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Goerling U, Hinz A, Koch-Gromus U, Hufeld JM, Esser P, Mehnert-Theuerkauf A. Prevalence and severity of anxiety in cancer patients: results from a multi-center cohort study in Germany. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04600-w. [PMID: 36757620 PMCID: PMC10356888 DOI: 10.1007/s00432-023-04600-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/25/2023] [Indexed: 02/10/2023]
Abstract
PURPOSE Anxiety is an accompanying symptom in cancer patients that can have a negative impact on patients. The aim of the present analyses is to determine the prevalence of anxiety, taking into account sociodemographic and medical variables, and to determine the odds ratio for the occurrence of anxiety in cancer patients compared to general population. METHODS In this secondary analyses, we included 4,020 adult cancer patients during and after treatment from a multi-center epidemiological study from 5 regions in Germany in different treatment settings and a comparison group consisting of 10,000 people from the general population in Germany. Anxiety was measured with the Generalized Anxiety Disorder (GAD-7) questionnaire. In multivariate analyses adjusted for age and sex, we calculated the odds of being anxious. RESULTS The prevalence of anxiety was observed to be 13.8% (GAD-7 ≥ 10). The level of anxiety was significant higher for patients in rehabilitation, compared to patients during inpatient and outpatient treatment (p = .013). Comparison with the general population yielded a 2.7-fold increased risk for anxiety among cancer patients (95% CI 2.4-3.1; p < .001). Patients with bladder cancer (OR, 5.3; 95% CI 3.0-9.4) and testicular cancer (OR, 5.0; 95% CI 2.1-12.1) showed the highest risk of having high levels of anxiety. CONCLUSION The results highlight the importance of identifying anxiety in cancer patients.
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Affiliation(s)
- Ute Goerling
- Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charité Comprehensive Cancer Center, Charitéplatz 1, 10117, Berlin, Germany.
| | - Andreas Hinz
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Uwe Koch-Gromus
- Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Julia Marie Hufeld
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Peter Esser
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
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Ye Z, Chen B, Gao N, Kong Q, Hu X, Lu Z, Qian J, Hu G, Cai J, Wu B. CYP2D6 gene polymorphism and apatinib affect the metabolic profile of fluvoxamine. Front Pharmacol 2022; 13:985159. [PMID: 36120346 PMCID: PMC9479105 DOI: 10.3389/fphar.2022.985159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
This study aimed 1) to investigate the influence of CYP2D6 variants on the catalyzing of fluvoxamine, and 2) to study the interaction between fluvoxamine and apatinib. An enzymatic reaction system was setup and the kinetic profile of CYP2D6 in metabolizing fluvoxamine was determined. In vivo, drug-drug interaction was investigated using Sprague–Dawley (SD) rats. Fluvoxamine was given gavage with or without apatinib. Ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) was used to determine the concentrations of fluvoxamine and desmethyl-fluvoxamine. The results demonstrated that the relative clearance rates of CYP2D6.A5V, V104A, D337G, F164L, V342M, R440C and R497C increased significantly compared with CYP2D6.1, ranging from 153.626% ± 6.718% to 394.310% ± 33.268%. The activities of other variants reduced to different extent, or even lost function, but there was no statistical difference. The IC50 of apatinib against fluvoxamine disposition was determined, which is 0.190 μM in RLM and 6.419 μM in HLM, respectively. In vivo, apatinib can enhance the plasma exposure of fluvoxamine remarkably characterized by increased AUC, Tmax and Cmax. Meanwhile, the produce of desmethyl fluvoxamine was dramatically inhibited, both AUC and Cmax decreased significantly. Mechanistically, apatinib inhibit the generation of fluvoxamine metabolite with a mixed manner both in RLM and HLM. Furthermore, there were differences in the potency of apatinib in suppressing fluvoxamine metabolism among CYP2D6.1, 2 and 10. In conclusion, CYP2D6 gene polymorphisms and drug-drug interaction can remarkably affect the plasma exposure of fluvoxamine. The present study provides basis data for guiding individual application of fluvoxamine.
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Affiliation(s)
- Zhize Ye
- Institute of Molecular Toxicology and Pharmacology, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Bingbing Chen
- Institute of Molecular Toxicology and Pharmacology, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Nanyong Gao
- Institute of Molecular Toxicology and Pharmacology, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Qihui Kong
- Institute of Molecular Toxicology and Pharmacology, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Xiaoqin Hu
- Institute of Molecular Toxicology and Pharmacology, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Zhongqiu Lu
- Emergency Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jianchang Qian
- Institute of Molecular Toxicology and Pharmacology, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
| | - Guoxin Hu
- Institute of Molecular Toxicology and Pharmacology, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Guoxin Hu, ; Jianping Cai, ; Bin Wu,
| | - Jianping Cai
- Institute of Molecular Toxicology and Pharmacology, School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, China
- *Correspondence: Guoxin Hu, ; Jianping Cai, ; Bin Wu,
| | - Bin Wu
- Emergency Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- *Correspondence: Guoxin Hu, ; Jianping Cai, ; Bin Wu,
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Influence of Psychological Nursing Intervention on Psychological State, Treatment Compliance, and Immune Function of Postoperative Patients with Rectal Cancer. JOURNAL OF ONCOLOGY 2021; 2021:1071490. [PMID: 34335750 PMCID: PMC8315871 DOI: 10.1155/2021/1071490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Accepted: 07/08/2021] [Indexed: 12/22/2022]
Abstract
In order to explore the clinical effect of psychological nursing intervention on postoperative chemotherapy for rectal cancer, 120 cases of rectal cancer patients were selected as the research subjects. The control group received conventional nursing treatment after operation, and the research group received comprehensive psychological nursing intervention on this basis. The self-rating anxiety scale (SAS) scores, self-rating depression scale (SDS) scores, hope level scores, nursing satisfaction, mental state changes, treatment compliance, and immune function of two groups were analyzed and compared. There was no significant difference between the two groups of patients in the preoperative SAS, SDS, and hope level scale scores. After the intervention, postoperative SAS and SDS scores and CD8+ value of the research group were significantly lower than those of the control group. In contrast, the postoperative hope level score, treatment compliance, and postoperative CD4+/CD8+ of the research group were significantly higher, and the nursing satisfaction was better than that of the control group. The application of psychological nursing intervention in postoperative chemotherapy for patients with rectal cancer can effectively relieve anxiety and depression of patients, promote patients to establish a healthy and coordinated mental state, improve treatment compliance, improve immune function, and promote disease recovery.
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Zhao W, Wu Z, Chen J, Jia H, Huang Z, Chen M, Gu X, Liu M, Zhang Z, Wang H, Wang P, Cheng W. Survival prediction of anxious emotion in advanced cancer patients receiving palliative care. Psychooncology 2016; 26:1463-1469. [DOI: 10.1002/pon.4314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 10/11/2016] [Accepted: 11/11/2016] [Indexed: 12/27/2022]
Affiliation(s)
- Weiwei Zhao
- Department of Integrated Therapy; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology, Shanghai Medical College; Fudan University; Shanghai China
| | - Zhenyu Wu
- Department of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety; Ministry of Education; Fudan University; Shanghai China
| | - Jianhua Chen
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center; Shanghai Jiao Tong University School of Medicine; Shanghai China
| | - Huixun Jia
- Department of Oncology, Shanghai Medical College; Fudan University; Shanghai China
| | - Zhe Huang
- Department of Integrated Therapy; Fudan University Shanghai Cancer Center; Shanghai China
| | - Menglei Chen
- Department of Integrated Therapy; Fudan University Shanghai Cancer Center; Shanghai China
| | - Xiaoli Gu
- Department of Integrated Therapy; Fudan University Shanghai Cancer Center; Shanghai China
| | - Minghui Liu
- Department of Integrated Therapy; Fudan University Shanghai Cancer Center; Shanghai China
| | - Zhe Zhang
- Department of Integrated Therapy; Fudan University Shanghai Cancer Center; Shanghai China
| | - Huaping Wang
- Department of Integrated Therapy; Fudan University Shanghai Cancer Center; Shanghai China
| | - Peng Wang
- Department of Oncology, Shanghai Medical College; Fudan University; Shanghai China
- Department of Integrative Oncology; Fudan University Shanghai Cancer Center; Shanghai China
| | - Wenwu Cheng
- Department of Integrated Therapy; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology, Shanghai Medical College; Fudan University; Shanghai China
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Discovery and replication of a peripheral tissue DNA methylation biosignature to augment a suicide prediction model. Clin Epigenetics 2016; 8:113. [PMID: 27822318 PMCID: PMC5093988 DOI: 10.1186/s13148-016-0279-1] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 10/20/2016] [Indexed: 12/25/2022] Open
Abstract
Background Suicide is the second leading cause of death among adolescents in the USA, and rates are rising. Methods to identify individuals at risk are essential for implementing prevention strategies, and the development of a biomarker can potentially improve prediction of suicidal behaviors. Prediction of our previously reported SKA2 biomarker for suicide and PTSD is substantially improved by questionnaires assessing perceived stress or anxiety and is therefore reliant on psychological assessment. However, such stress-related states may also leave a biosignature that could equally improve suicide prediction. In genome-wide DNA methylation data, we observed significant overlap between waking cortisol-associated and suicide-associated DNA methylation in blood and the brain, respectively. Results Using a custom bioinformatic brain to blood discovery algorithm, we derived a DNA methylation biosignature that interacts with SKA2 methylation to improve the prediction of suicidal ideation in our existing suicide prediction model across both blood and saliva data sets. This biosignature was independently validated in the Grady Trauma Project cohort and interacted with HPA axis metrics in the same cohort. The biosignature showed a relationship with immune status by its correlation with myeloid-derived cell proportions in all data sets and with IL-6 measures in a prospective postpartum depression cohort. Three probes showed significant correlations with the biosignature: cg08469255 (DDR1), cg22029879 (ARHGEF10), and cg24437859 (SHP1), of which SHP1 methylation correlated with immune measures. Conclusions We conclude that this biosignature interacts with SKA2 methylation to improve suicide prediction and may represent a biological state of immune and HPA axis modulation that mediates suicidal behavior. Electronic supplementary material The online version of this article (doi:10.1186/s13148-016-0279-1) contains supplementary material, which is available to authorized users.
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