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Zhang X, Zhang D, Liu Y, Tian Y, Yu F, Cao Y, Su Y. The effects of psychological interventions on suicide for cancer patients: a systematic review and network meta-analysis. PSYCHOL HEALTH MED 2024:1-23. [PMID: 38785256 DOI: 10.1080/13548506.2024.2356026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 05/10/2024] [Indexed: 05/25/2024]
Abstract
Numerous psychological interventions are available for suicidal and death ideation (SDI) and suicidal behavior among cancer patients. To identify the optimal psychological interventions for reducing SDI and suicidal behavior in cancer patients. However, it remains unclear which psychological intervention is the most effective. We performed a pairwise and network meta-analysis by searching seven databases from the date of inception until 8 April 2022. An important focus of this network meta-analysis was the comparison of the effects of various psychological interventions on the reduction of SDI and suicidal behavior among cancer patients. For determining efficacy, we used standardized mean differences (SMDs) and 95% confidence intervals (CIs). Besides, a pairwise meta-analysis, inconsistency test, network meta-analysis, the surface under the cumulative rankings curve (SUCRA), comparison-adjusted funnel plot, subgroup analysis, and sensitivity analysis were also carried out. A total of 8 studies involving 1,350 patients were searched in this study. It showed that empathy therapy (SUCRA = 95.3%) has the best effect among the six interventions. Comprehensive psychological intervention (SUCRA = 77.6%) was ranked in the top two positions, followed by meaning-centered therapy (SUCRA = 40.7%). Comparison-adjusted funnel plots revealed no significant publication bias. In addition, our conclusions have not changed significantly after the sensitivity analysis. In this network meta-analysis, empathy therapy was identified as the optimal choice for reducing SDI and suicidal behaviors in cancer patients. Further multi-center and high-quality RCT studies should be conducted to make our conclusion more rigorous.
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Affiliation(s)
- Xinyue Zhang
- School of Nursing & Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Dan Zhang
- Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Shandong University, Jinan, Shandong, China
| | - Yuqi Liu
- School of Nursing & Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Yinong Tian
- School of Foreign Languages and Literature, Shandong University, Jinan, Shandong, China
| | - Feiping Yu
- School of Nursing & Rehabilitation, Shandong University, Jinan, Shandong, China
| | - Yingjuan Cao
- School of Nursing & Rehabilitation, Shandong University, Jinan, Shandong, China
- Nursing Theory & Practice Innovation Research Center, Shandong University, Jinan, Shandong, China
- Department of Nursing, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yonggang Su
- School of Nursing & Rehabilitation, Shandong University, Jinan, Shandong, China
- Department of Medical Psychology and Ethics, School of Basic Medical Sciences, Shandong University, Jinan, Shandong, China
- School of Foreign Languages and Literature, Shandong University, Jinan, Shandong, China
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Gabanelli P, Monzani D, Fiabane E, Quaquarini E, Frascaroli M, Balletti E, Bernardo A, Teragni CM, Grossi F, Pravettoni G, Gorini A. Perceived risk, illness perception and dispositional optimism related to COVID-19 among oncologic outpatients undergoing in-hospital treatments and healthy controls. Psychol Health 2024; 39:417-433. [PMID: 35435083 DOI: 10.1080/08870446.2022.2065275] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 04/07/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE This study aimed to explore risk estimations (perceived risk, dispositional optimism) related to COVID-19 perception and distress in oncologic outpatients undergoing active hospital treatments compared to the general population. DESIGN AND MAIN OUTCOME MEASURES Data were collected during the Italian lockdown on 150 oncologic outpatients and a sample of 150 healthy subjects. They completed a battery of questionnaires including the Perceived Risk scale, the Brief Illness Perception Questionnaire, the Life Orientation Test- Revised and the Patient Health Questionnaire-4. Descriptive statistics, correlation analysis, and a moderated mediation model were performed to test the study hypotheses. RESULTS The moderated mediation model attested significant conditional indirect associations of both clinical status and dispositional optimism with distress through the mediation of COVID-19 perceived risk. Healthy individuals and less optimistic people were more likely than others to report higher psychological distress only when they showed neutral or negative COVID-19-related illness perception. CONCLUSIONS Cancer patients manifest a lower risk perception and a more positive illness representation related to COVID-19 compared to control subjects; the distress level is not associated with the clinical status, but it is moderated by illness perception. Adequate protective behaviors in cancer patients may avoid a dangerous underestimation of objective risks.
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Affiliation(s)
- Paola Gabanelli
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Pavia Institute, Italy
| | - Dario Monzani
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Elena Fiabane
- Department of Physical and Rehabilitation Medicine of Nervi Institute, Istituti Clinici Scientifici Maugeri IRCCS, Italy
| | - Erica Quaquarini
- Istituti Clinici Scientifici Maugeri IRCCS, Operative Unit of Medical Oncology of Pavia Institute, Italy
| | - Mara Frascaroli
- Istituti Clinici Scientifici Maugeri IRCCS, Operative Unit of Translational Oncology of Pavia Institute, Italy
| | - Emanuela Balletti
- Istituti Clinici Scientifici Maugeri IRCCS, Operative Unit of Medical Oncology of Pavia Institute, Italy
| | - Antonio Bernardo
- Istituti Clinici Scientifici Maugeri IRCCS, Operative Unit of Medical Oncology of Pavia Institute, Italy
| | - Cristina Maria Teragni
- Istituti Clinici Scientifici Maugeri IRCCS, Operative Unit of Medical Oncology of Pavia Institute, Italy
| | - Federica Grossi
- Istituti Clinici Scientifici Maugeri IRCCS, Psychology Unit of Pavia Institute, Italy
| | - Gabriella Pravettoni
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Alessandra Gorini
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
- Istituti Clinici Scientifici Maugeri IRCCS, Milano Institute, Italy
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3
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Mamudu L, Li J, McEligot AJ, Wood M, Rusmevichientong P, Tetteh-Bator E, Soale AN, Fortenberry JD, Williams F. Cancer worry and its impact on self-reported depressive symptoms among adult males and females in the US: a nationwide sample study. BMC Psychiatry 2024; 24:31. [PMID: 38191340 PMCID: PMC10773041 DOI: 10.1186/s12888-023-05405-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 11/25/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVE With cancer the second deadliest disease in the world, worry about cancer can have mental health or psychiatric implications. This study examines the prevalence, differences, and influence of cancer worry (CW), its interaction effect with age, and other confounders on self-reported depressive symptoms (SRDS) among adult males and females in the US. METHODS We utilized a nationally representative sample data of 2,950 individuals (males = 1,276; females = 1,674) from Cycle 4 of the Health Information National Trends Survey 5 (HINTS 5) 2020. Using frequencies, bivariate chi-square test, and multivariate logistic regression, we examined the prevalence, difference, and association of CW with SRDS, adjusting for confounders. RESULTS The prevalence rate of SRDS was found to be 32% among females and 23.5% among males. Among individuals with CW, females had a higher prevalence of SRDS compared to males (40.5% vs. 35.1%). However, there was a significant difference in the likelihood of experiencing SRDS between males and females with CW, with males having 84% increased risk compared to females. Across all age groups, the multivariate analysis of the relationship between CW and SRDS revealed that both males and females showed a significantly decreased likelihood of SRDS compared to those aged 18-34 years. However, males aged 35 years or older exhibited an even more pronounced decrease in likelihood compared to females in the same age group. Nonetheless, when examining the interaction of age and CW, we observed a significantly increased likelihood of SRDS across all age groups. Males, in particular, had a higher increased likelihood of SRDS compared to females across all ages, except for those aged 75 years and older. CONCLUSION The findings of this study highlight the significant influence of CW on individuals' SRDS and the modifying effect of age, particularly among males. These results are important for a better understanding of the risk of CW on mental health, which can be a preventive strategy or control mechanism.
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Affiliation(s)
- Lohuwa Mamudu
- Department of Public Health, California State University, 800 N. State College Boulevard, Fullerton, Fullerton, CA, 92831, USA.
| | - Jinyi Li
- Department of Public Health, University of California Irvine, Irvine, CA, 92967, USA
| | - Archana J McEligot
- Department of Public Health, California State University, 800 N. State College Boulevard, Fullerton, Fullerton, CA, 92831, USA
| | - Michele Wood
- Department of Public Health, California State University, 800 N. State College Boulevard, Fullerton, Fullerton, CA, 92831, USA
| | - Pimbucha Rusmevichientong
- Department of Public Health, California State University, 800 N. State College Boulevard, Fullerton, Fullerton, CA, 92831, USA
| | - Erasmus Tetteh-Bator
- Department of Mathematics and Statistics, University of South Florida, 4202 E. Fowler Ave, Tampa, FL, 33620, USA
| | - Abdul-Nasah Soale
- Department of Mathematics and Statistics, Applied Mathematics and Statistics, Case Western Reserve University, Yost Hall, 2049 Martin Luther King Jr. Drive, 44106-7058, Cleaveland, OH, USA
| | - James D Fortenberry
- Division of Adolescent Medicine, Indiana University School of Medicine, 410 W 10th St., Room 1001, Indianapolis, IN, 46202, USA
| | - Faustine Williams
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, 11545 Rockville Pike, T-10 C12, Rockville, MD, 20852, USA.
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De Muro M, Janssen AJ, Amadori S, de Fabritiis P, Sabatino D, Niscola P, Torti L, Trawinska MM, Tesei C, Bombaci F, Tarricone M, Bocchia M, Fava C, Galimberti S, Iurlo A, Luciano L, Abruzzese E. Impact on mental health, disease management, and socioeconomic modifications in hematological patients during the COVID-19 pandemic in Italy. Ther Adv Hematol 2023; 14:20406207231190683. [PMID: 37693118 PMCID: PMC10483981 DOI: 10.1177/20406207231190683] [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: 02/11/2023] [Accepted: 07/12/2023] [Indexed: 09/12/2023] Open
Abstract
Background Hematological patients are a highly vulnerable population with an increased risk of developing severe COVID-19 symptoms due to their immunocompromised status. COVID-19 has proven to cause serious mental health issues, such as stress, anxiety, and depression in the general population. However, data on the psycho-social impact of COVID-19 on hematological patients are lacking. Objectives This study aims to examine the psychological well-being of hematological patients in Italy during the initial period of the COVID-19 pandemic. Furthermore, it seeks to explore the association between modifications in the management of hematological diseases and employment status of these patients during the COVID-19 pandemic and the resulting mental health outcomes. Design and Methods A survey using the DASS-21 questionnaire was administered to 1105 hematological patients. Data analysis was conducted using the R software, and logistic regression analysis was performed to predict the association between hematological patient/general population and employment status with DASS scores. Results The hematological patient population reported significantly higher levels of depression (OR 0.947, 95% CI 0.966-0.982, p < 0.001), anxiety (OR 0.948, 95% CI 0.939-0.958, p < 0.001), and stress (OR 0.984, 95% CI 0.977-0.992, p < 0.001) compared with the general population. A significant relationship has been found in stress between employed and unemployed patients (OR 1.015, 95% CI 1.000-1.030, p = 0.044), as well as in the control group (OR 1.024, 95% CI 1.010-1.039, p = 0.001). In addition, employment status is significantly related to depression, anxiety, and stress in both the hematological patient group and the general population. Conclusion During the initial phase of the COVID-19 pandemic, hematological patients had elevated levels of depression, anxiety, and stress compared with the general population. The delay in their treatment and employment status played a role in their mental health outcomes. These findings emphasize the importance of further research to gain deeper insight into the long-term psychological effects and explore effective strategies for managing mental health in similar crises.
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Affiliation(s)
- Marianna De Muro
- Department of Hematology and Stem Cell Transplantation, Campus Bio-Medico University Hospital, Rome, Italy
| | | | | | - Paolo de Fabritiis
- Hematology S. Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, Italy
| | - Dante Sabatino
- Institute for Research on Population and Social Policies, National Research Council (CNR), Rome, Italy
| | - Pasquale Niscola
- Hematology S. Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, Italy
| | - Lorenza Torti
- Hematology S. Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, Italy
| | | | - Cristiano Tesei
- Hematology Unit, Tor Vergata University Hospital, Rome, Italy
| | - Felice Bombaci
- Italian Association against Leukemia (AIL) Onlus, Rome, Italy
| | - Mario Tarricone
- Italian Association against Leukemia (AIL) Onlus, Rome, Italy
| | - Monica Bocchia
- Unit of Hematology, Azienda Ospedaliera Universitaria Senese and University of Siena, Siena, Italy
| | - Carmen Fava
- Department of Clinical and Biological Sciences, University of Turin, Azienda Ospedaliera Ordine Mauriziano di Torino, Torino, Italy
| | - Sara Galimberti
- Section of Hematology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessandra Iurlo
- Hematology Division, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Elisabetta Abruzzese
- Hematology, S. Eugenio Hospital, Tor Vergata University, ASL Roma2. Piazzale dell’Umanesimo 10, 00144 Rome, Italy
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Michalek IM, Caetano dos Santos FL, Wojciechowska U, Didkowska J. Suicide after a Diagnosis of Cancer: Follow-Up of 1.4 Million Individuals, 2009-2019. Cancers (Basel) 2023; 15:4315. [PMID: 37686591 PMCID: PMC10486959 DOI: 10.3390/cancers15174315] [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] [Received: 07/29/2023] [Revised: 08/21/2023] [Accepted: 08/25/2023] [Indexed: 09/10/2023] Open
Abstract
Background: The study explores whether Polish cancer patients face elevated suicide risk, emphasizing the vital need to comprehend and mitigate their unique mental health struggles. Methods: We conducted a cohort study based on Polish National Cancer Registry data (diagnosis in 2009-2019). Age-, sex-, and year-standardized mortality ratios (SMR) are presented with 95% confidence intervals (CIs) overall and by sex. Results: The study included 1.43 million individuals diagnosed with cancer. There were 830 suicide cases in this group. The overall SMR for suicide was 1.34 (95% CI 1.25-1.43). The highest risk of suicide death was observed in the first six months after diagnosis (SMR = 1.94, 1.69-2.21): cancers of the heart and pleura (19.15, 2.32-69.18), an unspecified site (3.99, 1.09-10.22), and the esophagus (3.34, 1.08-7.79). The highest overall risk of suicide after cancer diagnosis was observed in esophageal (2.94, 1.47-5.26), gastric (2.70, 2.00-3.57), cervical (2.20, 1.06-4.05), and head and neck cancers (2.06, 1.52-2.72). Conclusions: Patients with cancer face significantly higher suicide risk, peaking within six months post-diagnosis. Urgent integration of suicide risk screening and prevention into cancer care is crucial, supporting mental well-being and guiding proactive healthcare strategies.
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Affiliation(s)
- Irmina Maria Michalek
- Polish National Cancer Registry, Maria Sklodowska-Curie National Research Institute of Oncology, 02-093 Warsaw, Poland
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Katayama ES, Moazzam Z, Woldesenbet S, Lima HA, Endo Y, Azap L, Yang J, Dillhoff M, Ejaz A, Cloyd J, Pawlik TM. Suicidal Ideation Among Patients with Gastrointestinal Cancer. Ann Surg Oncol 2023; 30:3929-3938. [PMID: 37061648 DOI: 10.1245/s10434-023-13471-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 03/22/2023] [Indexed: 04/17/2023]
Abstract
BACKGROUND Mental illness (MI) and suicidal ideation (SI) often are associated with a diagnosis of cancer. We sought to define the incidence of MI and SI among patients with gastrointestinal cancers, as well as ascertain the predictive factors associated with SI. METHODS Patients diagnosed between 2004 and 2016 with stomach, liver, pancreatic, and colorectal cancer were identified from the SEER-Medicare database. County-level social vulnerability index (SVI) was extracted from the Centers for Disease Control database. Multivariable logistic regression was used to identify factors associated with SI. RESULTS Among 382,266 patients, 83,514 (21.9%) individuals had a diagnosis of MI. Only 1410 (0.4%) individuals experienced SI, and 359 (0.1%) committed suicide. Interestingly, SI was least likely among patients with pancreatic cancer (ref: hepatic cancer; odds ratio [OR] 0.67, 95% confidence interval [CI] 0.52-0.86; p = 0.002), as well as individuals with stage III/IV disease (OR 0.59, 95% CI 0.52-067; p < 0.001). In contrast, male (OR 1.34, 95% CI 1.19-1.50), White (OR 1.34, CI 1.13-1.59), and single (OR 2.03, 95% CI 1.81-2.28) patients were at higher odds of SI risk (all p < 0.001). Furthermore, individuals living in relative privilege (low SVI) had markedly higher risk of SI (OR 1.33, 95% CI 1.14-1.54; p < 0.001). Moreover, living in a county with a shortage of mental health professionals was associated with increased odds of developing SI (OR 1.21, 95% CI 1.04-1.40; p = 0.012). CONCLUSIONS Oncology care teams should incorporate routine mental health and SI screening in the treatment of patients with gastrointestinal cancers, as well as target suicide prevention towards patients at highest risk.
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Affiliation(s)
- Erryk S Katayama
- Department of Surgery, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Zorays Moazzam
- Department of Surgery, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Selamawit Woldesenbet
- Department of Surgery, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Henrique A Lima
- Department of Surgery, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Yutaka Endo
- Department of Surgery, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Lovette Azap
- Department of Surgery, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Jason Yang
- Department of Surgery, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Mary Dillhoff
- Department of Surgery, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Aslam Ejaz
- Department of Surgery, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Jordan Cloyd
- Department of Surgery, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University, Wexner Medical Center and James Comprehensive Cancer Center, Columbus, OH, USA.
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Chavez MN, Marshall VK, Martinez Tyson D, Mason TM, Rechenberg K. Psychological Impact of COVID-19 on Oncology Patients: Perceptions of Oncology Health Care Providers. West J Nurs Res 2023; 45:152-160. [PMID: 35897163 PMCID: PMC10079896 DOI: 10.1177/01939459221114634] [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] [Indexed: 12/27/2022]
Abstract
The COVID-19 pandemic profoundly impacted psychological well-being worldwide. Oncology health care professionals' (OHCPs') perceptions of psychological effects of COVID-19 among people in active cancer treatment were explored. Semi-structured interviews with a purposive sample of OHCPs actively providing care were conducted. Interviews were audio-recorded, transcribed, and coded using Atlas.ti v8 and thematic analysis. In total, 30 OHCPs participated. Most were registered nurses (70%), worked in outpatient setting (56.7%) and were in their current position 1-5 years (53.3%). Overarching themes are as follows: (a) cancer treatment disrupted due to patients' fear of exposure to COVID-19; (b) social distancing restrictions caused discontinued social support and supportive services that exacerbated psychological distress; (c) pandemic-related stressors led to overwhelmed coping skills; and (d) OHCPs played a vital role in providing emotional support and connecting patients with family/friends through technology. Behavioral health interventions should focus within the "new world of COVID-19" of reduced face-to-face support and increased online support for patients.
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Affiliation(s)
- Melody N. Chavez
- College of Public Health, University of
South Florida, Tampa, FL, USA
| | | | | | - Tina M. Mason
- H. Lee Moffitt Cancer Center &
Research Institute, Tampa, FL, USA
- Tina M. Mason, Department of Nursing
Research, H. Lee Moffitt Cancer Center, 12902 Magnolia Drive, Tampa, FL 33612,
USA.
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Ma Z, Mao Y, Wang Y, Duan Z, Qu D, Li C, Chen R, Liu Z. Suicidal ideation and attempted suicide among cancer patients during the COVID-19 pandemic. J Med Virol 2022; 94:5827-5835. [PMID: 35982024 PMCID: PMC9538100 DOI: 10.1002/jmv.28076] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/04/2022] [Accepted: 08/17/2022] [Indexed: 01/06/2023]
Abstract
This study aimed to understand the suicidal ideation and suicidal attempts among cancer patients during the COVID-19 pandemic. The data were collected from patients diagnosed with cancer while attending the largest cancer center in the south of China. A structured questionnaire was used to investigate patients' demographic data, suicidal behavior, and factors related to COVID-19. Mental health conditions were measured by the Generalized Anxiety Disorder-7, the Patient Health Questionnaire-9, and the Brief Symptom Inventory. Comorbidities and medical conditions of cancer patients were extracted from the electronic healthcare records. Among the 5670 cancer patients, 755 (13.3%) reported suicidal ideation, and 266 (4.7%) reported suicidal attempts during the COVID-19 pandemic. The age group with the highest risk of suicidal ideation was 20-24 years (23.9%). Lifetime history of suffering from mental disorders, longer time since cancer diagnosis, regional and distant tumor stage, depression, anxiety, hostility, having a higher frequency of worrying about cancer management due to COVID-19, higher frequency feeling of overwhelming psychological pressure due to COVID-19, having a higher level of barriers to manage cancer due to COVID-19, and higher barriers to continue treatment of cancer due to inconveniences caused by COVID-19, were all significantly associated with increased risk of suicidal ideation. We also identified the risk factors of suicide attempts. This is the first study investigating the prevalence and risk factors associated with suicidal ideation and suicidal attempts in Chinese cancer patients during the COVID-19 pandemic. Our findings suggest that it is essential to monitor the mental health conditions of this vulnerable population, especially for cancer patients who have comorbidity with a history of mental disorders. Also, government policymakers should take action to protect cancer patients to avoid any interruption of their continued treatment. Further efforts are urgently required to develop specific psychological interventions to reduce the risk factors among cancer patients during the COVID-19 pandemic.
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Affiliation(s)
- Zikun Ma
- Department of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina
| | - Yize Mao
- Department of Pancreatobiliary Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education SciencesMinistry of EducationChina,School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive ScienceSouth China Normal UniversityChina
| | - Zhizhou Duan
- Preventive health service, Jiangxi provincial people's HospitalThe First Affiliated Hospital of Nanchang Medical CollegeNanchangJiangxiChina
| | - Diyang Qu
- Vanke School of Public HealthTsinghua UniversityBeijingChina,Department of Social and Behavioural SciencesCity University of Hong KongHong KongChina
| | - Chaofeng Li
- Department of Information Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina
| | - Runsen Chen
- Vanke School of Public HealthTsinghua UniversityBeijingChina,Institute for Healthy ChinaTsinghua UniversityBeijingChina
| | - Zhuowei Liu
- Department of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineSun Yat‐sen University Cancer CenterGuangzhouChina
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9
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Luo Y, Lai Q, Huang H, Luo J, Miao J, Liao R, Yang Z, Zhang L. Risk factor analysis and nomogram construction for predicting suicidal ideation in patients with cancer. BMC Psychiatry 2022; 22:353. [PMID: 35610595 PMCID: PMC9128228 DOI: 10.1186/s12888-022-03987-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/11/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Suicidal ideation in cancer patients is a critical challenge. At present, few studies focus on factors associated with suicidal ideation, and predictive models are still lacking. This study aimed at investigating the risk factors for suicidal ideation among cancer patients, and developed a predictive nomogram to screen high risk cancer patients for early prevention and intervention. METHODS A questionnaire survey was conducted among cancer patients between May 2021 and January 2022. The factors associated with suicidal ideation were used to construct a multivariate logistic regression model, which was visualized as a predictive nomogram to evaluate the risk of suicidal ideation. Areas under the curve, calibration plot, decision curve analysis, and internal and external validation were used to validate the discrimination, calibration and clinical usefulness of the model. RESULTS A total of 820 patients with cancer were recruited for this study and 213 (25.98%) developed suicidal ideation. Levels of demoralization, depression and cancer staging, marital status, residence, medical financial burden, and living condition were influence factors for suicidal ideation. Comparing nomogram with Self-rating Idea of Suicide Scale (SIOSS), the nomogram had a satisfactory discrimination ability with an AUC of 0.859 (95% CI: 0.827-0.890) and 0.818 (95% CI: 0.764-0.873) in the training and validation sets, respectively. The calibration plot and decision curve analysis revealed that this nomogram was in good fitness and could be beneficial in clinical applications. CONCLUSIONS Suicidal ideation is common in cancer patients. Levels of demoralization, depression and cancer staging were independent predictors of suicidal ideation. The nomogram is an effective and simple tool for predictive suicidal ideation in cancer patients.
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Affiliation(s)
- Yuanyuan Luo
- grid.284723.80000 0000 8877 7471School of Nursing, Southern Medical University, No. 1023 Sha Tai South road, Baiyun district, Guangzhou, 510515 China
| | - Qianlin Lai
- grid.284723.80000 0000 8877 7471School of Nursing, Southern Medical University, No. 1023 Sha Tai South road, Baiyun district, Guangzhou, 510515 China
| | - Hong Huang
- grid.284723.80000 0000 8877 7471School of Nursing, Southern Medical University, No. 1023 Sha Tai South road, Baiyun district, Guangzhou, 510515 China
| | - Jiahui Luo
- grid.284723.80000 0000 8877 7471School of Nursing, Southern Medical University, No. 1023 Sha Tai South road, Baiyun district, Guangzhou, 510515 China
| | - Jingxia Miao
- grid.416466.70000 0004 1757 959XDepartment of Medical Oncology, Nanfang Hospital, Southern Medical University, No. 1838, North Guangzhou Avenue, Baiyun District, Guangzhou, 510515 China
| | - Rongrong Liao
- grid.284723.80000 0000 8877 7471First Nursing Unit of Tumor Ward, Integrated Hospital of Traditional Chinese Medicine, Southern Medical University, No. 13, Pomegranate Gang Road, Haizhu District, Guangzhou, 510315 China
| | - Zhihui Yang
- School of Nursing, Southern Medical University, No. 1023 Sha Tai South road, Baiyun district, Guangzhou, 510515, China.
| | - Lili Zhang
- School of Nursing, Southern Medical University, No. 1023 Sha Tai South road, Baiyun district, Guangzhou, 510515, China.
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10
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Hallet J, Sutradhar R, Isenberg-Grzeda E, Noel CW, Mahar AL, Vigod SN, Bolton J, Deleemans J, Chan WC, Coburn NG, Eskander A. Association of Patient-Reported Outcomes With Subsequent Nonfatal Self-injury After a New Cancer Diagnosis. JAMA Oncol 2022; 8:e220203. [PMID: 35357419 DOI: 10.1001/jamaoncol.2022.0203] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Importance Nonfatal self-injury (NFSI) is a patient-centered manifestation of severe distress occurring in 3 out of 1000 patients after cancer diagnosis. How to identify patients at risk for NFSI remains unknown. Objective To examine the associations between patient-reported outcome measures and subsequent NFSI in patients with cancer. Design, Setting, and Participants This population-based matched case-control study included adults with a new cancer diagnosis reporting an Edmonton Symptom Assessment System (ESAS) score within 36 months of diagnosis in Ontario, Canada, 2007 to 2019. Data analysis was performed January 2007 to December 2019. Main Outcomes and Measures Cases included patients with NFSI, and controls were patients without NFSI. Cases and controls were matched 1:4. Multivariable conditional logistic regression assessed the association between moderate to severe ESAS symptom scores and total ESAS (t-ESAS, range 0-90) score with NFSI in the subsequent 180 days. Results Of 408 858 patients reporting 1 or more ESAS assessments, 425 patients experienced NFSI and reported an ESAS score in the preceding 180 days. Of those, 406 cases were matched to 1624 control patients without an NFSI. Cases reported a higher proportion of moderate to severe symptoms and higher t-ESAS score than controls prior to the event. After adjustment, moderate to severe anxiety (odds ratio [OR], 1.61; 95% CI, 1.14-2.27), depression (OR, 1.66; 95% CI, 1.20-2.31), and shortness of breath (OR, 1.65; 95% CI, 1.18-2.31) and each 10-point increase in t-ESAS score (OR, 1.51; 95% CI, 1.40-1.63) were independently associated with higher odds of subsequent NFSI. Conclusions and Relevance In this case-control study, reporting moderate to severe anxiety, depression, and shortness of breath and an increasing t-ESAS score after cancer diagnosis were associated with higher odds of NFSI in the following 180 days. These data support the prospective use of routine ESAS screening as a means of identifying patients at higher risk for NFSI to improve supportive care.
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Affiliation(s)
- Julie Hallet
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Division of Surgical Oncology, Odette Cancer Centre-Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada
| | - Rinku Sutradhar
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada
| | - Elie Isenberg-Grzeda
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Psychosocial Oncology, Odette Cancer Centre-Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Christopher W Noel
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Canada
| | - Alyson L Mahar
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Simone N Vigod
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Women's College Hospital and Research Institute, Toronto, Ontario, Canada
| | - James Bolton
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Julie Deleemans
- Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Natalie G Coburn
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada.,Division of Surgical Oncology, Odette Cancer Centre-Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada
| | - Antoine Eskander
- Division of Surgical Oncology, Odette Cancer Centre-Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, Canada
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11
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Soni S, Tiwari R, Pareek P, Manna S, Sharma R, Vyas RK, Devnani B. Assessment of knowledge, attitude, practices and distress level of cancer patients in COVID-19 pandemic: A cross-sectional study. Cancer Treat Res Commun 2022; 32:100610. [PMID: 35878518 PMCID: PMC9287590 DOI: 10.1016/j.ctarc.2022.100610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 07/12/2022] [Accepted: 07/13/2022] [Indexed: 11/29/2022]
Abstract
The diagnosis and treatment of cancer can be an extremely stressful experience for the patient. COVID-19 pandemic has further created an environment of stress and anxiety amongst cancer patients. A cross-sectional study was conducted from March 2020 to May 2020 using google forms to assess the knowledge, distress level, practices, and attitude toward the COVID-19 pandemic in cancer patients. It was observed that the females and elderly patients (> 55 years) were more knowledgeable about the COVID-19 pandemic. Also, females were more prone to emotional stress compared to males. While the younger age group (18–35 years) had a more hard time in dealing with family-related issues compared to other age groups. Therefore, the younger age group (18–35 years) and female gender being more prone to distress, warrant more attention from health care staff and caretakers. Moreover, the study highlights the need for mental and general health screening and intervention to balance the oncological care and COVID-19 situation.
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12
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Inoue K, Kawashima Y, Noguchi H, Fujimori M, Akechi T, Kawanishi C, Uchitomi Y, Matsuoka YJ. Attitude to suicide prevention and suicide intervention skills among oncology professionals: An online cross-sectional survey in Japan. Psychiatry Clin Neurosci 2021; 75:401-402. [PMID: 34435416 DOI: 10.1111/pcn.13297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 07/06/2021] [Accepted: 08/18/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Keisuke Inoue
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
| | - Yoshitaka Kawashima
- Clinical Psychology Course, Department of Psycho-Social Studies, School of Arts and Letters, Meiji University, Tokyo, Japan
| | - Hiroko Noguchi
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan.,School of Distance Learning, Department of Human Sciences, Musashino University, Tokyo, Japan
| | - Maiko Fujimori
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Chiaki Kawanishi
- Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine, Sapporo, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Yutaka J Matsuoka
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
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13
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Cancer diagnosis and suicide outcomes: Umbrella review and methodological considerations. J Affect Disord 2021; 295:1201-1214. [PMID: 34706434 DOI: 10.1016/j.jad.2021.08.131] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 07/29/2021] [Accepted: 08/27/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Suicide outcomes in cancer patients represent a major public health concern. We performed an umbrella review (UR) including all meta-analyses (MAs) and systematic reviews (SRs) published on the association between cancer and suicide outcomes. METHODS Eligible studies were searched in the main scientific databases up to January 23rd, 2021. Eligible MAs/SRs focused on all suicide phenotypes among cancer patients. Evidence of the association was extracted; the credibility and quality of the included studies were evaluated using ad-hoc tools, including "A MeaSurement Tool to Assess systematic Reviews-2-Revised" (AMSTAR-2-R). RESULTS Six MAs and 6 SRs were included. The standardized mortality ratio of suicide in cancer patients was 1.5 to 1.7-fold higher than in the general population. Risk factors for suicide outcomes among cancer patients were male sex and older age, a cancer diagnosis within the prior year, and some specific cancer sites. Among 107 associations, 90 (84.1%) were supported by high credibility of evidence (class II). However, all studies reported a large heterogeneity (I2> 50%) and the majority of them reported considerable heterogeneity (I2> 75%). All MAs used random-effects measures. All MAs but one assessed publication bias and only one disclosed it. The majority of MAs/SRs showed critically low quality based on AMSTAR-2-R. LIMITATIONS We could not perform additional analyses due to the limited number of MAs. CONCLUSIONS This UR underlines the inflated risk for suicide among cancer patients. Upcoming, well-designed studies are needed to account for a broader set of variables. Several methodological issues likewise warrant attention.
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14
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Noel CW, Eskander A, Sutradhar R, Mahar A, Vigod SN, Isenberg-Grzeda E, Bolton J, Deleemans J, Chan WC, Vasdev R, Zuk V, Haas B, Mason S, Coburn NG, Hallet J. Incidence of and Factors Associated With Nonfatal Self-injury After a Cancer Diagnosis in Ontario, Canada. JAMA Netw Open 2021; 4:e2126822. [PMID: 34559226 PMCID: PMC8463938 DOI: 10.1001/jamanetworkopen.2021.26822] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
IMPORTANCE Psychological distress is a key component of patient-centered cancer care. While a greater risk of suicide among patients with cancer has been reported, more frequent consequences of distress, including nonfatal self-injury (NFSI), remain unknown. OBJECTIVE To examine the risk of NFSI after a cancer diagnosis. DESIGN, SETTING, AND PARTICIPANTS This population-based retrospective cohort study used linked administrative databases to identify adults diagnosed with cancer between 2007 and 2019 in Ontario, Canada. EXPOSURES Demographic and clinical factors. MAIN OUTCOMES AND MEASURES Cumulative incidence of NFSI, defined as emergency department presentation of self-injury, was computed, accounting for the competing risk of death from all causes. Factors associated with NFSI were assessed using multivariable Fine and Gray models. RESULTS In total, 806 910 patients met inclusion criteria. The mean (SD) age was 65.7 (14.3) years, and 405 161 patients (50.2%) were men. Overall, 2482 (0.3%) had NFSI and 182 (<0.1%) died by suicide. The 5-year cumulative incidence of NFSI was 0.27% (95% CI, 0.25%-0.28%). After adjusting for key confounders, prior severe psychiatric illness, whether requiring inpatient care (subdistribution hazard ratio [sHR], 12.6; 95% CI, 10.5-15.2) or outpatient care (sHR, 7.5; 95% CI, 6.5-8.8), and prior self-injury (sHR, 6.6; 95% CI, 5.5-8.0) were associated with increased risk of NFSI. Young adults (age 18-39 years) had the highest NFSI rates relative to individuals aged 70 years or older (sHR, 5.4; 95% CI, 4.5-6.5). The magnitude of association between prior inpatient psychiatric illness and NFSI was greatest for young adults (sHR, 17.6; 95% CI, 12.0-25.8). Certain cancer subsites were also associated with increased risk, including head and neck cancer (sHR, 1.5; 95% CI, 1.2-1.9). CONCLUSIONS AND RELEVANCE In this study, patients with cancer had a higher incidence of NFSI than suicide after diagnosis. Younger age, history of severe psychiatric illness, and prior self-injury were independently associated with risk of NFSI. These exposures appeared to act synergistically, placing young adults with a prior mental health history at the greatest risk of NFSI. These factors should be used to identify at-risk patients.
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Affiliation(s)
- Christopher W. Noel
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- ICES, Toronto, Ontario, Canada
| | - Antoine Eskander
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- ICES, Toronto, Ontario, Canada
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Rinku Sutradhar
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- ICES, Toronto, Ontario, Canada
| | - Alyson Mahar
- Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Simone N. Vigod
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- ICES, Toronto, Ontario, Canada
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
- Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Elie Isenberg-Grzeda
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- ICES, Toronto, Ontario, Canada
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - James Bolton
- Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Julie Deleemans
- Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | | | - Ravleen Vasdev
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Victoria Zuk
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Barbara Haas
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- ICES, Toronto, Ontario, Canada
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Stephanie Mason
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- ICES, Toronto, Ontario, Canada
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Natalie G. Coburn
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- ICES, Toronto, Ontario, Canada
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Julie Hallet
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- ICES, Toronto, Ontario, Canada
- Clinical Evaluative Sciences, Sunnybrook Research Institute, Toronto, Ontario, Canada
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15
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Prevalence and risk factors for suicidality in cancer patients and oncology healthcare professionals strategies in identifying suicide risk in cancer patients. Curr Opin Support Palliat Care 2021; 14:239-246. [PMID: 32740271 DOI: 10.1097/spc.0000000000000503] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The aim of this study was to summarize the literature on prevalence and risk factors for suicidality in cancer patients and to document the research on oncology healthcare professionals' strategies in identifying this risk. RECENT FINDINGS Cancer patients exhibit increased risk of suicidality compared with the general population. Various risk factors have been identified including sociodemographic factors such as poverty, being male and elderly as well as disease-related attributes such as cancer type and stage. The literature on how healthcare professionals identify suicide risk is sparse. Ten articles were found that focused on two main themes. These included information on systematic strategies in identifying suicide risk and factors that affect healthcare professionals' ability to identify risk in their patients. SUMMARY Although there is an immense amount of literature documenting the problem of suicidality among patients, the research on how healthcare professionals identify and respond to these indications in patients is nearly nonexistent. Cancer centres should implement standardized and systematic screening of cancer patients for suicidality and research on this patient population should collect and report these data. Ongoing training and education for healthcare professionals who work in the oncology setting on how to identify and respond to suicide risk among cancer patients is urgently needed.
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16
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Harashima S, Fujimori M, Akechi T, Matsuda T, Saika K, Hasegawa T, Inoue K, Yoshiuchi K, Miyashiro I, Uchitomi Y, J Matsuoka Y. Death by suicide, other externally caused injuries and cardiovascular diseases within 6 months of cancer diagnosis (J-SUPPORT 1902). Jpn J Clin Oncol 2021; 51:744-752. [PMID: 33529336 DOI: 10.1093/jjco/hyab001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To conduct the first national population-based study in Japan to characterize risks of death by suicide, other externally caused injuries and cardiovascular diseases within 6 months of cancer diagnosis. METHODS Cancer patients diagnosed between 1 January and 30 June 2016 and registered in the National Cancer Registry in Japan were followed up until death or 6 months after diagnosis. We calculated standardized mortality ratios and excess absolute risks per 10 000 person-years for death by suicide, other externally caused injuries and cardiovascular diseases compared with the Japanese general population. RESULTS Of 546 148 patients with cancer (249 116 person-years at risk), we observed 145 suicides, 298 deaths due to other externally caused injuries and 2366 cardiovascular deaths during the follow-up period. Standardized mortality ratios within 6 months were 2.68 for suicide (95% confidence interval, 2.26-3.16; excess absolute risk, 3.65), 1.49 for other externally caused injuries (95% confidence interval, 1.32-1.67; excess absolute risk, 3.92) and 1.38 for cardiovascular diseases (95% confidence interval, 1.33-1.44; excess absolute risk, 26.85). Risks were highest during the first month after cancer diagnosis (standardized mortality ratios: suicide, 4.06 [95% confidence interval, 2.90-5.53]; other externally caused injuries, 2.66 [95% confidence interval, 2.17-3.12] and cardiovascular diseases, 2.34 [95% confidence interval, 2.18-2.51]). CONCLUSIONS The first 6 months, and especially the first month, after cancer diagnosis were found to be a critical period for risks of death by suicide, other externally caused injuries and cardiovascular diseases. Our findings suggest that oncologists need to evaluate suicidal and cardiovascular risks of patients immediately after cancer diagnosis and provide preventive interventions.
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Affiliation(s)
- Saki Harashima
- Division of Behavioral Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan.,Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Maiko Fujimori
- Division of Behavioral Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tomohiro Matsuda
- Center for Cancer Registries, Center for Cancer Control and Information Services, National Cancer Center Japan, Tokyo, Japan
| | - Kumiko Saika
- Center for Cancer Registries, Center for Cancer Control and Information Services, National Cancer Center Japan, Tokyo, Japan
| | - Takaaki Hasegawa
- Center for Psycho-Oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
| | - Keisuke Inoue
- Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan.,Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Isao Miyashiro
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center Hospital, Tokyo, Japan
| | - Yutaka J Matsuoka
- Division of Health Care Research, Behavioral Science and Survivorship Research Group, Center for Public Health Sciences, National Cancer Center Japan, Tokyo, Japan
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17
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Ross S, Agin-Liebes G, Lo S, Zeifman RJ, Ghazal L, Benville J, Franco Corso S, Bjerre Real C, Guss J, Bossis A, Mennenga SE. Acute and Sustained Reductions in Loss of Meaning and Suicidal Ideation Following Psilocybin-Assisted Psychotherapy for Psychiatric and Existential Distress in Life-Threatening Cancer. ACS Pharmacol Transl Sci 2021; 4:553-562. [PMID: 33860185 PMCID: PMC8033770 DOI: 10.1021/acsptsci.1c00020] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Indexed: 12/13/2022]
Abstract
People with advanced cancer are at heightened risk of desire for hastened death (DHD), suicidal ideation (SI), and completed suicide. Loss of Meaning (LoM), a component of demoralization, can be elevated by a cancer diagnosis and predicts DHD and SI in this population. We completed a randomized controlled trial in which psilocybin-assisted psychotherapy (PAP) produced rapid and sustained improvements in depression, demoralization, and hopelessness in people with cancer. Converging epidemiologic and clinical trial findings suggests a potential antisuicidal effect of this treatment. To probe our hypothesis that PAP relieves SI through its beneficial impacts on depression and demoralization (LoM in particular), we performed secondary analyses assessing within- and between-group differences with regard to LoM and an SI composite score. Among participants with elevated SI at baseline, PAP was associated with within-group reductions in SI that were apparent as early as 8 h and persisted for 6.5 months postdosing. PAP also produced large reductions in LoM from baseline that were apparent 2 weeks after treatment and remained significant and robust at the 6.5 month and 3.2 and 4.5 year follow-ups. Exploratory analyses support our hypothesis and suggest that PAP may be an effective antisuicidal intervention following a cancer diagnosis due to its positive impact on hopelessness and demoralization and its effects on meaning-making in particular. These preliminary results implicate psilocybin treatment as a potentially effective alternative to existing antidepressant medications in patients with cancer that are also suicidal, and warrant further investigation in participants with elevated levels of depression and suicidality.
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Affiliation(s)
- Stephen Ross
- NYU Langone Health Center for Psychedelic Medicine, 462 First Avenue, New York, New York, 10016, United States.,NYU Grossman School of Medicine Department of PsychiatryNew York, New York, 10016, United States.,Bellevue Hospital Center, New York, New York, 10016, United States
| | - Gabrielle Agin-Liebes
- University of California, San Francisco, Department of Psychiatry & Behavioral Sciences, San Francisco, California, 94110, United States.,Zuckerberg San Francisco General Hospital, San Francisco, California, 94110, United States
| | - Sharon Lo
- Pacific University College of Health Professions, Hillsboro, Oregon 97123-4218, United States
| | | | - Leila Ghazal
- NYU Langone Health Center for Psychedelic Medicine, 462 First Avenue, New York, New York, 10016, United States.,NYU Grossman School of Medicine Department of PsychiatryNew York, New York, 10016, United States
| | - Julia Benville
- NYU Langone Health Center for Psychedelic Medicine, 462 First Avenue, New York, New York, 10016, United States.,NYU Grossman School of Medicine Department of PsychiatryNew York, New York, 10016, United States
| | - Silvia Franco Corso
- Columbia University, Department of Psychiatry, New York State Psychiatric Institute, New York, New York, 10032-3784, United States
| | - Christian Bjerre Real
- Memorial Sloan Kettering Cancer Center, New York, New York, 10065-6007, United States
| | - Jeffrey Guss
- NYU Langone Health Center for Psychedelic Medicine, 462 First Avenue, New York, New York, 10016, United States.,NYU Grossman School of Medicine Department of PsychiatryNew York, New York, 10016, United States.,Bellevue Hospital Center, New York, New York, 10016, United States
| | - Anthony Bossis
- NYU Langone Health Center for Psychedelic Medicine, 462 First Avenue, New York, New York, 10016, United States.,NYU Grossman School of Medicine Department of PsychiatryNew York, New York, 10016, United States.,Bellevue Hospital Center, New York, New York, 10016, United States
| | - Sarah E Mennenga
- NYU Langone Health Center for Psychedelic Medicine, 462 First Avenue, New York, New York, 10016, United States.,NYU Grossman School of Medicine Department of PsychiatryNew York, New York, 10016, United States
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18
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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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19
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Akechi T, Okuyama T, Uchida M, Kubota Y, Hasegawa T, Suzuki N, Komatsu H, Kusumoto S, Iida S. Factors associated with suicidal ideation in patients with multiple myeloma. Jpn J Clin Oncol 2020; 50:1475-1478. [DOI: 10.1093/jjco/hyaa143] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/13/2020] [Accepted: 08/04/2020] [Indexed: 12/25/2022] Open
Abstract
Abstract
Patients with multiple myeloma are at risk of suicide. The study objective was to investigate the clinical risk factors of suicidal ideation among multiple myeloma patients. Consecutive inpatients with a new primary diagnosis of multiple myeloma were recruited. Patients were asked to complete the Patient Health Questionnaire-9 to measure suicidal ideation and depression. Patient demographic and biomedical characteristics (age, gender, education, marital status, employment, performance status and cancer stage) and pain and depression scores were analyzed as potential factors associated with suicidal ideation. Of the 79 patients, 10 [12.6% (95% confidence interval: 7–22)] had suicidal ideation. The results of a logistic regression analysis showed that being unmarried, less advanced cancer stage and depression were significantly associated with the presence of suicidal ideation. These findings suggest that a non-negligible proportion of patients with multiple myeloma experience suicidal ideation and that several multidimensional factors are significantly associated.
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Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
| | - Toru Okuyama
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
| | - Megumi Uchida
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
| | - Yosuke Kubota
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
| | - Takaaki Hasegawa
- Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
| | - Nana Suzuki
- Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hirokazu Komatsu
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shigeru Kusumoto
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shinsuke Iida
- Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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20
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Wang Y, Duan Z, Ma Z, Mao Y, Li X, Wilson A, Qin H, Ou J, Peng K, Zhou F, Li C, Liu Z, Chen R. Epidemiology of mental health problems among patients with cancer during COVID-19 pandemic. Transl Psychiatry 2020; 10:263. [PMID: 32737292 PMCID: PMC7393344 DOI: 10.1038/s41398-020-00950-y] [Citation(s) in RCA: 165] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 07/09/2020] [Accepted: 07/20/2020] [Indexed: 12/15/2022] Open
Abstract
The current study aimed to explore mental health problems in patients diagnosed with cancer during the COVID-19 pandemic. A cluster sampling, cross-sectional survey with 6213 cancer patients was conducted in one of the largest cancer centers in China. The socio-demographic and clinical characteristics, psychosomatic conditions, interpersonal relationships and social support, COVID-19 infection-related psychological stress, and mental health status were measured. Medical conditions were extracted from patients' electronic healthcare records. Among the 6213 cancer patients, 23.4% had depression, 17.7% had anxiety, 9.3% had PTSD, and 13.5% had hostility. Hierarchical liner regression models showed that having a history of mental disorder, excessive alcohol consumption, having a higher frequency of worrying about cancer management due to COVID-19, having a higher frequency feeling of overwhelming psychological pressure from COVID-19, and having a higher level of fatigue and pain were the predominant risk factors for mental health problems in cancer patients. However, there were only 1.6% of them were seeking psychological counseling during COVID-19. We also revealed the protective factors associated with lower risk of mental health problems among cancer patients. The present study revealed a high prevalence of mental health problems and gaps in mental health services for cancer patients, which also indicated high distress from COVID-19-elevated risks. We call for systematic screening of mental health status for all cancer patients, and developing specific psychological interventions for this vulnerable population.
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Affiliation(s)
- Yuanyuan Wang
- grid.216417.70000 0001 0379 7164Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Centre on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan China ,grid.48815.300000 0001 2153 2936Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Zhizhou Duan
- grid.216417.70000 0001 0379 7164Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Centre on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan China ,grid.49470.3e0000 0001 2331 6153School of Health Sciences, Wuhan University, Wuhan, China
| | - Zikun Ma
- grid.488530.20000 0004 1803 6191Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine, 510060 Guangzhou, China
| | - Yize Mao
- grid.488530.20000 0004 1803 6191Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine, 510060 Guangzhou, China
| | - Xiyuan Li
- grid.488530.20000 0004 1803 6191Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine, 510060 Guangzhou, China
| | - Amanda Wilson
- grid.48815.300000 0001 2153 2936Division of Psychology, Faculty of Health and Life Sciences, De Montfort University, Leicester, UK
| | - Huiying Qin
- grid.488530.20000 0004 1803 6191Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine, 510060 Guangzhou, China
| | - Jianjun Ou
- grid.216417.70000 0001 0379 7164Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Centre on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan China
| | - Ke Peng
- grid.216417.70000 0001 0379 7164Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Centre on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan China
| | - Fangjian Zhou
- grid.488530.20000 0004 1803 6191Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine, 510060 Guangzhou, China ,grid.488530.20000 0004 1803 6191Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Chaofeng Li
- grid.488530.20000 0004 1803 6191Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine, 510060 Guangzhou, China
| | - Zhuowei Liu
- Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China Collaborative Innovation Center for Cancer Medicine, 510060, Guangzhou, China. .,Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, China.
| | - Runsen Chen
- Department of Psychiatry & Mental Health Institute of the Second Xiangya Hospital, Central South University, Chinese National Clinical Research Centre on Mental Disorders (Xiangya), Chinese National Technology Institute on Mental Disorders, Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China.
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21
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Kawashima Y, Yonemoto N, Inagaki M, Inoue K, Kawanishi C, Yamada M. Response to "suicide prevention among patients with cancer". Gen Hosp Psychiatry 2020; 64:123. [PMID: 31735437 DOI: 10.1016/j.genhosppsych.2019.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 10/31/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Yoshitaka Kawashima
- Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan; Clinical Psychology Course, Department of Psycho-Social Studies, School of Arts and Letters, Meiji University, Japan.
| | - Naohiro Yonemoto
- Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan; Department of Biostatistics, School of Public Health, Kyoto University, Japan
| | - Masatoshi Inagaki
- Department of Psychiatry, Faculty of Medicine, Shimane University, Japan
| | - Keisuke Inoue
- Psychiatric Center, Yokohama City University Medical Center, Japan
| | - Chiaki Kawanishi
- Department of Neuropsychiatry, Sapporo Medical University Graduate School of Medicine, Japan
| | - Mitsuhiko Yamada
- Department of Neuropsychopharmacology, National Institute of Mental Health, National Center of Neurology and Psychiatry, Japan
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22
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Akechi T. Suicide prevention among patients with cancer. Gen Hosp Psychiatry 2020; 64:119-120. [PMID: 31767212 DOI: 10.1016/j.genhosppsych.2019.09.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 09/22/2019] [Accepted: 09/27/2019] [Indexed: 11/18/2022]
Affiliation(s)
- Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Japan.
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