 2023; 12:17296-17307. [PMID: 37554017 PMCID: PMC10501282 DOI: 10.1002/cam4.6323] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 06/04/2023] [Accepted: 06/23/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND We tested the hypothesis of supporters of assisted dying that assisted suicide (AS) might be able to prevent cases of conventional suicide (CS). METHODS By using data from the Federal Statistical Office, we analyzed the long-term development of 30,756 self-initiated deaths in Switzerland over a 20-year period (1999-2018; CS: n = 22,018, AS: n = 8738), focusing on people suffering from cancer who died from AS or CS. RESULTS While cancer was the most often listed principal disease for AS (n = 3580, 41.0% of AS cases), cancer was listed in only a small minority of CS cases (n = 832, 3.8% of CS cases). There was a significant increase in the absolute number of cancer-associated AS cases: comparing four 5-year periods, there was approximately a doubling of cases every 5 years (1999-2003: n = 228 vs.2004-2008: n = 474, +108% compared with the previous period; 2009-2013: n = 920, +94%; 2014-2018: n = 1958, +113%). The ratio of cancer-associated AS in relationship with all cancer-associated deaths increased over time to 2.3% in the last observation period (2014-2018). In parallel, the numbers of cancer-associated CS showed a downward trend only at the beginning of the observation period (1999-2003, n = 240 vs. 2004-2008, n = 199, -17%). Thereafter, the number of cases remained stable in the subsequent 5-year period (2009-2013, n = 187, -6%), and increased again toward the most recent period (2014-2018, n = 206, +10%). CONCLUSION The assumption that, with the increasingly accessible option of AS for patients with cancer, CS suicide will become "superfluous" cannot be confirmed. There are strong reasons indicating that situations and circumstances of cancer-associated CS are different from those for cancer-associated AS.
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Affiliation(s)
- Uwe Güth
- Department of Breast SurgeryBrust‐Zentrum ZürichZurichSwitzerland
- Faculty of MedicineUniversity of BaselBaselSwitzerland
| | | | - Bernice Simone Elger
- Institute for Biomedical EthicsUniversity of BaselBaselSwitzerland
- Center for Legal MedicineUniversity of GenevaGenèveSwitzerland
| | - Constanze Elfgen
- Department of Breast SurgeryBrust‐Zentrum ZürichZurichSwitzerland
- Faculty of MedicineUniversity of Witten/HerdeckeWittenGermany
| | - Giacomo Montagna
- Breast Service, Department of SurgeryMemorial Sloan Kettering Cancer CenterNew YorkNew YorkUSA
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Thapa S, Sharma S, Shrestha S, Ghimire BR, Dahal S, Maharjan R, Thapa S, Koirala R. Distress Thermometer Score Is Useful For Predicting Suicidal Ideation in Patients With Cancer. JCO Glob Oncol 2023; 9:e2300071. [PMID: 37625105 PMCID: PMC10581637 DOI: 10.1200/go.23.00071] [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: 03/14/2023] [Revised: 07/09/2023] [Accepted: 07/19/2023] [Indexed: 08/27/2023] Open
Abstract
PURPOSE Suicidal ideation (SI) and depressive symptoms are common in patients with cancer. A Distress Thermometer (DT) is an effective tool to screen depression and anxiety in such cohorts. We investigated the value of the DT for predicting SI and the prevalence and associated risk factors of SI in the study population. METHODS This cross-sectional study enrolled a total of 162 heterogeneous patients with cancer. Information regarding sociodemographic and clinical characteristics, the Hospital Anxiety and Depression Scale, DT score, and the past month SI were collected. Receiver operating characteristic (ROC) analysis was performed to find accuracy and the optimal cutoff score for predicting risk of SI. The significance of difference between DT scores was obtained using the median independence test. Likelihood of risk was analyzed through odds ratio. RESULTS DT possesses good overall accuracy (area under the ROC curve = 0.797) for predicting SI in patients with cancer. The DT had a sensitivity of 0.929 and a specificity of 0.522 with a cutoff score of ≥4. The patients with SI had significantly higher DT scores than the patients without SI (7 [5,8] v 3 [1,6]; P < .001). The 1-month prevalence of SI was 17.3%. Depression, anxiety, and psychological distress were the predictive factors of SI. CONCLUSION SI is a global issue in patients with cancer. The DT scores may be a rapid predicting tool for identifying SI in patients with cancer. Higher DT scores and patients with psychosocial problems need to be routinely screened for SI, which may help to prevent suicidal risk.
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Affiliation(s)
- Sudip Thapa
- Department Medical Oncology, B&B Hospital Pvt. Ltd, Lalitpur, Nepal
| | - Susmita Sharma
- Department Medical Oncology, Nepal Cancer Hospital and Research Center Pvt. Ltd, Lalitpur, Nepal
| | - Sudip Shrestha
- Department Medical Oncology, Nepal Cancer Hospital and Research Center Pvt. Ltd, Lalitpur, Nepal
| | - Bijesh Raj Ghimire
- Department Medical Oncology, Nepal Cancer Hospital and Research Center Pvt. Ltd, Lalitpur, Nepal
| | - Sanuja Dahal
- Vinayak College of Health Science, Kathmandu, Nepal
| | - Rubina Maharjan
- PGY-1, Pediatrics, New York Health and Hospitals, Woodhull Medical Center, Brooklyn, NY
| | - Sadiksha Thapa
- Department Medical Oncology, Nepal Cancer Hospital and Research Center Pvt. Ltd, Lalitpur, Nepal
| | - Rishav Koirala
- Department of Psycho-oncology, Nepal Cancer Hospital and Research Center Pvt. Ltd, Lalitpur, Nepal
- Brain and Neuroscience Center, Kathmandu, Nepal
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Fernando A, Tokell M, Ishak Y, Love J, Klammer M, Koh M. Mental health needs in cancer - a call for change. Future Healthc J 2023; 10:112-116. [PMID: 37786642 PMCID: PMC10540791 DOI: 10.7861/fhj.2023-0059] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
There is continued under-recognition and underinvestment in the psychological and mental health aspects of care for cancer patients, despite the fact that increased patient survival rates in cancer mean that patients are living longer after diagnosis. In this article, we advocate for better integration and joint working between clinicians across all areas, including education and research, impacting positively on the outcomes and care of cancer patients.
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Affiliation(s)
- Asanga Fernando
- St George's University Hospitals NHS Foundation Trust, London, UK, and honorary senior lecturer, St George's, University of London, London, UK
| | | | - Yostina Ishak
- St George's University Hospitals NHS Foundation Trust, London, UK, and clinical pharmacology tutor, St George's, University of London, London, UK
| | - Jenna Love
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - Matthias Klammer
- St George's University Hospitals NHS Foundation Trust, London, UK and honorary senior lecturer, St George's, University of London, London, UK
| | - Mickey Koh
- St George's University Hospitals NHS Foundation Trust, London, UK, and St George's, University of London, London, UK
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7
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Turner K, Stover AM, Tometich DB, Geiss C, Mason A, Nguyen OT, Hume E, McCormick R, Powell S, Hallanger-Johnson J, Patel KB, Kirtane KS, Jammigumpula N, Moore C, Perkins R, Rollison DE, Jim HS, Oswald LB, Crowder S, Gonzalez BD, Robinson E, Tabriz AA, Islam JY, Gilbert SM. Oncology Providers' and Professionals' Experiences With Suicide Risk Screening Among Patients With Head and Neck Cancer: A Qualitative Study. JCO Oncol Pract 2023; 19:e892-e903. [PMID: 36395441 PMCID: PMC10337750 DOI: 10.1200/op.22.00433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/03/2022] [Accepted: 10/11/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE There has been limited study of the implementation of suicide risk screening for patients with head and neck cancer (HNC) as a part of routine care. To address this gap, this study assessed oncology providers' and professionals' perspectives about barriers and facilitators of implementing a suicide risk screening among patients with HNC. MATERIALS AND METHODS All patients with HNC with an in-person visit completed a suicide risk screening on an electronic tablet. Patients reporting passive death wish were then screened for active suicidal ideation and referred for appropriate intervention. Interviews were conducted with 25 oncology providers and professionals who played a key role in implementation including nurses, medical assistants, patient access representatives, advanced practice providers, physicians, social workers, and informatics staff. The interview guide was based on the Consolidated Framework for Implementation Research. Interviews were transcribed and analyzed for themes. RESULTS Participants identified multilevel implementation barriers, such as intervention level (eg, patient difficulty with using a tablet), process level (eg, limited nursing engagement), organizational level (eg, limited clinic Wi-Fi connectivity), and individual level (eg, low clinician self-efficacy for interpreting and acting upon patient-reported outcome scores). Participants noted facilitators, such as effective care coordination across nursing and social work staff and the opportunity for patients to be screened multiple times. Participants recommended strengthening patient and clinician education and providing patients with other modalities for data entry (eg, desktop computer in the waiting room). CONCLUSION Participants identified important intervention modifications that may be needed to optimize suicide risk screening in cancer care settings.
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Affiliation(s)
- Kea Turner
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Gastrointestinal Oncology, Moffitt Cancer Center, Tampa, FL
- Department of Oncological Sciences, University of South Florida, Tampa, FL
| | - Angela M. Stover
- Department of Health Policy and Management, UNC Chapel Hill, Chapel Hill, NC
- Lineberger Comprehensive Cancer Center, UNC Chapel Hill, Chapel Hill, NC
| | | | - Carley Geiss
- Participant Research, Interventions, and Measurement Core, Moffitt Cancer Center, Tampa, FL
| | - Arianna Mason
- Participant Research, Interventions, and Measurement Core, Moffitt Cancer Center, Tampa, FL
| | - Oliver T. Nguyen
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Emma Hume
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Rachael McCormick
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
| | - Sean Powell
- Department of Social Work, Moffitt Cancer Center, Tampa, FL
| | | | - Krupal B. Patel
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, FL
| | - Kedar S. Kirtane
- Department of Head and Neck-Endocrine Oncology, Moffitt Cancer Center, Tampa, FL
| | - Neelima Jammigumpula
- Department of Clinical Informatics, Center for Digital Health, Moffitt Cancer Center, Tampa, FL
| | - Colin Moore
- Department of Clinical Informatics, Center for Digital Health, Moffitt Cancer Center, Tampa, FL
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL
| | - Randa Perkins
- Department of Clinical Informatics, Center for Digital Health, Moffitt Cancer Center, Tampa, FL
- Department of Internal and Hospital Medicine, Moffitt Cancer Center, Tampa, FL
| | - Dana E. Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL
| | - Heather S.L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Oncological Sciences, University of South Florida, Tampa, FL
| | - Laura B. Oswald
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Oncological Sciences, University of South Florida, Tampa, FL
| | - Sylvia Crowder
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Oncological Sciences, University of South Florida, Tampa, FL
| | - Brian D. Gonzalez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Oncological Sciences, University of South Florida, Tampa, FL
| | - Edmondo Robinson
- Department of Clinical Informatics, Center for Digital Health, Moffitt Cancer Center, Tampa, FL
- Department of Internal and Hospital Medicine, Moffitt Cancer Center, Tampa, FL
| | - Amir Alishahi Tabriz
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL
- Department of Oncological Sciences, University of South Florida, Tampa, FL
| | - Jessica Y. Islam
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL
| | - Scott M. Gilbert
- Department of Genitourinary Oncology, Moffitt Cancer Center, Tampa, FL
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Eseadi C, Ngwu MO. Significance of music therapy in treating depression and anxiety disorders among people with cancer. World J Clin Oncol 2023; 14:69-80. [PMID: 36908676 PMCID: PMC9993142 DOI: 10.5306/wjco.v14.i2.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/16/2023] [Accepted: 02/07/2023] [Indexed: 02/21/2023] Open
Abstract
Globally, cancer cases and mortality have recently escalated and have attracted global concern. The clinical diagnosis and manifestation of cancer can result in significant mental health issues like depression and anxiety disorders. The tendency of people with cancer to suffer from psychological disorders such as anxiety and depression is usually high. A significant number of deaths related to cancer may likely not be from the killer disease but from psychological disorders associated with the illness. The utilization of music as a remedial approach to healing mental disorders cannot be overstated. Thus, identifying the impacts of music therapy in dealing with depression and anxiety disorders among people with cancer is relevant, as the majority of methods used in treating cancer have some side effects which may trigger psychological disorders in cancer patients. Ultimately, this study explored the significance of music therapy in treating depression and anxiety disorders among people with cancer. To achieve the aim of this study, the authors employed a narrative literature review to investigate the significance of music therapy in addressing depression and anxiety disorders among people with cancer. The type of literature review employed in this study is to provide an understanding of the selected research papers. The review found that music therapy significantly reduces depression and anxiety disorders among breast cancer, lung cancer, prostate cancer, and colorectal cancer patients. It is needful for healthcare providers to incorporate music therapy interventions while treating people with cancer. This will help reduce cancer deaths resulting from psychological disorders rather than the killer disease, cancer. However, the standardized procedures and evaluation criteria for applying music-based intervention strategies in oncology medicine still need to be further established and improved.
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Affiliation(s)
- Chiedu Eseadi
- Department of Educational Psychology, University of Johannesburg, Gauteng 2006, South Africa
| | - Millicent O Ngwu
- Department of Sociology and Anthropology, University of Nigeria, Nsukka 41001, Enugu, Nigeria
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Hu X, Ma J, Jemal A, Zhao J, Nogueira L, Ji X, Yabroff KR, Han X. Suicide Risk Among Individuals Diagnosed With Cancer in the US, 2000-2016. JAMA Netw Open 2023; 6:e2251863. [PMID: 36662522 PMCID: PMC9860529 DOI: 10.1001/jamanetworkopen.2022.51863] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/25/2022] [Indexed: 01/21/2023] Open
Abstract
Importance Individuals diagnosed with cancer have elevated suicide risks compared with the general population. National estimates of suicide risks among individuals with cancer are lacking in the US, and knowledge about risk factors is limited. Objective To provide contemporary estimates of suicide risks associated with cancer and to identify sociodemographic and clinical factors associated with suicide risks among individuals diagnosed with cancer. Design, Setting, and Participants A population-based cohort of individuals diagnosed with cancer from January 1, 2000, to December 31, 2016, from 43 states in the US were followed up through December 31, 2016. Standardized mortality ratios (SMRs) were calculated adjusting for attained age at death, sex, and race and ethnicity groups to compare suicide risks in the cancer cohort vs the general US population. Cox proportional hazards regression models were fitted to identify cancer-specific risk factors of suicide among the cancer cohort. Analyses were conducted from October 27, 2020, to May 13, 2022. Main Outcomes and Measures The main outcomes were risk of suicide death compared with the general population, measured by the standardized mortality ratio; and risk of suicide death associated with sociodemographic and clinical factors among individuals with cancer. Exposure Diagnosis of cancer. Results Among a total of 16 771 397 individuals with cancer, 8 536 814 (50.9%) were 65 years or older at cancer diagnosis, 8 645 631 (51.5%) were male, 13 149 273 (78.4%) were non-Hispanic White, and 20 792 (0.1%) died from suicide. The overall SMR for suicide was 1.26 (95% CI, 1.24-1.28), with a decreasing trend (from an SMR of 1.67 [95% CI, 1.47-1.88] in 2000 to 1.16 [95% CI, 1.11-1.21] in 2016). Compared with the general population, elevated suicide risks were observed in the cancer cohort across all sociodemographic groups, with particularly high SMRs among Hispanic individuals (SMR, 1.48; 95% CI, 1.38-1.58), Medicaid-insured individuals (SMR, 1.72; 95% CI, 1.61-1.84), Medicare-insured individuals 64 years or younger (SMR, 1.94; 95% CI, 1.80-2.07), or uninsured individuals (SMR, 1.66; 95% CI, 1.53-1.80). Moreover, the highest SMR was observed in the first 6 months after the cancer diagnosis (SMR, 7.19; 95% CI, 6.97-7.41). Among individuals diagnosed with cancer, relatively higher suicide risks (ie, hazard ratios) were observed for cancer types with a poor prognosis and high symptom burden in the first 2 years after diagnosis, including cancers of oral cavity and pharynx, esophagus, stomach, brain and other nervous system, pancreas, and lung. After 2 years, individuals with cancers subject to long-term quality-of-life impairments, such as oral cavity and pharynx, leukemia, female breast, uterine, and bladder, had higher suicide risks. Conclusions and Relevance In this cohort study of individuals with cancer, elevated suicide risks remained despite a decreasing trend during the past 2 decades. Suicide risks varied by sociodemographic and clinical factors. Timely symptom management and targeted psychosocial interventions are warranted for suicide prevention in individuals diagnosed with cancer.
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Affiliation(s)
- Xin Hu
- Department of Health Policy and Management, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Jiemin Ma
- Merck & Co Inc, Kenilworth, New Jersey
| | - Ahmedin Jemal
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Jingxuan Zhao
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Leticia Nogueira
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Xu Ji
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
- Aflac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, Georgia
| | - K. Robin Yabroff
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
| | - Xuesong Han
- Surveillance and Health Equity Science, American Cancer Society, Atlanta, Georgia
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Friberg AS, Carlsson SV, Vickers AJ, Dalton SO, Larsen SB, Saltbæk L, Høeg BL, Bidstrup PE, Helgstrand T, Røder A, Brasso K, Johansen C. Impact of previous depression on the risk of suicide among prostate cancer patients. Acta Oncol 2023; 62:89-99. [PMID: 36749737 PMCID: PMC10320769 DOI: 10.1080/0284186x.2023.2173536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/23/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Prior studies of suicide risk among prostate cancer patients are conflicting. We compared the risk of suicide in prostate cancer patients to cancer-free men including adjustment for clinical stage, socioeconomic position, somatic comorbidity, and previous depression. MATERIALS AND METHODS A cohort of 37,527 men diagnosed with prostate cancer in Denmark during 1998-2011 was identified in the Danish Prostate Cancer Registry (DaPCaR) and compared with 357,384 cancer-free men matched by age at the time of diagnosis. The primary outcome was death from suicide. Data were analyzed using cumulative incidence functions and multivariable Cox regression models. RESULTS Among prostate cancer patients, 3813 had a previous depression, defined as filed antidepressant prescription within three years before diagnosis. In the study period, 108 prostate cancer patients were registered with suicide as the cause of death, hereof 26 with previous depression. There was no difference in the cumulative incidence of suicide between prostate cancer patients and cancer-free men. There was no effect modification of previous depression on the risk of suicide (p = .12). The hazard ratio (HR) for suicide varied with time since diagnosis. A sensitivity analysis showed that the risk of suicide was highest within the first year of diagnosis where prostate cancer patients had a 1.70-fold increased hazard compared with cancer-free men (95% CI, 1.11-2.59). Men with prostate cancer and previous depression had a three-fold increased hazard for suicide compared with prostate cancer patients without a history of depression (HR 2.84, 95% CI, 1.82-4.45). CONCLUSION The absolute risk of suicide is low following a prostate cancer diagnosis. Time since diagnosis and a history of depression was associated with the highest risk of suicide. Healthcare professionals should be aware of an increased risk of suicide among men with previous depression, especially in the immediate aftermath of the diagnosis.
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Affiliation(s)
- Anne Sofie Friberg
- Department of Oncology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Sigrid V Carlsson
- Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Institute of Clinical Sciences, Department of Urology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Andrew J Vickers
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Susanne Oksbjerg Dalton
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Clinical Oncology and Palliative Services, Zealand University Hospital Næstved, Denmark
| | - Signe Benzon Larsen
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Section of Epidemiology, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lena Saltbæk
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Clinical Oncology and Palliative Services, Zealand University Hospital Næstved, Denmark
| | - Beverley Lim Høeg
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Pernille Envold Bidstrup
- Psychological Aspects of Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
- Institute of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Helgstrand
- Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Andreas Røder
- Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Klaus Brasso
- Copenhagen Prostate Cancer Center, Department of Urology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Christoffer Johansen
- Department of Oncology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
- Survivorship and Inequality in Cancer, Danish Cancer Society Research Center, Copenhagen, Denmark
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11
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Zhang L, Liu X, Tong F, Zou R, Peng W, Yang H, Liu F, Yang D, Huang X, Yi L, Wen M, Jiang L. Cognitive behavioral therapy for anxiety and depression in cancer survivors: a meta-analysis. Sci Rep 2022; 12:21466. [PMID: 36509786 PMCID: PMC9744858 DOI: 10.1038/s41598-022-25068-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 11/24/2022] [Indexed: 12/15/2022] Open
Abstract
This study aimed to investigate the effects of cognitive behavioral therapy (CBT) on anxiety and depression in cancer survivors. The PubMed, Embase, PsycINFO, and Cochrane Library databases were searched. Randomized controlled trials that evaluated the effects of CBT in cancer survivors were included. The standardized mean difference (SMD) was used as an effect size indicator. Fifteen studies were included. For the depression score, the pooled results of the random effects model were as follows: pre-treatment versus post-treatment, SMD (95% confidence interval [CI]) = 0.88 (0.46, 1.29), P < 0.001; pre-treatment versus 3-month follow-up, 0.83 (0.09, 1.76), P = 0.08; pre-treatment versus 6-month follow-up, 0.92 (0.27, 1.58), P = 0.006; and pre-treatment versus 12-month follow-up, 0.21 (- 0.28, 0.70), P = 0.40. For the anxiety score, the pooled results of the random effects model were as follows: pre-treatment versus post-treatment, 0.97 (0.58, 1.36), P < 0.001; pre-treatment versus 3-month follow-up, 1.45 (- 0.82, 3.72), P = 0.21; and pre-treatment versus 6-month follow-up, 1.00 (0.17, 1.83), P = 0.02). The pooled result of the fixed effects model for the comparison between pre-treatment and the 12-month follow-up was 0.10 (- 0.16, 0.35; P = 0.45). The subgroup analysis revealed that the geographical location, treatment time and treatment form were not sources of significant heterogeneity. CBT significantly improved the depression and anxiety scores of the cancer survivors; such improvement was maintained until the 6-month follow-up. These findings support recommendations for the use of CBT in survivors of cancer.
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Affiliation(s)
- Lemeng Zhang
- grid.216417.70000 0001 0379 7164Thoracic Medicine Department 1, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Changsha, 410013 People’s Republic of China
| | - Xiaohong Liu
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
| | - Fei Tong
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
| | - Ran Zou
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
| | - Wanglian Peng
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
| | - Hui Yang
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
| | - Feng Liu
- grid.216417.70000 0001 0379 7164Department of Radiation Oncology, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Changsha, 410013 People’s Republic of China
| | - Desong Yang
- grid.216417.70000 0001 0379 7164Department of Thoracic Surgery, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Changsha, 410013 People’s Republic of China
| | - Xufen Huang
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
| | - Lili Yi
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
| | - Minni Wen
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
| | - Ling Jiang
- grid.216417.70000 0001 0379 7164Department of Clinical Spiritual Care, Hunan Cancer Hospital/The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Hunan Province, Tongzipo Rd 283#, Yuelu District, Changsha, 410013 People’s Republic of China
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12
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Sarode GS, Sengupta N, Yuwanati M, Gondivkar S, Gadbail A, Upadhyay P, Sarode SC. Perspective on the risk of suicide associated with oral cancer diagnosis. Future Oncol 2022; 18:3863-3865. [PMID: 36346066 DOI: 10.2217/fon-2022-0991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Gargi S Sarode
- Department of Oral Pathology & Microbiology, Dr. D. Y. Patil Dental College & Hospital, Dr. D. Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune, Maharashtra, 411018, India
| | - Namrata Sengupta
- Department of Oral Pathology & Microbiology, Dr. D. Y. Patil Dental College & Hospital, Dr. D. Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune, Maharashtra, 411018, India
| | - Monal Yuwanati
- Saveetha Dental College & Hospitals, Saveetha Institute of Medical & Technical Sciences, Saveetha University, Chennai, 600077, India
| | - Shailesh Gondivkar
- Department of Oral Medicine & Radiology, Government Dental College & Hospital, Nagpur, Maharashtra, India
| | - Amol Gadbail
- Department of Dentistry, Indira Gandhi Government Medical College & Hospital, Nagpur, Maharashtra, India
| | - Prashit Upadhyay
- Department of Oral Pathology & Microbiology, Dr. D. Y. Patil Dental College & Hospital, Dr. D. Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune, Maharashtra, 411018, India
| | - Sachin C Sarode
- Department of Oral Pathology & Microbiology, Dr. D. Y. Patil Dental College & Hospital, Dr. D. Y. Patil Vidyapeeth, Sant-Tukaram Nagar, Pimpri, Pune, Maharashtra, 411018, India
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13
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Milligan F. Suicide and women living with and beyond a breast cancer diagnosis. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:954-960. [PMID: 36227794 DOI: 10.12968/bjon.2022.31.18.954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Early diagnosis and intervention, and the use of targeted cancer treatments, have significantly reduced mortality from breast cancer. Emotional distress following a diagnosis of cancer is a normal and anticipated, but it may manifest in some individuals at some point as a level of anxiety or depression that significantly affects quality of life and coping. In extreme cases, these feelings can move from physical symptoms of low energy and an inability to complete basic tasks to despair and hopelessness. Confronting a cancer diagnosis is a life-changing experience, bringing a sense of vulnerability. This may create or precipitate a crisis that threatens to overwhelm a person, resulting in a negative impact on established coping mechanisms. There appears to be a paucity of literature on suicide or suicide attempts by people living with and beyond a cancer diagnosis. A literature search identified 19 papers on suicide and or suicide ideation in patients who had had a cancer diagnosis, which were included in the review. Two clear themes emerged from the literature: that a cancer diagnosis with or without pre-existing mental health comorbidities is a risk factor for suicide; and that there is a significant incidence and prevalence of anxiety and depression in cancer patient populations. The literature identifies multiple variables that impact on prevalence of mental health disorders after a breast cancer diagnosis. Despite this, there appears to be a lack of guidance at national level for screening for mental health comorbidities in patients with a cancer diagnosis.
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Affiliation(s)
- Fiona Milligan
- Lecturer, Adult Nursing and Health, University of the West of Scotland, and Staff Nurse (Bank), NHS Ayrshire and Arran, Nursing Department, Ayr
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14
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Kahn GD, Tam SH, Felton JW, Westphal J, Simon GE, Owen‐Smith AA, Rossom RC, Beck AL, Lynch FL, Daida YG, Lu CY, Waring S, Frank CB, Akinyemi EO, Ahmedani BK. Cancer and psychiatric diagnoses in the year preceding suicide. Cancer Med 2022; 12:3601-3609. [PMID: 36114785 PMCID: PMC9939190 DOI: 10.1002/cam4.5201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/09/2022] [Accepted: 08/23/2022] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Patients with cancer are known to be at increased risk for suicide but little is known about the interaction between cancer and psychiatric diagnoses, another well-documented risk factor. METHODS Electronic medical records from nine healthcare systems participating in the Mental Health Research Network were aggregated to form a retrospective case-control study, with ICD-9 codes used to identify diagnoses in the 1 year prior to death by suicide for cases (N = 3330) or matching index date for controls (N = 297,034). Conditional logistic regression was used to assess differences in cancer and psychiatric diagnoses between cases and controls, controlling for sex and age. RESULTS Among patients without concurrent psychiatric diagnoses, cancer at disease sites with lower average 5-year survival rates were associated with significantly greater relative risk, while cancer disease sites with survival rates of >70% conferred no increased risk. Patients with most psychiatric diagnoses were at higher risk, however, there was no additional risk conferred to these patients by a concurrent cancer diagnosis. CONCLUSION We found no evidence of a synergistic effect between cancer and psychiatric diagnoses. However, cancer patients with a concurrent psychiatric illness remain at the highest relative risk for suicide, regardless of cancer disease site, due to strong independent associations between psychiatric diagnoses and suicide. For patients without a concurrent psychiatric illness, cancer disease sites associated with worse prognoses appeared to confer greater suicide risk.
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Affiliation(s)
- Geoffrey D. Kahn
- Center for Health Policy & Health Services ResearchHenry Ford HealthDetroitMichiganUSA
| | - Samantha H. Tam
- Department of Otolaryngology – Head and Neck SurgeryHenry Ford HealthDetroitMichiganUSA
| | - Julia W. Felton
- Center for Health Policy & Health Services ResearchHenry Ford HealthDetroitMichiganUSA
| | - Joslyn Westphal
- Center for Health Policy & Health Services ResearchHenry Ford HealthDetroitMichiganUSA
| | - Gregory E. Simon
- Kaiser Permanente Washington Health Research InstituteSeattleWAUSA
| | - Ashli A. Owen‐Smith
- Department of Health Policy and Behavioral SciencesGeorgia State University School of Public HealthAtlantaGeorgiaUSA
| | | | - Arne L. Beck
- Institute for Health Research, Kaiser Permanente ColoradoAuroraColoradoUSA
| | - Frances L. Lynch
- Center for Health ResearchKaiser Permanente HawaiiPortlandOregonUSA
| | - Yihe G. Daida
- Center for Integrated Health Care ResearchKaiser Permanente HawaiiHonoluluHawaiiUSA
| | - Christine Y. Lu
- Department of Population MedicineHarvard Medical School and Harvard Pilgrim Health Care InstituteBostonMassachusettsUSA
| | | | | | | | - Brian K. Ahmedani
- Center for Health Policy & Health Services ResearchHenry Ford HealthDetroitMichiganUSA
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15
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Tang L, He Y, Pang Y, Su Z, Zhou Y, Wang Y, Lu Y, Jiang Y, Han X, Song L, Wang L, Li Z, Lv X, Wang Y, Yao J, Liu X, Zhou X, He S, Zhang Y, Song L, Li J, Wang B. Suicidal Ideation in Advanced Cancer Patients without Major Depressive Disorder. Psychooncology 2022; 31:1941-1950. [DOI: 10.1002/pon.6033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 09/03/2022] [Accepted: 09/13/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Lili Tang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Psycho‐oncology Peking University Cancer Hospital & Institute Beijing China
| | - Yi He
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Psycho‐oncology Peking University Cancer Hospital & Institute Beijing China
| | - Ying Pang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Psycho‐oncology Peking University Cancer Hospital & Institute Beijing China
| | - Zhongge Su
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Psycho‐oncology Peking University Cancer Hospital & Institute Beijing China
| | - Yuhe Zhou
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Psycho‐oncology Peking University Cancer Hospital & Institute Beijing China
| | - Yu Wang
- Department of Breast Cancer Radiotherapy Shanxi Provincial Cancer Hospital Taiyuan China
| | - Yongkui Lu
- The Fifth Department of Chemotherapy The Affiliated Cancer Hospital of Guangxi Medical University Nanning Guangxi Zhuang Autonomous Region China
| | - Yu Jiang
- Department of Medical Oncology Cancer Center West China Hospital Sichuan University Chengdu China
| | - Xinkun Han
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Psycho‐oncology Peking University Cancer Hospital & Institute Beijing China
| | - Lihua Song
- Department of Breast Cancer Internal Medicine Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan China
| | - Liping Wang
- Department of Oncology the First Affiliated Hospital of Zhengzhou University Zhengzhou China
| | - Zimeng Li
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Psycho‐oncology Peking University Cancer Hospital & Institute Beijing China
| | - Xiaojun Lv
- Department of Oncology Xiamen Humanity Hospital Xiamen China
| | - Yan Wang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Psycho‐oncology Peking University Cancer Hospital & Institute Beijing China
| | - Juntao Yao
- Department of Integrated Chinese and Western Medicine Shaanxi Cancer Hospital Affiliated to Medical College of Xi'an Jiaotong University Xi'an China
| | - Xiaohong Liu
- Hunan Cancer Hospital/ The Affiliated Cancer Hospital of Xiangya School of Medicine Central South University Changsha China
| | - Xiaoyi Zhou
- Radiotherapy Center Hubei Cancer Hospital Wuhan China
| | - Shuangzhi He
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Psycho‐oncology Peking University Cancer Hospital & Institute Beijing China
| | - Yening Zhang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Psycho‐oncology Peking University Cancer Hospital & Institute Beijing China
| | - Lili Song
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Psycho‐oncology Peking University Cancer Hospital & Institute Beijing China
| | - Jinjiang Li
- Department of Psycho‐oncology Shandong Cancer Hospital and Institute Shandong First Medical University and Shandong Academy of Medical Sciences Jinan China
| | - Bingmei Wang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing) Department of Psycho‐oncology Peking University Cancer Hospital & Institute Beijing China
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16
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Demoralization in oral cancer inpatients and its association with spiritual needs, quality of life, and suicidal ideation: a cross-sectional study. Health Qual Life Outcomes 2022; 20:60. [PMID: 35366908 PMCID: PMC8976948 DOI: 10.1186/s12955-022-01962-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 03/15/2022] [Indexed: 11/17/2022] Open
Abstract
Background Demoralization is a common problem in oral cancer patients owing to the chronic and severe nature of their affliction. However, the association between demoralization and the patient’s spiritual needs, quality of life, and suicidal ideation remains unclear. This study aims to provide insights into possible links between demoralization among oral cancer patients and its effects on the patient’s spiritual needs, quality of life, and suicidal ideation.
Methods We examined 155 Taiwanese oral cancer inpatients in Taichung Veterans General Hospital, Taiwan, using the following three rating scales: (a) Demoralization Scale Mandarin Version (DS-MV), (b) Spiritual Interests Related to Illness Tool, and (c) The Taiwan Chinese versions of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire. Suicidal ideation was established if at least one of the two suicide-related items on the DS-MV scale were checked. We divided the participants into high- and low-demoralization groups, per the cutoff score of 30. We then explored group associations with sociodemographic features, quality of life, and spiritual needs. Logistic regression and receiver operating characteristic (ROC) curves were used to determine demoralization and its association between these variables. Results Fifty-five (35.5%) patients were categorized as having high demoralization (DS-MV scale score > 30), with scores for DS-MV for all patients being 27.2 ± 16.8. The rates of suicidal ideation were 29.1% (16/55) in the high-demoralization group and 2% (2/100) in the low-demoralization group, with an odds ratio (95% confidence interval) of 20.10 (4.41–91.55). Logistic regression analysis revealed significant effects of spiritual needs and global health status on the DS-MV scores (p < 0.001). Multivariate analyses further confirmed that only overall quality of life scores < 62.5 and spiritual needs < 3.7 significantly predicted the occurrence of high demoralization. Conclusion High demoralization is associated with low satisfaction with spiritual needs, poor quality of life, and high risk of suicidal ideation. DS-MV may potentially be an effective tool for achieving holistic health care among oral cancer patients.
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Predictive value of the Distress Thermometer score for risk of suicide in patients with cancer. Support Care Cancer 2022; 30:5047-5053. [PMID: 35201384 PMCID: PMC9046327 DOI: 10.1007/s00520-022-06801-4] [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: 04/23/2021] [Accepted: 12/31/2021] [Indexed: 12/24/2022]
Abstract
PURPOSE This study aimed to assess the association between the Distress Thermometer (DT) score and risk of suicide in patients with cancer. In addition, we aimed to determine the best cutoff score to predict patients at risk of suicide. METHODS From 2015 to 2016, we retrospectively collected data on patients with cancer. DT scores were collected, and the association between DT score and risk of suicide (suicide ideation or death ideation) was analyzed. Furthermore, receiver operating characteristic (ROC) analysis was performed to identify the appropriate cutoff score for predicting risk of suicide. RESULTS A total of 260 patients with cancer were included, and suicidal ideation was identified in 33 cases referred for psychological intervention. The DT scores of the patients with suicidal ideation were significantly higher than those of patients without suicidal ideation (6.30±2.11 vs. 4.29±1.72, p<0.05). In addition, the area under the ROC curve for predicting risk for suicide was 0.758. The cutoff DT score of 3 had the highest sensitivity of 1.00 to rule out suicidal ideation, while 9 had the highest specificity of 1.00 to rule in suicidal ideation. Moreover, the appropriate cutoff DT score to predict patients with suicidal ideation was 5, with a sensitivity of 0.52, specificity of .84, positive likelihood ratio of 3.24, and negative likelihood ratio of 0.58. CONCLUSION The DT score may be a helpful clinical tool to evaluate emotional distress and risk of suicide in patients with cancer. Clinically, for DT scores greater than 5 in patients with cancer, the risk of suicide greatly increases. In view of the DT's widespread use internationally by non-mental health clinicians in cancer to guide the need for specialist mental health interventions, its potential utility in also predicting suicide risk is of great interest.
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18
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Grassi L, Riba MB. Disparities and inequalities in cancer care and outcomes in patients with severe mental illness: Call to action. Psychooncology 2021; 30:1997-2001. [PMID: 34874094 DOI: 10.1002/pon.5853] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVES People with severe mental illness (SMI) are at extreme risk of being stigmatized and to receive poor quality physical care. It has been demonstrated that they have higher morbidity and poorer prognosis of several medical diseases than the general population, with an at least 10-20-year reduction in life expectancy. METHODS A special issue of Psycho-Oncology focusing on cancer care among patients affected by SMI was called by the Editorial Board of the journal, with the aim to explore cancer health disparities and inequalities among people with SMI, mortality from cancer, problems of communication between multidisciplinary oncology and psychiatric teams and need for more structured intervention (i.e., screening, prevention, treatment). RESULTS Authors from eight countries contributed. The problem of stigma and barriers to cancer care provision for patients with SMI were studied (e.g., the complex nature of SMI and healthcare providers' misunderstanding of SMI). Key barriers were related to both patients, clinicians and institutional problems, such as fragmentation of care. A higher mortality from cancer and poor knowledge about cancer risk-factors was shown in patients with SMI. Models of intervention were also proposed. CONCLUSIONS Several conclusions have been recommended by the authors, such as the need for guidelines and clinical procedures specific for cancer care in mental health settings; large-scale studies to address the disparities of care in people with SMI; a larger vision of psychosocial oncology as the facilitator of the liaison between oncology and psychiatry.
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Affiliation(s)
- Luigi Grassi
- Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.,University Hospital Psychiatric Unit, S. Anna Hospital, Ferrara, Italy.,Local Health Trust, Ferrara, Italy
| | - Michelle B Riba
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA.,Psychoncology Program, University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA
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Elghazali Bakhiet T, Ali SM, Bakhiet AM. Prevalence of depression and anxiety among adult patients undergoing chemotherapy in Khartoum, Sudan: A cross-sectional study. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021. [DOI: 10.1016/j.jadr.2021.100218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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20
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Understanding the impact of clinical characteristics and healthcare utilizations on suicide among cancer sufferers: a case-control study in Hong Kong. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2021; 17:100298. [PMID: 34734204 PMCID: PMC8551816 DOI: 10.1016/j.lanwpc.2021.100298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/16/2021] [Accepted: 09/19/2021] [Indexed: 11/20/2022]
Abstract
Background Few studies have investigated whether hospital utilization patterns of cancer sufferers are associated with their suicide. This study aims to explore whether clinical profiles and healthcare utilization patterns are related to suicide among cancer sufferers. Methods Verified suicide cases with cancer (2012-2016) were identified. Each case was matched with two non-suicide controls suffering cancer, by birthyear, sex, and admission year. Cancer-related information, physical and psychiatric comorbidities, opioid-based painkiller usage, the number and length of inpatient admissions, and the number of outpatient and Accident & Emergency (A&E) attendances, in the six months leading up to the suicide, were identified. Conditional logistic regression models were constructed to explore the influence of clinical profiles and hospital utilization on suicide. These models were stratified by age and cancer stage. Outcomes 383 cases and 766 controls were included in the analyses. Overall, younger age, metastasis/recurrent status, suffering head and neck cancer, having psychiatric comorbidities, using opioid-based painkillers, and high frequency of A&E attendances and inpatient admissions increased the odds of suicide. Being diagnosed with liver cancer, consuming high numbers of outpatient attendances, and high numbers of inpatient days decreased the odds of suicide. Stratified analyses confirmed the influence of young age and metastatic/recurrent cancer status on risk of suicide. Interpretations Suicidal cancer sufferers had distinctive clinical profiles and hospital utilization patterns. Detecting and mitigating suicidal risk should be incorporated as an important component in treatment of cancer sufferers in the clinical setting. Funding Li Ka Shing Foundation and Hong Kong Research Grants Council
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21
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Nugent SM, Morasco BJ, Handley R, Clayburgh D, Hooker ER, Ganzini L, Knight SJ, Chen JI, Sullivan DR, Slatore CG. Risk of Suicidal Self-directed Violence Among US Veteran Survivors of Head and Neck Cancer. JAMA Otolaryngol Head Neck Surg 2021; 147:981-989. [PMID: 34617963 DOI: 10.1001/jamaoto.2021.2625] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Importance Head and neck cancer (HNC) survivors are about twice as likely to die by suicide compared with other cancer survivors. Objective To examine the associations between precancer mental health and pain and postcancer receipt of mental health, substance use disorder (SUD), or palliative care services with risk of suicidal self-directed violence (SSDV). Design, Setting, and Participants This retrospective cohort study used the Veterans Health Administration data of 7803 veterans with a diagnosis of HNC (stage I-IVB) who received cancer treatment between January 1, 2012, and January 1, 2018. Data were analyzed between May 2020 and July 2021. Exposures Presence of precancer chronic pain and SUD diagnoses, and postcancer SUD, mental health, or palliative care treatment. Exposures were defined using International Classification of Diseases, Ninth Revision and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes in Veterans Health Administration administrative data. Main Outcomes and Measures Documented SSDV event, including suicide attempt or death by suicide, after HNC diagnosis. Results Among the cohort of 7803 veterans (7685 [98.4%] male; mean [SD] age, 65 [10.7] years), 72 (0.9%) had at least 1 documented SSDV event following their cancer diagnosis, and 51 (0.7%) died by suicide. Four adjusted modified Poisson regression analyses identified that precancer chronic pain (incidence rate ratio [IRR], 2.58; 95% CI 1.54-4.32) or mood disorder diagnoses (IRR, 1.95; 95% CI, 1.17-3.24) were associated with higher risk of postcancer SSDV. Those who had at least 1 documented mental health (IRR, 2.73; 95% CI, 1.24-6.03) or SUD (IRR, 3.92; 95% CI, 2.46-6.24) treatment encounter in the 90 days following HNC diagnosis were at higher risk for SSDV. A palliative care encounter within 90 days of postcancer diagnosis was associated with decreased risk of SSVD (IRR, 0.49; 95% CI, 0.31-0.78). Conclusions and Relevance In this cohort study, a high proportion of HNC survivors with an SSVD event died from their injuries. Identification of risk factors for SSDV among HNC survivors may help direct additional resources to those who are at high risk. Referral to palliative care appears to be an important component of supportive oncologic care to reduce the risk of SSDV.
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Affiliation(s)
- Shannon M Nugent
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon.,Department of Psychiatry, School of Medicine, Oregon Health & Science University, Portland.,Knight Cancer Institute, Oregon Health & Science University, Portland
| | - Benjamin J Morasco
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon.,Department of Psychiatry, School of Medicine, Oregon Health & Science University, Portland
| | - Robert Handley
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon
| | - Daniel Clayburgh
- Operative Care Division, VA Portland Health Care System, Portland, Oregon.,Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Oregon Health & Science University, Portland
| | - Elizabeth R Hooker
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon
| | - Linda Ganzini
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon.,Department of Psychiatry, School of Medicine, Oregon Health & Science University, Portland
| | - Sara J Knight
- Informatics, Decision-Enhancement and Analytic Sciences Center, VA Salt Lake City Healthcare System, Salt Lake City, Utah.,Division of Epidemiology, Department of Internal Medicine, School of Medicine, University of Utah, Salt Lake City
| | - Jason I Chen
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon.,Department of Psychiatry, School of Medicine, Oregon Health & Science University, Portland
| | - Donald R Sullivan
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon.,Knight Cancer Institute, Oregon Health & Science University, Portland.,Division of Pulmonology and Critical Care Medicine, Department of Medicine, School of Medicine, Oregon Health & Science University, Portland
| | - Christopher G Slatore
- Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, Oregon.,Knight Cancer Institute, Oregon Health & Science University, Portland.,Division of Pulmonology and Critical Care Medicine, Department of Medicine, School of Medicine, Oregon Health & Science University, Portland
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22
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Alias A, Bertrand L, Bisson-Gervais V, Henry M. Suicide in obstructive lung, cardiovascular and oncological disease. Prev Med 2021; 152:106543. [PMID: 34538370 DOI: 10.1016/j.ypmed.2021.106543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 03/28/2021] [Accepted: 03/30/2021] [Indexed: 01/04/2023]
Abstract
Healthcare institutions face increasing demands stemming from the burden of noncommunicable diseases. The personal, social, financial and societal impact of these diseases are well-documented. However, the mental health concerns and trajectories of patients afflicted by chronic medical diseases have been under-recognized and are under-resourced. Despite that chronic diseases are associated with substantially increased risk of suicide, the medical world has largely failed to properly address suicide in the medically ill. Considering their high prevalence and mortality rate, this review article will highlight the mental health burden and suicide risk in obstructive lung, cardiovascular (including stroke) and oncological disease, in light of relevant data and conceptual models of suicide. Finally, general evidence-based suicide intervention strategies and potential selective adaptation of these strategies to the chronic medically ill patient populations and medical settings will be reviewed.
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Affiliation(s)
- Ali Alias
- Faculty of Medicine and Health Sciences, McGill University, 3605 de la Montagne, Montreal, QC H3G 2M1, Canada
| | - Lia Bertrand
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, St Joseph's Healthcare Hamilton, West 5(th) Campus, 100 West 5(th) Street, Hamilton, ON L8N 3K7, Canada.
| | - Vanessa Bisson-Gervais
- Faculty of Medicine and Health Sciences, McGill University, 3605 de la Montagne, Montreal, QC H3G 2M1, Canada
| | - Melissa Henry
- Gerald Bronfman Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, 5100 de Maisonneuve Blvd. West, Suite 720, Montreal, QC H4A 3T2, Canada; Segal Cancer Centre, Jewish General Hospital, 3755 Chemin de la Cote-Sainte-Catherine, Montreal, QC H3T 1E2, Canada; Lady-Davis Institute for Medical Research, Jewish General Hospital, 3755 Chemin de la Cote-Sainte-Catherine, Montreal, QC H3T 1E2, Canada
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23
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Heynemann S, Thompson K, Moncur D, Silva S, Jayawardana M, Lewin J. Risk factors associated with suicide in adolescents and young adults (AYA) with cancer. Cancer Med 2021; 10:7339-7346. [PMID: 34586755 PMCID: PMC8525084 DOI: 10.1002/cam4.4246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 07/30/2021] [Accepted: 08/10/2021] [Indexed: 01/17/2023] Open
Abstract
Background Higher rates of death by suicide are recognized both in individuals of any age with cancer and, separately, among adolescents and young adults (AYA) without cancer. Given this intersection, identifying risk factors associated with suicidal risk among AYA with cancer is critical. Objective To identify characteristics associated with suicide among AYA with cancer. Methods A retrospective analysis of AYA (aged 15–39) during 1975–2016 from the Surveillance, Epidemiology, and End Results database was conducted. Clinical and demographic factors associated with death by suicide among the AYA cancer population were compared to (i) US population normative data (standardized mortality ratios [SMRs]) and (ii) other AYA individuals with cancer (odds ratios). Results In total, 922 suicides were found in 500,366 AYA with cancer (0.18%), observed for 3,198,261 person‐years. The SMR for AYA with cancer was 34.1 (95% confidence interval [CI]: 31.4–36.9). Suicide risk was particularly high in females (SMR = 43.4, 95% CI: 37.2–50.4), unmarried persons (SMR = 50.6, 95% CI: 44.7–57.1), those with metastatic disease (SMR = 45.2, 95% CI: 33.1–60.3), or certain histological subtypes (leukemia, central nervous system, and soft tissue sarcoma). Risk generally reduced over time, however remained elevated ≥5 years following a cancer diagnosis (SMR > 5 years = 28.1, 95% CI: 25.4–31.0). When comparing those who died from suicide and those who did not, the following factors demonstrated significant associations: sex (males > females), race (White ethnicity > Black/other ethnicity), relationship status (never married > other), and disease stage (distant > localized). Conclusions Death due to suicide/non‐accidental injury is high compared to normative data, requiring increased awareness among health‐care providers, suicide risk monitoring in AYA, and appropriately tailored psychosocial interventions.
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Affiliation(s)
- Sarah Heynemann
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Kate Thompson
- ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Donovan Moncur
- ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Department of Psychiatry, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Sandun Silva
- Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Hawthorn, Victoria, Australia.,NHMRC Clinical Trials Centre, University of Sydney, Sydney, New South Wales, Australia
| | - Madawa Jayawardana
- Office of Cancer Research, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
| | - Jeremy Lewin
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,ONTrac at Peter Mac Victorian Adolescent and Young Adult Cancer Service, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.,Sir Peter MacCallum Department of Oncology, The University of Melbourne, Parkville, Victoria, Australia
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24
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Chen C, Lin H, Xu F, Liu J, Cai Q, Yang F, Lv L, Jiang Y. Risk factors associated with suicide among esophageal carcinoma patients from 1975 to 2016. Sci Rep 2021; 11:18766. [PMID: 34548616 PMCID: PMC8455550 DOI: 10.1038/s41598-021-98260-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 08/25/2021] [Indexed: 12/24/2022] Open
Abstract
Throughout the world, esophageal cancer patients had a greater suicidal risk compared with ordinary people. Thus, we aimed to affirm suicide rates, standardized mortality rates, and underlying suicide-related risk factors of esophageal cancer patients. Patients suffering esophageal cancer were chosen from the Surveillance, Epidemiology, and End Results repository in 1975–2016. Suicide rates as well as standardized mortality rates in the patients were measured. Univariable and multivariable Cox regression had been adopted for establishing the latent suicide risk factors among patients suffering esophageal cancer. On multivariable Cox regression, gender (male vs. female, HR: 6.37), age of diagnosis (70–105 vs. 0–55, HR: 2.69), marital status, race (white race vs. black race, HR: 6.64; American Indian/Alaska Native, Asian/Pacific Islander vs. black race, HR: 8.60), histologic Grade (Grade III vs. Grade I, HR: 2.36), no surgery performed (no/unknown vs. yes, HR: 2.01), no chemotherapy performed were independent risk factors related to suicide in patients suffering esophageal cancer. Male sex, the older age, unmarried state, non-black race, histologic Grade III, no surgery performed, no chemotherapy performed were strongly related to suicide in patients suffering esophageal cancer.
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Affiliation(s)
- Chongfa Chen
- Department of Hepatobiliary Surgery, Dongfang Hospital, Xiamen University, No.156, West Second Ring North Road, Gulou District, Fuzhou, People's Republic of China
| | - Huapeng Lin
- Department of Intensive Care Unit, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, People's Republic of China
| | - Fengfeng Xu
- Department of Cardiothoracic Surgery, 900 Hospital of the Joint Logistics Team, Fuzhou, People's Republic of China
| | - Jianyong Liu
- Department of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Team, Fuzhou, People's Republic of China
| | - Qiucheng Cai
- Department of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Team, Fuzhou, People's Republic of China
| | - Fang Yang
- Department of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Team, Fuzhou, People's Republic of China
| | - Lizhi Lv
- Department of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Team, Fuzhou, People's Republic of China
| | - Yi Jiang
- Department of Hepatobiliary Surgery, Dongfang Hospital, Xiamen University, No.156, West Second Ring North Road, Gulou District, Fuzhou, People's Republic of China.
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Abstract
OBJECTIVE The present study aimed to determine whether the suicide risk increased after a cancer diagnosis. DESIGN Population-based cohort study. SETTING AND PARTICIPANTS This study incorporated the National Health Insurance Service-National Sample Cohort in South Korea. Of the 975 348 subjects, 39 027 with cancer and 936 321 who were cancer free participated between 2005 and 2013. PRIMARY OUTCOME MEASURE Suicide. RESULTS A total of 110 suicides (82 men, 28 women) were identified among these 39 027 subjects with cancer during a total of 127 184 person-years; among the 936 321 cancer-free subjects, 2163 suicides were reported during a total of 8 222 479 person-years. Cox proportional hazards models were used to compare all-cause and suicide mortalities after cancer diagnosis following adjustment for possible confounding covariates. After adjusting for factors related to suicide, we identified an elevated relative risk of suicide among patients with cancer (HR: 1.480, 95% CI: 1.209 to 1.812). Among men, the relative risk was substantially increased among patients with lip, oral cavity/pharyngeal, colon and rectal, pancreatic and lung cancers when compared with cancer-free subjects; whereas among women, the relative risk was substantially increased among patients with colon and rectal cancers. CONCLUSION Our study observed an increased risk of suicide among patients with cancer that varied according to the anatomical cancer site, even after accounting for clinical comorbidities and psychiatric illness. Our findings indicate a need for social support and suicide prevention strategies for patients with cancer.
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Affiliation(s)
- Young Choi
- Department of Healthcare Management, Catholic University of Pusan, Busan, Republic of Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine and Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea
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Elshanbary AA, Zaazouee MS, Hasan SM, Abdel-Aziz W. Risk factors for suicide mortality and cancer-specific mortality among patients with gastric adenocarcinoma: A SEER based study. Psychooncology 2021; 30:2067-2076. [PMID: 34453467 DOI: 10.1002/pon.5804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/16/2021] [Accepted: 08/20/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVE This study aims to investigate the risk factors for suicide in patients with gastric adenocarcinoma (GAC) to recognize patients at higher risk who require special mental health care. METHODS Patients' data were collected from the Surveillance, Epidemiology, and End Results database from 1975 to 2016. The relationships among categorical variables were assessed using Person's chi-square test. Standardized mortality ratio was used to compare ratios of suicide and other causes of death between the US population and adenocarcinoma patients. Cox regression and Kaplan-Meier were used for multivariate and univariate analyses. The probability of suicide was assessed using the binary regression analysis. All analyses were conducted using SPSS software. RESULTS Among 59,580 patients included in this study, 86 died due to suicide. The mean survival months was higher in patients <50 years (81.759) than in patients ≥50 years (42.961), and in females (49.116) than in males (44.591). The multivariate analysis showed a higher suicide mortality risk in divorced patients (HR = 2.461; 95% CI [1.015, 5.966], p = 0.046), patients not recommended for surgery (HR = 1.997; 95% CI [1.08, 3.694], p = 0.027) and patients with distant stage of the disease (HR = 2.68; 95% CI [1.395, 5.147], p = 0.003). Females had a lower suicide mortality risk (HR = 0.124; 95% CI [0.045, 0.314], p < 0.001). CONCLUSION GAS predisposes to suicide. The risk is higher in patients who are males, divorced, not recommended for surgery, or have a distant spread of the disease.
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Senf B, Bender B, Fettel J. Suicidal ideation, distress, and related factors in a population of cancer patients treated in a general acute hospital. Support Care Cancer 2021; 30:487-496. [PMID: 34324058 PMCID: PMC8636422 DOI: 10.1007/s00520-021-06429-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/11/2021] [Indexed: 11/26/2022]
Abstract
Purpose Suicidality and suicidal ideation (SI) in oncology has long been an underestimated danger. Although there are cancer-specific distress screening tools available, none of these specifically incorporates items for SI. We examined the prevalence of SI in cancer patients, investigated the relation between SI and distress, and tried to identify additional associated factors. Methods A cross-sectional study with patients treated for cancer in a primary care hospital was conducted. Psychosocial distress and SI in 226 patients was assessed. An expert rating scale (PO-Bado-SF) and a self-assessment instrument (QSC-R23) were used to measure distress. SI was assessed with item 9 of the PHQ-9. Data was descriptively analyzed, and correlations and group comparisons between clinically distressed and non-distressed patients were calculated. Results SI was reported by 15% of patients. Classified as clinically distressed were 24.8% (QSC-R23) to 36.7% (PO-Bado-SF). SI was correlated with externally (rτ = 0.19, p < 0.001) and self-rated distress (rτ = 0.31, p < 0.001). Symptoms sufficiently severe for at least a medium major depressive episode were recorded in 23.5% of patients (PHQ-9). Factors associated with SI were feeling bad about oneself, feeling down, depressed, and hopeless, deficits in activities of daily life, psycho-somatic afflictions, social restrictions, and restrictions in daily life. Being in a steady relationship seemed to have a protective effect. Conclusions SI is common in cancer patients. Distress and associated factors are increased in patients with SI. A distress screening with the ability to assess SI could be an important step in prevention, but more research is necessary. Supplementary Information The online version contains supplementary material available at 10.1007/s00520-021-06429-w.
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Affiliation(s)
- Bianca Senf
- Department of Psycho-Oncology, University Cancer Center (UCT), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany.
| | - Bernd Bender
- Department of Psycho-Oncology, University Cancer Center (UCT), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - Jens Fettel
- Department of Psycho-Oncology, University Cancer Center (UCT), Johann Wolfgang Goethe University, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
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Hagezom HM, Amare T, Hibdye G, Demeke W. Magnitude and Associated Factors of Suicidal Ideation Among Cancer Patients at Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia, 2019: Cross-sectional Study. Cancer Manag Res 2021; 13:4341-4350. [PMID: 34103989 PMCID: PMC8179746 DOI: 10.2147/cmar.s268669] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 04/30/2021] [Indexed: 12/24/2022] Open
Abstract
Background Suicide is a worldwide public health issue and considered as a psychiatric emergency. The majority of all completed suicides occur in low- and middle-income countries. A diagnosis of cancer has been associated with an increased risk of suicidal ideation and suicide is one of the leading causes of non-cancer-related mortality among cancer patients in recent years. Suicidal ideation is four times higher in cancer patients than in the general population. There is limited evidence on suicidal ideation on patients diagnosed with cancer in Ethiopia as well as in African countries. Objective To assess the magnitude and associated factors of suicide ideation among cancer patients at Ayder Comprehensive Specialized Hospital, Mekelle, Ethiopia, 2019. Methods An institution-based cross-sectional study was conducted from May 1 to 30, 2019. Systematic random sampling technique was used and a total of 410 of cancer patients participated in the study. Data were collected using the Suicide Manual of Composite International Diagnostic Interview (CIDI) questionnaire. Data were coded, entered into EpiData manager version 4.4 and analyzed using SPSS version 20. Descriptive, analytical statistical procedures, bivariable, multivariable logistic regression with odds ratio, 95% confidence interval were employed. The statistical significance was declared at P-value <0.05. Results The finding of the present study on magnitude of suicidal ideation among cancer patients were 28.5% with 95%CI: 24.1–33.2, respectively. In multivariable logistic regression analysis being female advanced stage, perceived stigma and anxiety was significantly associated with suicidal ideation. Conclusion and Recommendation The magnitude of suicidal ideation among cancer patients was higher than in the general population. It also reported that, advanced stage, perceived stigma, anxiety and being female were factors significantly associated with suicidal ideation. This study gives us clues that cancer patients are prone to suicide ideation. Therefore, cancer patients need special attention to reduce these problems.
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Affiliation(s)
- Haftamu Mamo Hagezom
- Department of Psychiatry, Adigrat University College of Medicine and Health Sciences, Adigrat, Ethiopia
| | - Tadele Amare
- Department of Psychiatry, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Getahun Hibdye
- Department of Psychiatry, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
| | - Wubit Demeke
- Department of Psychiatry, Amanuel Mental Specialized Hospital, Addis Ababa, Ethiopia
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Lee MJ, Huang CW, Lee CP, Kuo TY, Fang YH, Chin-Hung Chen V, Yang YH. Investigation of anxiety and depressive disorders and psychiatric medication use before and after cancer diagnosis. Psychooncology 2021; 30:919-927. [PMID: 33724591 DOI: 10.1002/pon.5672] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 02/08/2021] [Accepted: 02/23/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Data regarding the prevalence of depression and anxiety among cancer patients, especially before cancer diagnosis, remains scarce. This study investigated the prevalence of these conditions and associated drug use among cancer patients pre- and post-diagnosis. METHODS This population-based cohort study using data from Taiwan's National Health Insurance Research Database recruited patients with a registered cancer diagnosis and matched control between January 1, 2000, and December 31, 2011. We compared the prevalence of anxiety and depressive disorders between cancer patients and non-cancer participants during a 2-year period both pre- and post-diagnosis by Pearson's chi-square test. Psychiatric medication use was also examined for the associated mental condition. RESULTS We examined participants diagnosed with liver (N = 17,154), colorectal (N = 30,391), breast (N = 40,036), gynecological (N = 23,218), and lung (N = 15,671) cancer. Before the cancer diagnosis, the prevalence of depression was higher in non-cancer participants than in gynecological cancer patients (p = 0.018) but anxiety is higher in liver, colorectal, and lung cancer patients when compared to non-cancer participants (p < 0.05). After the cancer diagnosis, the prevalence of anxiety and depression became significantly higher in all enrolled cancer patients than non-cancer participants (p < 0.05). Similar results were observed in psychiatric medication use trends. CONCLUSIONS This study proposed that patients with liver, colorectal, and lung cancer had an increased risk of developing anxiety, which might be a sentinel diagnosis. The participants had a significantly higher level of anxiety and depressive disorder post-diagnosis, which highlights the importance of the care for both mental and physical conditions in cancer management.
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Affiliation(s)
- Min-Jing Lee
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan, ROC.,School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Chien-Wei Huang
- Division of Nephrology, Department of Medicine, Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan, ROC.,School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC
| | - Chuan-Pin Lee
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan, ROC
| | - Ting-Yu Kuo
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan, ROC
| | - Yu-Hung Fang
- Division of Thoracic Oncology, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan, ROC
| | - Vincent Chin-Hung Chen
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan, ROC.,School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC
| | - Yao-Hsu Yang
- School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.,Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan, ROC.,Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan, ROC
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30
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Yu K, Wu B, Chen Y, Kang H, Song K, Dong Y, Peng R, Li F. Suicide and accidental deaths among patients with primary malignant bone tumors. J Bone Oncol 2021; 27:100353. [PMID: 33889483 PMCID: PMC8047448 DOI: 10.1016/j.jbo.2021.100353] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/09/2021] [Accepted: 03/05/2021] [Indexed: 11/17/2022] Open
Abstract
Background It has been recognized that cancer is associated with a higher risk of suicide or accidental death. Earlier studies have evidenced that patients with malignant bone tumors usually experience psychological dysfunction and physical disability following surgery, which are shared risk factors between suicidal and accidental deaths. To our knowledge, there is no large population-based study on the risk of suicide or accidental death among patients with malignant bone tumors. Questions/purposes This study aimed to determine whether patients with primary malignant bone tumors are at a higher risk of suicide and accidental death than the general population and to identify the demographic and tumour-related characteristics and type of surgery associated with a higher risk of suicide and accidental death among these patients. Methods Overall, 50,817 patients diagnosed with primary malignant bone tumors between 1973 and 1975 were identified from the Surveillance, Epidemiology, and End Results database. The standardised mortality ratio (SMR) was calculated based on the general population's mortality data, gathered by the National Center for Health Statistics. The Cox regression model was developed to determine risk factors associated with a higher risk of suicide and accidental death. Results Patients with primary malignant bone tumors had a higher risk of suicide and accidental death than the general population in the United States (US) (SMR = 2.17; 95% confidence interval (CI) [1.80-2.62] and SMR = 1.73; 95% CI [1.54-1.95]). Compared with limb salvage, amputation significantly increased the risk of suicide (SMR = 3.99; 95% CI [2.52-6.34], hazard ratio (HR) = 2.32; 95% CI [1.31-4.09]; P < 0.01) but did not increase the risk of accidental death (SMR = 1.61; 95% CI [1.07-2.42], HR = 1.11; 95% CI [0.71-1.74]; P = 0.65). Higher suicide risk was observed among older patients whose age at diagnosis was more than 60 years (HR = 4.04; 95% CI [1.98-8.26]; P < 0.001), males (HR = 3.48; 95% CI [2.16-5.62]; P < 0.001), and whites (HR = 3.71; 95% CI [1.17-11.73]; P < 0.001). The risk of suicide and accidental death was highest in the first year after diagnosis (SMR = 2.95; 95% CI [1.86-4.69] and SMR = 2.02; 95% CI [1.48-2.74]). Conclusion We first reported that patients with primary malignant bone tumors had a higher risk of suicide and accidental death than the general US population. Therefore, clinicians should pay more attention to the psychological status, physical function, and cognitive level of these survivors.
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Affiliation(s)
- Kaixu Yu
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Bian Wu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Ying Chen
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Honglei Kang
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Kehan Song
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yimin Dong
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Renpeng Peng
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Feng Li
- Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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Chen C, Jiang Y, Yang F, Cai Q, Liu J, Wu Y, Lin H. Risk factors associated with suicide among hepatocellular carcinoma patients: A surveillance, epidemiology, and end results analysis. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2021; 47:640-648. [PMID: 33051117 PMCID: PMC7538389 DOI: 10.1016/j.ejso.2020.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 10/02/2020] [Indexed: 12/09/2022]
Abstract
BACKGROUND Throughout the world, hepatocellular carcinoma (HCC) remains the primary type of liver cancer. The suicide risk was higher among patients with HCC than the general population. Hence, the purpose of this study was to confirm the suicide rates, standardized mortality ratios (SMRs), and the potential risk factors associated with suicide among HCC patients. METHODS HCC patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database during 1975-2016. Suicide rates and SMRs among these patients were calculated, and the general population of the United States (U.S.) during 1975-2016 was used as a reference. Univariable and multivariable Cox regression were taken to find out the underlying risk factors of suicide in HCC patients. RESULTS There were 70 suicides identified among 102,567 individuals with HCC observed for 160,500.88 person years. The suicide rate was 43.61 per 100,000 person-years, and SMR was 2.26 (95% CI: 1.78-2.84). On Cox regression, year of diagnosis (1975-1988 vs. 2003-2016, HR: 3.00, 95% CI: 1.01-8.89, P = 0.047; 1989-2002 vs. 2003-2016, HR: 1.92, 95% CI: 1.10-3.34, P = 0.021), gender (male vs. female, HR: 8.72, 95% CI: 2.73-27.81, P < 0.001), age at diagnosis (63-105 years old vs. 0-55 years old, HR: 2.28, 95% CI: 1.21-4.31, P = 0.011), race (white race vs. American Indian/Alaska Native, Asian/Pacific Islander, HR: 3.02, 95% CI: 1.35-6.76, P = 0.007) were independent risk factors of suicide among HCC patients. CONCLUSIONS Diagnosed in the early years (1975-2002), male sex, the older age (63-105 years old), white race, survival months (<2 months) were significantly associated with suicide among HCC patients. For the sake of preventing suicide behaviors, the government, clinicians, and family members should take adequate measures to decrease the rate of suicide, especially in patients with high-risk factors of suicide.
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Affiliation(s)
- Chongfa Chen
- Department of Hepatobiliary Surgery, Dongfang Hospital, Xiamen University, China
| | - Yi Jiang
- Department of Hepatobiliary Surgery, Dongfang Hospital, Xiamen University, China
| | - Fang Yang
- Department of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Team, China
| | - Qiucheng Cai
- Department of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Team, China
| | - Jianyong Liu
- Department of Hepatobiliary Surgery, 900 Hospital of the Joint Logistics Team, China
| | - Yushen Wu
- Chongqing Key Laboratory of Molecular Oncology and Epigenetics, The First Affiliated Hospital of Chongqing Medical University, China.
| | - Huapeng Lin
- Department of Intensive Care Unit, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, China.
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Aboumrad M, Shiner B, Mucci L, Neupane N, Schroeck FR, Klaassen Z, Freedland SJ, Young-Xu Y. Posttraumatic stress disorder and suicide among veterans with prostate cancer. Psychooncology 2020; 30:581-590. [PMID: 33247977 DOI: 10.1002/pon.5605] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 10/06/2020] [Accepted: 11/24/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To evaluate the effect of a preexisting posttraumatic stress disorder (PTSD) diagnosis on suicide and non-suicide mortalities among men with newly diagnosed prostate cancer, and examine potential mediating factors for the relationship between PTSD and suicide. METHODS We used patient-level data from Veterans Health Administration electronic medical records to identify men (age ≥40 years) diagnosed with prostate cancer between 2004 and 2014. We used Fine and Gray regression model to estimate the risk for competing mortality outcomes (suicide, non-suicide, and alive). We used structural equation models to evaluate the mediating factors. RESULTS Our cohort comprised 214,649 men with prostate cancer, of whom 12,208 (5.7%) had a preexisting PTSD diagnosis. Patients with PTSD compared to those without utilized more healthcare services and had lower risk cancer at diagnosis. Additionally, they experienced more suicide deaths (N = 26, 0.21% vs. N = 269, 0.13%) and fewer non-suicide deaths (N = 1399, 11.5% vs. N = 45,625, 22.5%). On multivariable analysis, PTSD was an independent suicide risk factor (HR = 2.35; 95% CI: 1.16, 4.78). Depression, substance use disorder, and any definitive prostate cancer treatment were partial mediators. However, PTSD was associated with lower non-suicide mortality risk (HR = 0.86; 95% CI: 0.77, 0.96). CONCLUSION Patients with PTSD experienced greater suicide risk even after adjusting for important mediators. They may have experienced lower non-suicide mortality risk due to favorable physical health resulting from greater healthcare service use and early diagnosis of lower risk cancer. Our findings highlight the importance of considering psychiatric illnesses when treating patients with prostate cancer and the need for interventions to ameliorate suicide risk.
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Affiliation(s)
- Maya Aboumrad
- White River Junction Veterans Affairs Medical Center, White River Junction, Vermont, USA
| | - Brian Shiner
- White River Junction Veterans Affairs Medical Center, White River Junction, Vermont, USA.,Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Lorelei Mucci
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Nabin Neupane
- White River Junction Veterans Affairs Medical Center, White River Junction, Vermont, USA
| | - Florian R Schroeck
- White River Junction Veterans Affairs Medical Center, White River Junction, Vermont, USA.,Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
| | - Zachary Klaassen
- Medical College of Georgia at Augusta University, Augusta, Georgia, USA
| | - Stephen J Freedland
- Cedars-Sinai Medical Center, Los Angeles, California, USA.,Durham Veterans Affairs Medical Center, Durham, North Carolina, USA
| | - Yinong Young-Xu
- White River Junction Veterans Affairs Medical Center, White River Junction, Vermont, USA.,Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, USA
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Du L, Shi HY, Qian Y, Jin XH, Li Y, Yu HR, Liu XM, Fu XL, Chen HL. Association between social support and suicidal ideation in patients with cancer: A systematic review and meta-analysis. Eur J Cancer Care (Engl) 2020; 30:e13382. [PMID: 33277772 DOI: 10.1111/ecc.13382] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 10/27/2020] [Accepted: 11/18/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To quantitatively examine the relationship between social support and suicidal ideation (SI) among patients with cancer and identify the moderators that influence the magnitude of this association. METHODS Publications were searched in PubMed, PsycINFO, EMBASE, Cochrane Library and Chinese National Knowledge Infrastructure from database inception to May, 2020. Correlation coefficients (r) were chosen as the effect size with a random model to evaluate the overall effect size between social support and SI in patients with cancer. To assess statistical heterogeneity, we examined potential moderator variables on the social support and SI. RESULTS A total of 881 studies were identified in initial search, and twelve studies were eligible. A negative, small but significant correlation (r = -0.22, 95% CIs: -0.30,-0.14, p < 0.001) was observed between social support and SI in patients with cancer, with a significant heterogeneity (I2 = 95.24%, Q = 231.27, p < 0.001). Moderator analyses indicated that race/ethnicity (Q(1) = 8.4, p < 0.05) and measurements of social support (Q(3) = 9.78, p < 0.05) and SI (Q(3) = 9.69, p < 0.05) significantly moderate the effect size between social support and SI. CONCLUSION Taken together, we found a negative yet significant association between social support and SI in patients with cancer, which supported the importance of social support for the prevention of SI in patients with cancer.
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Affiliation(s)
- Lin Du
- School of Medicine, Nantong University, Nantong, China
| | - Hai-Yan Shi
- Department of Thoracic Oncology, Rugao People's Hospital, Nantong, China
| | - Yan Qian
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, China
| | - Xiao-Hong Jin
- Department of Oncology, Affiliated Hospital of Nantong University, Nantong, China
| | - Yang Li
- School of Public Health, Nantong University, Nantong, China
| | - Hai-Rong Yu
- Department of Thoracic Oncology, Affiliated Hospital of Nantong University, Nantong, China
| | - Xiao-Man Liu
- Department of Ophthalmology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Xue-Lei Fu
- School of Medicine, Nantong University, Nantong, China
| | - Hong-Lin Chen
- School of Public Health, Nantong University, Nantong, China
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Yu H, Cai K, Huang Y, Lyu J. Risk factors associated with suicide among leukemia patients: A Surveillance, Epidemiology, and End Results analysis. Cancer Med 2020; 9:9006-9017. [PMID: 33022890 PMCID: PMC7724501 DOI: 10.1002/cam4.3502] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 09/10/2020] [Accepted: 09/15/2020] [Indexed: 12/24/2022] Open
Abstract
Previous studies have found that the risk of suicide is higher in patients diagnosed with cancer than in the general population. We aimed to identify potential risk factors associated with suicide in leukemia patients by analyzing data obtained from the Surveillance, Epidemiology, and End Results (SEER) database. We screened the SEER database for leukemia patients added between 1975 and 2017, and calculated their suicide rate and standardized mortality rate (SMR) relative to the total United States population from 1981 to 2017 as a reference. Univariate and multivariate Cox regression analyses were used to determine the risk factors for suicide in leukemia patients. We collected 142,386 leukemia patients who had been added to the SEER database from 1975 to 2017, of whom 191 patients committed suicide over an observation period of 95,397 person‐years. The suicide rate of leukemia patients was 26.41 per 100,000 person‐years, and hence the SMR of the suicided leukemia patients was 2.16 (95% confidence interval [CI] = 1.85–2.47). The univariate and multivariate Cox regression analyses showed that a high risk of suicide was associated with male sex (vs. female: hazard ratio [HR] = 4.41, 95% CI = 2.93–6.63, p < 0.001), older age at diagnosis (60–69 years vs. ≤39 years: HR = 2.60, 95% CI = 1.60–4.23, p < 0.001; 70–79 years vs. ≤39 years: HR = 2.84, 95% CI = 1.72–4.68, p < 0.001; ≥80 years vs. ≤39 years: HR = 2.94, 95% CI = 1.65–5.21, p < 0.001), white race (vs. black: HR = 6.80, 95% CI = 1.69–27.40, p = 0.007), acute myeloid leukemia (vs. lymphocytic leukemia: HR = 1.59, 95% CI = 1.09–2.33, p = 0.016), unspecified and other specified leukemia (vs. lymphocytic leukemia: HR = 2.72, 95% CI = 1.55–4.75, p < 0.001), and living in a small city (vs. large city: HR = 2.10, 95% CI = 1.23–3.60, p = 0.007). Meanwhile, being a non‐Hispanic black (vs. Hispanic: HR = 0.06, 95% CI = 0.01–0.62, p = 0.019) was a protective factor for suicide. Male sex, older age at diagnosis, white race, and acute myeloid leukemia were risk factors for suicide in leukemia patients, while being a non‐Hispanic black was a protective factor. Medical workers should, therefore, provide targeted preventive measures to leukemia patients with a high risk of suicide.
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Affiliation(s)
- Haohui Yu
- The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ke Cai
- The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yulin Huang
- The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Jun Lyu
- The First Affiliated Hospital of Jinan University, Guangzhou, China
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Xu Q, Jia S, Fukasawa M, Lin L, Na J, Mu Z, Li B, Li N, Zhao T, Ju Z, He M, Yu L, Kawakami N, Li Y, Jiang C. A cross-sectional study on associations of physical symptoms, health self-efficacy, and suicidal ideation among Chinese hospitalized cancer patients. BMC Psychiatry 2020; 20:544. [PMID: 33213416 PMCID: PMC7678141 DOI: 10.1186/s12888-020-02945-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 11/07/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Epidemiological studies have shown increased risk of suicide in cancer patients compared with the general population. The present study aimed to examine the association between physical symptoms and suicidal ideation in Chinese hospitalized cancer patients and test the modifying effect of health self-efficacy on the association. METHODS A cross-sectional study was conducted with 544 hospitalized cancer patients in two general hospitals in northeast China via face-to-face interviews. Suicidal ideation was measured by using the first four items on the Yale Evaluation of Suicidality scale and then dichotomized into a positive and negative score. Multivariate logistic regression analyses were conducted to examine the impacts of physical symptoms, health self-efficacy, and their interactions on suicidal ideation. RESULTS The suicidal ideation rate was 26.3% in the enrolled cancer patients. Logistic regression showed that insomnia (aOR = 1.84, 95% CI 1.13 to 3.00, p = 0.015) and lack of appetite (aOR = 2.14, 95% CI 1.26 to 3.64, p = 0.005) were significantly associated with suicidal ideation. Low health self-efficacy had a marginally significant exaggerating effect on the association between pain and suicidal ideation (aOR = 2.77, 95% CI 0.99 to 7.74, p = 0.053), after adjusting for significant socio-demographics, clinical characteristics, and depression. CONCLUSIONS These findings demonstrate significant associations between physical symptoms (insomnia and/or lack of appetite) and suicidal ideation and highlight the potential modifying role of health self-efficacy in the identification and prevention of suicide among cancer patients.
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Affiliation(s)
- Qingyi Xu
- grid.411971.b0000 0000 9558 1426Department of Psychology, College of Humanities and Social Sciences, Dalian Medical University, Dalian, China
| | - Shuhua Jia
- grid.411971.b0000 0000 9558 1426Department of Psychology, College of Humanities and Social Sciences, Dalian Medical University, Dalian, China
| | - Maiko Fukasawa
- grid.26999.3d0000 0001 2151 536XDepartment of Mental Health, the Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Lin Lin
- grid.412735.60000 0001 0193 3951School of Psychology, Tianjin Normal University, Tianjin, China
| | - Jun Na
- Liaoning Provincial Center for Disease Control and Prevention, Institute of Chronic Disease, Shenyang, China
| | - Zhen Mu
- grid.411971.b0000 0000 9558 1426Department of Psychology, College of Humanities and Social Sciences, Dalian Medical University, Dalian, China
| | - Bo Li
- grid.452505.30000 0004 1757 6882Department of Geriatrics, Guangzhou Brain Hospital, Guangzhou, China
| | - Ningning Li
- Department of Psychology, Benxi Kangning Hospital, Benxi, China
| | - Tong Zhao
- grid.440706.10000 0001 0175 8217Department of Oncology, Zhongshan Affiliated Hospital of Dalian University, Dalian, China
| | - Zaishuang Ju
- grid.440706.10000 0001 0175 8217Department of Oncology, Zhongshan Affiliated Hospital of Dalian University, Dalian, China
| | - Meng He
- grid.452828.1Department of Oncology, Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lianzheng Yu
- Liaoning Provincial Center for Disease Control and Prevention, Institute of Chronic Disease, Shenyang, China
| | - Norito Kawakami
- grid.26999.3d0000 0001 2151 536XDepartment of Mental Health, the Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Yuejin Li
- grid.260238.d0000 0001 2224 4258Department of Biology, Morgan State University, Baltimore, Maryland USA
| | - Chao Jiang
- Department of Psychology, College of Humanities and Social Sciences, Dalian Medical University, Dalian, China.
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Suicidality in Chronic Illness: An Overview of Cognitive–Affective and Interpersonal Factors. J Clin Psychol Med Settings 2020; 28:137-148. [DOI: 10.1007/s10880-020-09749-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2020] [Indexed: 12/18/2022]
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McFarland DC, Miller AH, Nelson C. A Longitudinal Analysis of Inflammation and Depression in Patients With Metastatic Lung Cancer: Associations With Survival. Biol Res Nurs 2020; 23:301-310. [PMID: 32959680 DOI: 10.1177/1099800420959721] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Depression and inflammation are concomitantly elevated in patients with lung cancer and may have collective survival implications. However, the longitudinal relationship between depression and inflammation in patients with metastatic lung cancer is not fully appreciated. We hypothesized that longitudinal changes in inflammation and depression would be concordant; that longitudinally elevated inflammation would lead to greater depression over time; and that depression with inflammation would be more persistent than depression without inflammation. METHODS Patients with metastatic lung cancer (n = 68) were assessed for clinically significant depression (Hospital Anxiety and Depression Scale ≥ 8) and inflammation (C-Reactive Protein ≥ 1 mg/L) along with demographic variables. Survival estimations were made using Cox Proportional Hazard Model and Kaplan-Meier plot analyses. RESULTS At baseline (T1), 15% had depression and 35% had increased inflammation followed by 18% with depression and 38% with increased inflammation 4.7 months later (T2). The odds ratio of depression in the presence of clinically significant inflammation was 4.8 at T1 and 5.3 at T2. Between time points, inflammation difference correlated with depression difference (r = -.26, p = .03). Significant depression at both time points was associated with a 4 fold risk of inferior survival while significant inflammation at any time point was associated with >3 fold risk of inferior survival. CONCLUSIONS Depression and inflammation track together over time and have variable implications on survival. Persistent depression is particularly detrimental but incidental inflammation is more sensitive to predicting poor survival. These findings have implications for treating depression early in the lung cancer trajectory.
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Affiliation(s)
- Daniel C McFarland
- 423828Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrew H Miller
- Department of Psychiatry and Behavioral Sciences, 12239Emory University School of Medicine, Atlanta, GA, USA
| | - Christian Nelson
- 423828Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Schomberg J, Teismann T, Bussmann S, Vaganian L, Gerlach AL, Cwik JC. The significance of the Interpersonal-Psychological Theory of Suicide in an oncological context-A scoping review. Eur J Cancer Care (Engl) 2020; 30:e13330. [PMID: 32959421 DOI: 10.1111/ecc.13330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/09/2020] [Accepted: 08/07/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Since individuals afflicted with cancer are at an elevated risk of dying by suicide, understanding suicide-related ideation and behaviours is critical in identifying vulnerable patients. The interpersonal theory of suicide (IPTS) provides a framework to research risk factors for suicide and has been validated in different samples. The aim of this scoping review is to study literature related to IPTS and cancer patients. METHODS This scoping review was registered with the OPEN Science Framework (osf.io/92465). The databases PsycINFO, Web of Science, PubMed and PubMed Central were searched. Eligible research needed to use a minimum of one psychometric element to measure at least one of the factors of the IPTS in individuals with cancer. RESULTS Ninety-six studies were identified and screened. Eligible research included individuals with cancer and the use of at least one measurement of at least one of the factors of the IPTS. Overall, four articles met the inclusion criteria and three studies found significant associations of components of the IPTS and suicidal ideation/behaviour. CONCLUSION While these initial findings support the notion that the IPTS is relevant for individuals with cancer as well, a direct validation of the IPTS in cancer patients is needed.
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Affiliation(s)
- Jan Schomberg
- Department of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Northrhine-Westphalia, Germany
| | - Tobias Teismann
- Mental Health Research and Treatment Center, Department of Psychology, Ruhr-University of Bochum, Bochum, Northrhine-Westphalia, Germany
| | - Sonja Bussmann
- Department of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Northrhine-Westphalia, Germany
| | - Lusine Vaganian
- Department of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Northrhine-Westphalia, Germany
| | - Alexander L Gerlach
- Department of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Northrhine-Westphalia, Germany
| | - Jan C Cwik
- Department of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Northrhine-Westphalia, Germany
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Tsai W, Nusrath S, Zhu R. Systematic review of depressive, anxiety and post-traumatic stress symptoms among Asian American breast cancer survivors. BMJ Open 2020; 10:e037078. [PMID: 32895276 PMCID: PMC7478010 DOI: 10.1136/bmjopen-2020-037078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES This paper aimed to review the experience of psychopathology symptoms (ie, depressive, anxiety and post-traumatic stress) and their social, cognitive and affective correlates among Asian American breast cancer survivors. Studies on psychosocial interventions for reducing psychopathology symptoms were also included in this review. DESIGN A systematic review was conducted. METHODS PubMed, PsycINFO and Web of Science were searched from database inception to November 2018. Empirical, peer-reviewed articles on adult women of Asian heritage residing in the USA with breast cancer diagnoses were included in this review. The methodological quality of the included articles was coded. RESULTS The search yielded 16 empirical articles, which were all deemed to be of high methodological quality. Eleven studies utilised a quantitative design, two studies utilised a qualitative design and three studies utilised a mixed-methods design. Thirteen were cross-sectional and three were longitudinal in design. Only two intervention studies were identified. Studies showed that Asian American breast cancer survivors endorsed moderate to high levels of depressive symptoms, anxiety and post-traumatic stress symptoms; those who are more acculturated demonstrated lower levels of depressive and anxiety symptoms. Asian American breast cancer survivors with social constraints were more likely to have intrusive thoughts and, in turn, have high levels of psychopathology symptoms. Intervention studies were limited, but the use of community-based participatory research approaches and cultural adaptations were noted strengths of the studies. DISCUSSION In addition to discussing clinical implications, we highlight limitations of the literature, including a lack of longitudinal studies and the limited use of standardised diagnostic instruments for assessing psychopathology symptoms among this population. Clarifying the prospective relationships between psychopathology symptoms and their social, cognitive and affective correlates will help inform the development of culturally sensitive psychosocial interventions among Asian American breast cancer survivors.
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Affiliation(s)
- William Tsai
- Applied Psychology, New York University, New York, New York, USA
| | - Sumaiya Nusrath
- Applied Psychology, New York University, New York, New York, USA
| | - Ruidi Zhu
- Applied Psychology, New York University, New York, New York, USA
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Barrigon ML, Cegla-Schvartzman F. Sex, Gender, and Suicidal Behavior. Curr Top Behav Neurosci 2020; 46:89-115. [PMID: 32860593 DOI: 10.1007/7854_2020_165] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
This chapter reviews gender differences in suicide, commonly known as the gender paradox in suicide. While men are more likely to complete suicide, suicide attempts are more frequent in women. Although there are exceptions, this paradox occurs in most countries over the world, and it is partially explained by the preference of men for more lethal methods. Nevertheless, there are differences in the known risk factors for suicide between men and women, and this chapter summarizes the more relevant findings for the gender paradox. Apart from previous attempts, which still is the strongest predictor of death by suicide, with a higher rate in males than in females, we will emphasize in the role of male depression. It is commonly recognized that over 90% of people who die by suicide had a psychiatric diagnosis, mostly depression, and male depression seems to be a distinct clinical phenotype challenging to recognize, which might contribute to the gender paradox. Finally, in light of all the information reviewed, some recommendations on prevention of suicide from a gender perspective in the clinical setting will be made.
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Senf B, Maiwurm P, Fettel J. Exposure to suicidality in professionals working with oncology patients: An online survey. Psychooncology 2020; 29:1620-1629. [PMID: 32672869 DOI: 10.1002/pon.5479] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/03/2020] [Accepted: 07/06/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To explore and describe exposure to suicidality in healthcare providers (HCP) working with oncological patients. Special emphasis was put on five central aspects from the HCPs perspective: Exposure, Confidence, Expertise, Distress, and Education. METHODS A 48-item online questionnaire was developed and distributed to HCPs working with cancer patients. Three hundred fifty-four answered questionnaires were analyzed. RESULTS Overall 83.3% of HCPs reported to have encountered at least one suicidal patient in the last year. Feeling confident in talking about suicidality was reported by 72.1% of HCPs, with 71.2% of nurses reporting feeling insecure compared with only 5.1% of psychotherapists. Similarly, 22.3% of HCPs felt overwhelmed when confronted with a patient who substantiated his suicidality during consultation. A lack of personal knowledge concerning suicidality in general and in oncological patients in particular, was reported by 39.6% and 49.8%, respectively. In total, 88.1% of HCPs reported feeling distressed when confronted with suicidality, while 81.1% of participants wanted further education regarding suicidality in cancer patients despite that 73.2% had already received some sort of psycho-oncology education. CONCLUSIONS Despite the well-documented fact of elevated suicide rates in cancer patients, there remain deficits in knowledge, which induce feelings of insecurity and helplessness in HCPs. There is a demand for further education concerning the treatment of suicidal cancer patients. Therefore, special curricula addressing this topic should be devised. A general debate about suicidality in cancer patients could help raise awareness of this problem and generate means of prevention.
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Affiliation(s)
- Bianca Senf
- Department of Psycho-Oncology, University Cancer Center (UCT), Johann Wolfgang Goethe University, Frankfurt/Main, Germany
| | - Paula Maiwurm
- Department of Psycho-Oncology, University Cancer Center (UCT), Johann Wolfgang Goethe University, Frankfurt/Main, Germany
| | - Jens Fettel
- Department of Psycho-Oncology, University Cancer Center (UCT), Johann Wolfgang Goethe University, Frankfurt/Main, Germany
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Sharpley CF, Christie DRH, Bitsika V. Depression and prostate cancer: implications for urologists and oncologists. Nat Rev Urol 2020; 17:571-585. [PMID: 32733038 DOI: 10.1038/s41585-020-0354-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2020] [Indexed: 02/07/2023]
Abstract
Many patients with prostate cancer experience severe levels of depression, which can negatively affect their treatment and disease course. Some prostate cancer treatments can increase the severity of a patient's depression, for example, by increasing anhedonia and erectile dysfunction. Depression is often thought of as a unitary phenomenon, but multiple subtypes can be distinguished. This variety of manifestations challenges the successful application of universal antidepressant treatment options and argues for a multi-symptom assessment process that considers a patient's disease burden and their particular form of depression. Inclusion of screening and detailed diagnosis of depression can be argued to be part of good practice, and clinicians are urged to consider when and how this might be accomplished within their urological practice.
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Affiliation(s)
- Christopher F Sharpley
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.
| | - David R H Christie
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia.,Genesiscare, John Flynn Private Hospital, Tugun, Queensland, Australia
| | - Vicki Bitsika
- Brain-Behaviour Research Group, University of New England, Armidale, New South Wales, Australia
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Jang SY, Yang DS, Cha YH, Yoo HJ, Kim KJ, Choy WS. Suicide in Elderly Patients with Hip Fracture: A South Korean Nationwide Cohort Study. J Bone Joint Surg Am 2020; 102:1059-1065. [PMID: 32310843 DOI: 10.2106/jbjs.19.01436] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND The purpose of the present study was to evaluate the incidence rate (IR) of suicide in elderly patients with hip fracture on the basis of a nationwide cohort and to analyze the change in the hazard ratio for suicide after hip fracture over time in comparison with a control group. METHODS Patients with hip fracture and their matched controls were selected from the National Health Insurance Service-Senior cohort (NHIS-Senior) of the Republic of Korea. The NHIS-Senior consists of 558,147 people selected by a 10% simple random-sampling method from a total of 5.5 million subjects ≥60 years of age in 2002. Risk-set matching (1:2) on the propensity score was performed with use of a nearest neighbor matching algorithm with a maximum caliper of 0.1 for the hazard components. The IR of suicide and 95% confidence interval (CI) were calculated on the basis of a generalized linear model with a Poisson distribution. The effect size was presented as a hazard ratio (HR) with use of the Cox proportional-hazard model with a robust variance estimator that accounts for clustering within matched pairs. RESULTS A total of 11,477 patients with hip fracture and 22,954 matched controls were included. The mean duration of follow-up was 4.59 years, generating 158,139 person-years. During follow-up, a total of 170 suicides were identified. Comparisons at up to 180 days and 365 days showed that patients with hip fracture were at higher risk for suicide than matched controls (p = 0.009 and 0.004, respectively; stratified log-rank test). During the first 180 days of follow-up, 14 suicides were identified in patients with hip fracture during 11,152 person-years (IR, 266.1 per 100,000 person-years; 95% CI, 157.6 to 449.4). Patients with hip fracture were 2.97 times more likely to kill themselves than their matched controls during the same period (HR = 2.97; 95% CI, 1.32 to 6.69). CONCLUSIONS Hip fracture in elderly patients increased suicide risk within a year. A new approach to psychiatric evaluation and management is needed in elderly patients with hip fracture. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Suk-Yong Jang
- Department of Preventive Medicine, Eulji University College of Medicine, Daejeon, Republic of Korea
| | - Dae-Suk Yang
- Department of Orthopedic Surgery, Eulji University Hospital, Daejeon, Republic of Korea
| | - Yong-Han Cha
- Department of Orthopedic Surgery, Eulji University Hospital, Daejeon, Republic of Korea
| | - Heon-Jong Yoo
- Department of Obstetrics and Gynecology, Chungnam National University College of Medicine, Daejeon, Republic of Korea
| | - Kap-Jung Kim
- Department of Orthopedic Surgery, Eulji University Hospital, Daejeon, Republic of Korea
| | - Won-Sik Choy
- Department of Orthopedic Surgery, Eulji University Hospital, Daejeon, Republic of Korea
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Zhou Y, Hu D, Zhang K, Mao J, Teng F, Yu T, Xu K, Tan R, Ding X, Liu Y. The mechanism of family adaptability and cohesion in suicidal ideation among Chinese cancer patients. J Psychosoc Oncol 2020; 38:612-626. [PMID: 32508254 DOI: 10.1080/07347332.2020.1757799] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Yi Zhou
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Deying Hu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Keke Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Fen Teng
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ting Yu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ke Xu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Rong Tan
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaoping Ding
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yilan Liu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Harashima S, Fujimori M. Risk of suicide among adolescents and young adults with cancer and a need for targeted interventions. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:428. [PMID: 32395472 PMCID: PMC7210179 DOI: 10.21037/atm.2020.02.180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Saki Harashima
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Chuo-ku, Tokyo, Japan.,Department of Stress Sciences and Psychosomatic Medicine, The University of Tokyo Graduate School of Medicine, Tokyo, Japan
| | - Maiko Fujimori
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Chuo-ku, Tokyo, Japan
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Kolva E, Hoffecker L, Cox-Martin E. Suicidal ideation in patients with cancer: A systematic review of prevalence, risk factors, intervention and assessment. Palliat Support Care 2020; 18:206-219. [PMID: 31554521 DOI: 10.1017/s1478951519000610] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES Suicidal ideation (SI) underlies risk of death by suicide. It is well established that patients with cancer are at increased risk of death by suicide. Therefore, understanding SI in patients with cancer is critically important. The goal of this systematic review was to investigate the prevalence, risk factors, intervention, and assessment of SI in patients with cancer. METHODS This systematic review was registered with the PROSPERO database (CRD42018115405) and was guided by the PRISMA statement. We searched Medline, PsycInfo, Embase, CINAHL, the Cochrane Database of Systematic Reviews, and Cochrane Central. Two reviewers independently screened abstracts and assessed for quality assurance using a revised Newcastle-Ottawa Scale. RESULTS We identified 439 studies to screen for eligibility. Eligible studies included adults with cancer diagnoses and listed SI as an outcome. Ultimately, 44 studies were included in the analyses. Prevalence of SI ranged greatly from 0.7% to 46.3%. Single items drawn from validated measures were the most frequent method of assessing SI (n = 20, 45.5%); additional methods included validated measures and psychological interviews. Commonly identified risk factors for SI included age, sex, and disease/treatment-related characteristics, as well as psychological constructs including depression, anxiety, hopelessness, existential distress, and social support. SIGNIFICANCE OF RESULTS Assessment of SI in patients with cancer is the concern of researchers worldwide. Prevalence of SI varied with study population and was likely influenced by the method of assessment. Psychological distress consistently predicted SI. Increasing awareness of demographic, clinical, and psychological associations is critical for risk assessment and intervention development.
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Affiliation(s)
- Elissa Kolva
- Division of Medical Oncology, University of Colorado - Anschutz Medical Campus
| | - Lilian Hoffecker
- Health Sciences Library, University of Colorado - Anschutz Medical Campus
| | - Emily Cox-Martin
- Division of Medical Oncology, University of Colorado - Anschutz Medical Campus
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Sun L, Lin C, Shen W, Kao C. Suicide attempts in patients with head and neck cancer in Taiwan. Psychooncology 2020; 29:1026-1035. [DOI: 10.1002/pon.5373] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 02/23/2020] [Accepted: 02/27/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Li‐Min Sun
- Department of Radiation OncologyZuoying Branch of Kaohsiung Armed Forces General Hospital Kaohsiung Taiwan
- Institute of Medical Science and TechnologyNational Sun Yat‐Sen University Kaohsiung Taiwan
| | - Cheng‐Li Lin
- Management Office for Health DataChina Medical University Hospital Taichung Taiwan
- College of MedicineChina Medical University Taichung Taiwan
| | - Wei‐Chih Shen
- Department of Computer Science and Information EngineeringAsia University Taichung Taiwan
- Center of Augmented Intelligence in HealthcareChina Medical University Hospital Taichung Taiwan
| | - Chia‐Hung Kao
- Center of Augmented Intelligence in HealthcareChina Medical University Hospital Taichung Taiwan
- Department of Nuclear Medicine and PET CenterChina Medical University Hospital Taichung Taiwan
- Graduate Institute of Biomedical Sciences, School of Medicine, College of MedicineChina Medical University Taichung Taiwan
- Department of Bioinformatics and Medical EngineeringAsia University Taichung Taiwan
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Zhang Y, Li W, Zhang Z, Sun H, Garg S, Yang Y, Wang H. Suicidal Ideation in Newly-Diagnosed Chinese Cancer Patients. Front Psychiatry 2020; 11:708. [PMID: 32793000 PMCID: PMC7390886 DOI: 10.3389/fpsyt.2020.00708] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/06/2020] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE Suicide is one of the main reasons cited behind the death rate of cancer, and suicidal ideation (SI) is the first step toward it. This study aimed to investigate the prevalence and associates of suicidal ideation in newly-diagnosed Chinese cancer patients. METHODS This multicenter study was conducted from January 2018 to September 2019. Eligible participants were asked to complete a Case Record Form (CRF), the Patient Health Questionnaire (PHQ-9), General Anxiety Disorder Questionnaire (GAD-7), Fear of Cancer Recurrence Questionnaire (FCRQ-7), and McGill Pain Questionnaire-Visual Analogue Scale (MPQ-VAS). Univariate analyses and multivariate logistic regression analyses were conducted for assessment. RESULTS Out of 603 patients, 91 (15.1%, 95%CI: 12.23%-17.96%) reported suicidal ideation in the last 2 weeks. Physical comorbidities (OR=1.808, P=0.039), childhood adversity experience (OR=5.999, P=0.001), cancer pain (OR=1.828, P=0.047), depression (OR=2.811, P=0.013), and anxiety (OR=6.532, P<0.001) were significantly associated with suicidal ideation. It was also found that patients who regularly exercised were less likely to report suicidal thoughts (OR=0.172, P=0.007). CONCLUSION Physical comorbidities, body ache, and mood disturbances are possible risk factors for suicidal ideation that warrant further attention in clinical practice. Preventive measures, such as systematic screening and arrangement for regular check-ups, could be beneficial to lower the risk of suicide.
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Affiliation(s)
- Yongfu Zhang
- Department of Anesthesiology, Guangzhou Women and Children's Medical Centre, Guangzhou, China
| | - Wengao Li
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Zijun Zhang
- Social Work and Counselling Team, CNSST Foundation, Auckland, New Zealand
| | - Hengwen Sun
- Department of Radiotherapy, Cancer Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Guangzhou, China
| | - Samradhvi Garg
- School of Health in Social Science, University of Edinburgh, Edinburgh, United Kingdom
| | - Yuan Yang
- Department of Psychiatry, Southern Medical University Nanfang Hospital, Guangzhou, China
| | - Hongmei Wang
- Department of Radiation Oncology, Southern Medical University Nanfang Hospital, Guangzhou, China
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Ludolph P, Kunzler AM, Stoffers-Winterling J, Helmreich I, Lieb K. Interventions to Promote Resilience in Cancer Patients. DEUTSCHES ARZTEBLATT INTERNATIONAL 2019; 51-52:865-872. [PMID: 31941574 DOI: 10.3238/arztebl.2019.0865] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 06/24/2019] [Accepted: 07/30/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Resilience is the ability to maintain or rapidly regain mental health during or after stressful life experiences. Cancer is a major risk factor for stress- associated mental illness. In this review, we attempt to identify effective resilience- promoting interventions in adults with cancer. METHODS The analysis was restricted to randomized, controlled trials of resilience- promoting interventions in adults with cancer in which training was provided for at least one psychosocial resilience factor. A selective search, with systematic compo- nents, for relevant publications was carried out in the PubMed and CENTRAL data- bases. Effect sizes (Hedges' g) were calculated wherever a fully reported dataset for resilience or post-traumatic growth was available. RESULTS Twenty-two trials with a total of 2,912 patients were included in the analy- sis; the intervention was provided in an individual setting in five trials and in group format in 17. Beneficial effects on resilience and post-traumatic growth, some of them large, were observed in patients who were acutely ill with cancer and after in- terventions that were provided in more than 12 sessions. The effect size ranged from g = 0.33 to g = 1.45. Largely beneficial effects were achieved by interventions based on the concepts of positive psychology, supportive-expressive group therapy, behavioral therapy, or mindfulness, with considerable variation in individual effect sizes. CONCLUSION Interventions that promote resilience should be made available to inter- ested and motivated cancer patients. These interventions should be provided, in as soon as the diagnosis is made and should ex- tend over more than 12 sessions whenever possible.
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Affiliation(s)
- Paul Ludolph
- Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany; German Resilience Center (DRZ) Mainz, Mainz, Germany
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Bingo SAM, Maree JE, Jansen van Rensburg JJM. Living with cancer of the head and neck: A qualitative inquiry into the experiences of South African patients. Eur J Cancer Care (Engl) 2019; 29:e13205. [PMID: 31829489 DOI: 10.1111/ecc.13205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 10/09/2019] [Accepted: 11/22/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the experiences of South African patients living with head and neck cancer. METHODS We used a qualitative descriptive design and conducted unstructured interviews with 18 (n = 18) purposive selected participants. Data saturation determined the sample size. Qualitative content analysis was used to analyse the data. RESULTS The majority of the sample were Black males; on average, 50.8 years (SD ± 13.6) old. Two themes and eight subthemes arose from the data. The themes were living with the consequences of the illness and treatment, and coping with a changed life. The lives the participants knew before becoming sick changed and became a living hell; pain was a major problem as was eating and for some, communicating. The participants were stigmatised, ridiculed and rejected which added to their suffering. Receiving support from family and friends and their faith in God assisted them to cope with their changed lives. CONCLUSION Our study poses various challenges to clinical practice. Pain management is of the utmost importance; the nutritional status of these patients should be monitored and best practices in terms of management applied. Raising awareness of cancer and its complications could improve knowledge and decrease blame, stigmatisation and rejection and improve patient outcomes.
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Affiliation(s)
- Samuel Alloss Mbale Bingo
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Johanna Elizabeth Maree
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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