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Bhasin AA, Molnar AO, McArthur E, Nash DM, Busse JW, Cooper R, Heale E, Ip J, Pang J, Blake PG, Garg AX, Kurdyak P, Kim SJ, Sultan H, Walsh M. Mental health and addiction service utilization among people living with chronic kidney disease. Nephrol Dial Transplant 2024; 39:1115-1124. [PMID: 38017620 DOI: 10.1093/ndt/gfad240] [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: 05/24/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Mental health problems, particularly anxiety and depression, are common in patients with chronic kidney disease (CKD) and negatively impact quality of life, treatment adherence and mortality. However, the degree to which mental health and addiction services are utilized by those with CKD is unknown. We examined the history of mental health and addiction service use of individuals across levels of kidney function. METHODS We performed a population-based cross-sectional study using linked healthcare databases from Ontario, Canada from 2009 to 2017. We abstracted the prevalence of individuals with mental health and addiction service use within the previous 3 years across levels of kidney function [estimated glomerular filtration rate (eGFR) ≥60, 45 to <60, 30 to <45, 15 to <30, <15 ml/min/1.73 m2 and maintenance dialysis]. We calculated prevalence ratios (PRs) to compare prevalence across kidney function strata, while adjusting for age, sex, year of cohort entry, urban versus rural location, area-level marginalization and Charlson comorbidity index. RESULTS Of 5 956 589 adults, 9% (n = 534 605) had an eGFR <60 ml/min/1.73 m2 or were receiving maintenance dialysis. Fewer individuals with an eGFR <60 ml/min/1.73 m2 had a history of any mental health and addiction service utilization (crude prevalence range 28-31%) compared with individuals with an eGFR ≥60 ml/min/1.73 m2 (35%). Compared with an eGFR ≥60 ml/min/1.73 m2, the lowest prevalence of individuals with any mental health and addiction service utilization was among those with an eGFR of 15 to <30 ml/min/1.73 m2 {adjusted PR 0.86 [95% confidence interval (CI) 0.85 to 0.88]}, an eGFR <15 ml/min/1.73 m2 [adjusted PR 0.81 (95% CI 0.76-0.86)] and those receiving maintenance dialysis [adjusted PR 0.83 (95% CI 0.81-0.84)]. Less use of outpatient services accounted for differences in service utilization. CONCLUSIONS Mental health and addiction service utilization is common but less so in individuals with advanced CKD in Ontario, Canada.
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Affiliation(s)
- Arrti A Bhasin
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Amber O Molnar
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- ICES, Toronto, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Eric McArthur
- ICES, Toronto, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
| | - Danielle M Nash
- ICES, Toronto, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
| | - Jason W Busse
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Department of Anesthesia, McMaster University, Hamilton, ON, Canada
| | - Rebecca Cooper
- Ontario Renal Network, Ontario Health, Toronto, ON, Canada
| | - Esti Heale
- Ontario Renal Network, Ontario Health, Toronto, ON, Canada
| | - Jane Ip
- Ontario Renal Network, Ontario Health, Toronto, ON, Canada
| | - Jocelyn Pang
- Ontario Renal Network, Ontario Health, Toronto, ON, Canada
| | - Peter G Blake
- Lawson Health Research Institute, London, ON, Canada
- Ontario Renal Network, Ontario Health, Toronto, ON, Canada
- Department of Medicine, London Health Sciences Centre, London, ON, Canada
| | - Amit X Garg
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- ICES, Toronto, ON, Canada
- Lawson Health Research Institute, London, ON, Canada
- Ontario Renal Network, Ontario Health, Toronto, ON, Canada
- Department of Medicine, London Health Sciences Centre, London, ON, Canada
| | - Paul Kurdyak
- ICES, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - S Joseph Kim
- ICES, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
- Department of Medicine, University Health Network, Toronto, ON, Canada
| | - Heebah Sultan
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Michael Walsh
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Department of Medicine, McMaster University, Hamilton, ON, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- Ontario Renal Network, Ontario Health, Toronto, ON, Canada
- Population Health Research Institute, Hamilton, ON, Canada
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Crump C, Stattin P, Brooks JD, Sundquist J, Sieh W, Sundquist K. Mortality Risks Associated with Depression in Men with Prostate Cancer. Eur Urol Oncol 2024:S2588-9311(24)00089-0. [PMID: 38575410 DOI: 10.1016/j.euo.2024.03.012] [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: 12/13/2023] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Men diagnosed with prostate cancer (PC) have an increased risk of depression; however, it is unclear to what extent depression affects long-term survival. A better understanding of such effects is needed to improve long-term care and outcomes for men with PC. OBJECTIVE To determine the associations between major depression and mortality in a national cohort of men with PC. DESIGN, SETTING, AND PARTICIPANTS A national cohort study was conducted of all 180 189 men diagnosed with PC in Sweden during 1998-2017. Subsequent diagnoses of major depression were ascertained from nationwide outpatient and inpatient records through 2018. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Deaths were identified from nationwide records through 2018. Cox regression was used to compute hazard ratios (HRs) for all-cause mortality associated with major depression, adjusting for sociodemographic factors and comorbidities. Subanalyses assessed differences by PC treatment during 2005-2017. PC-specific mortality was examined using competing risks models. RESULTS AND LIMITATIONS In 1.3 million person-years of follow-up, 16 134 (9%) men with PC were diagnosed with major depression and 65 643 (36%) men died. After adjusting for sociodemographic factors and comorbidities, major depression was associated with significantly higher all-cause mortality in men with high-risk PC (HR, 1.50; 95% confidence interval [CI], 1.44-1.55) or low- or intermediate-risk PC (1.64; 1.56-1.71). These risks were elevated regardless of PC treatment or age at PC diagnosis, except for youngest men (<55 yr) in whom the risks were nonsignificant. Major depression was also associated with increased PC-specific mortality in men with either high-risk PC (HR, 1.35; 95% CI, 1.28-1.43) or low- or intermediate-risk PC (1.42; 1.27-1.59). This study was limited to Sweden and will need replication in other countries when feasible. CONCLUSIONS In this national cohort of men with PC, major depression was associated with ∼50% higher all-cause mortality. Men with PC need timely detection and treatment of depression to support their long-term outcomes and survival. PATIENT SUMMARY In this report, we examined the effects of depression on survival in men with prostate cancer. We found that among all men with prostate cancer, those who developed depression had a 50% higher risk of dying than those without depression. Men with prostate cancer need close monitoring for the detection and treatment of depression to improve their long-term health outcomes.
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Affiliation(s)
- Casey Crump
- Department of Family and Community Medicine, The University of Texas Health Science Center, Houston, TX, USA; Department of Epidemiology, The University of Texas Health Science Center, Houston, TX, USA.
| | - Pär Stattin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - James D Brooks
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Weiva Sieh
- Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA
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Friesen EL, Mataruga A, Bolton J, Kurdyak P. Characterizing the clinical subgroups of individuals who present to the emergency department for alcohol-related harms in Ontario, Canada: A latent class analysis. Psychiatry Res 2024; 333:115726. [PMID: 38224632 DOI: 10.1016/j.psychres.2024.115726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 12/15/2023] [Accepted: 01/06/2024] [Indexed: 01/17/2024]
Abstract
Alcohol-related emergency department (ED) visits are common and associated with adverse clinical outcomes, including premature mortality. This population-based retrospective cohort study identified clinically distinct subgroups of individuals who experience alcohol-related ED visits and characterized differences in the risk of adverse outcomes between them. 73,658 individuals who experienced an alcohol-related ED visit in Ontario, Canada between 2017 and 2018 were identified. Latent class analysis (LCA) revealed five clinically distinct subgroups within the overall cohort. These subgroups followed a severity gradient from low-frequency service use for acute intoxication to high-frequency service use for alcohol use disorder (AUD) and related comorbidities. Relative to those presenting for acute intoxication, those presenting for AUD and comorbidities had a much higher risk of hospital admission (adjusted odds ratio [aOR]: 8.26, 95 % confidence interval [CI]: 7.81-8.75) and post-discharge mortality (adjusted hazard ratio [aHR]: 3.07, 95 % CI: 2.81-3.37). There was a subgroup of individuals with a history of high frequency alcohol-related health service use who were at the highest risk of experiencing another alcohol-related ED visit after the index event (aHR: 4.76, 95 % CI: 4.55-4.99). Individuals who experience alcohol-related ED visits are not a homogenous population, but a constellation of subgroups with different clinical characteristics and risk of adverse outcomes.
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Affiliation(s)
- Erik Loewen Friesen
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; Manitoba Centre for Health Policy, Winnipeg, Manitoba, Canada.
| | | | - James Bolton
- Manitoba Centre for Health Policy, Winnipeg, Manitoba, Canada; Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Paul Kurdyak
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada
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de Arruda JAA, Heimlich FV, Oliveira SR, Drumond VZ, Travassos DV, Abreu LG, Teixeira AL, Mesquita RA, Silva TA. Influence of anxiety/depression on chemotherapy-induced oral mucositis and related quality of life: A prospective cohort study. J Psychosom Res 2024; 177:111577. [PMID: 38154442 DOI: 10.1016/j.jpsychores.2023.111577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/15/2023] [Accepted: 12/19/2023] [Indexed: 12/30/2023]
Abstract
OBJECTIVE The impact of anxiety and depression on chemotherapy-induced oral mucositis has not been extensively explored in the literature. The aim of the present study was to evaluate anxiety/depressive symptoms, health-related quality of life, and oral health-related quality of life and their association with oral mucositis among individuals receiving chemotherapy. METHODS This is a prospective longitudinal study carried out at a Brazilian referral service. The Hospital Anxiety and Depression Scale (HADS), World Health Organization Quality of Life-BREF (WHOQOL-BREF), and Oral Health Impact Profile questionnaire (OHIP-14) were applied at D0 (before chemotherapy) and D15 of chemotherapy. Clinicodemographic data and oral mucositis severity scores were evaluated. RESULTS A total of 37 individuals (median age: 49 years) were included in the study. Nearly 38% of patients developed chemotherapy-induced oral mucositis and had higher anxiety/depression scores at baseline. Oral mucositis had a negative impact on oral health-related quality of life regarding functional limitation, physical pain, physical disability, and handicap. CONCLUSION Anxiety/depressive symptoms are associated with oral mucositis that affects overall health and oral health-related quality of life.
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Affiliation(s)
- José Alcides Almeida de Arruda
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Fernanda Vieira Heimlich
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Sicília Rezende Oliveira
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Denise Vieira Travassos
- Multiprofessional Integrated Residency in Health, Hospital das Clínicas, Department of Social and Preventive Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Lucas Guimarães Abreu
- Department of Child and Adolescent Oral Health, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Antonio Lucio Teixeira
- Faculdade Santa Casa BH, Belo Horizonte, Minas Gerais, Brazil; Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Ricardo Alves Mesquita
- Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| | - Tarcília Aparecida Silva
- Multiprofessional Integrated Residency in Health, Hospital das Clínicas, Department of Oral Surgery, Pathology and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Friesen EL, Mataruga A, Nickel N, Kurdyak P, Bolton JM. Outcomes in Clinical Subgroups of Patients With Alcohol-Related Hospitalizations. JAMA Netw Open 2024; 7:e2353971. [PMID: 38294814 PMCID: PMC10831574 DOI: 10.1001/jamanetworkopen.2023.53971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/08/2023] [Indexed: 02/01/2024] Open
Abstract
Importance Alcohol-related hospitalizations are common and associated with significant cost to the health care system. We have a limited understanding of the characteristics of individuals who experience alcohol-related hospitalizations, which limits our capacity to prioritize those at the highest risk of postdischarge harm. Objective To identify and characterize the clinical subgroups of individuals who are hospitalized for alcohol-related harms. Design, Setting, and Participants This cohort study used latent class analysis (LCA) to identify clinical subgroups of individuals experiencing alcohol-related hospitalizations in 2 provinces in Canada. All individuals between ages 10 and 105 years who were hospitalized for an alcohol-related harm between January 2017 and December 2018 (ie, the index hospitalization) were eligible. Data were analyzed between June 2023 and August 2023. Exposures The exposure of interest was the clinical subgroup that an individual belonged to. These subgroups were identified using an LCA based on (1) the characteristics of the index hospitalization and (2) the history of alcohol-related health service use. Main Outcomes and Measures In-hospital mortality, alcohol-related hospital readmission, and all-cause mortality in the year following discharge from the index hospitalization. The association between subgroup membership and the risk of in-hospital and postdischarge outcomes was evaluated using multivariable regression. Results A total of 34 043 individuals were included in analysis, 4753 from Manitoba (median [IQR] age, 49 [40-58] years; 1786 female [37.6%]) and 29 290 from Ontario (median [IQR] age, 57 [45-67] years; 8527 female [29.1%]). Seven subgroups were identified following a gradient from low-frequency service use for acute intoxication to high-frequency service use for severe alcohol use disorder and liver disease. In Ontario, there were 4431 individuals in the liver disease subgroup representing 15.5% of the cohort who were at the highest risk of 1-year mortality (1382 [31.2%]) relative to the acute intoxication subgroup (42 [4.0%]) (adjusted hazard ratio [aHR], 3.83; 95% CI, 2.80-5.24). There was also a small subgroup (10.6%) of individuals with high-frequency alcohol-related health service use who had a much higher hazard of readmission following the index hospitalization (1-year readmission: 703 of 1526 [46.1%] vs 104 of 1058 [9.8%] in the acute intoxication subgroup; aHR, 5.09; 95% CI, 4.11-6.31). Conclusions and Relevance In this population-based cohort study of individuals experiencing alcohol-related hospitalizations, we identified several small, clinically distinct subgroups that were at a disproportionately high risk of readmission and mortality. These groups could merit prioritization in strategies aimed at reducing the risk of adverse outcomes following alcohol-related hospitalizations.
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Affiliation(s)
- Erik L. Friesen
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Mental Health and Addictions Research Program, ICES Central, Toronto, Ontario, Canada
- Manitoba Centre for Health Policy, Winnipeg, Manitoba, Canada
| | - Andrea Mataruga
- Mental Health and Addictions Research Program, ICES Central, Toronto, Ontario, Canada
| | - Nathan Nickel
- Manitoba Centre for Health Policy, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Paul Kurdyak
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Mental Health and Addictions Research Program, ICES Central, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - James M. Bolton
- Manitoba Centre for Health Policy, Winnipeg, Manitoba, Canada
- Department of Psychiatry, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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Kurdyak P, Lebenbaum M, Patrikar A, Rivera L, Lu H, Scales DC, Guttmann A. SARS-CoV-2 vaccination prevalence by mental health diagnosis: a population-based cross-sectional study in Ontario, Canada. CMAJ Open 2023; 11:E1066-E1074. [PMID: 37989512 PMCID: PMC10681672 DOI: 10.9778/cmajo.20220210] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Since the onset of the COVID-19 pandemic, there has been concern about the impact of SARS-CoV-2 infection among individuals with mental illnesses. We analyzed the SARS-CoV-2 vaccination status of Ontarians with and without a history of mental illness. METHODS We conducted a population-based cross-sectional study of all community-dwelling Ontario residents aged 19 years and older as of Sept. 17, 2021. We used health administrative data to categorize Ontario residents with a mental disorder (anxiety, mood, substance use, psychotic or other disorder) within the previous 5 years. Vaccine receipt as of Sept. 17, 2021, was compared between individuals with and without a history of mental illness. RESULTS Our sample included 11 900 868 adult Ontario residents. The proportion of individuals not fully vaccinated (2 doses) was higher among those with substance use disorders (37.7%) or psychotic disorders (32.6%) than among those with no mental disorders (22.9%), whereas there were similar proportions among those with anxiety disorders (23.5%), mood disorders (21.5%) and other disorders (22.1%). After adjustment for age, sex, neighbourhood income and homelessness, individuals with psychotic disorders (adjusted prevalence ratio 1.19, 95% confidence interval [CI] 1.18-1.20) and substance use disorders (adjusted prevalence ratio 1.35, 95% CI 1.34-1.35) were more likely to be partially vaccinated or unvaccinated relative to individuals with no mental disorders. INTERPRETATION Our study found that psychotic disorders and substance use disorders were associated with an increased prevalence of being less than fully vaccinated. Efforts to ensure such individuals have access to vaccinations, while challenging, are critical to ensuring the ongoing risks of death and other adverse consequences of SARS-CoV-2 infection are mitigated in this high-risk population.
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Affiliation(s)
- Paul Kurdyak
- ICES Central (Kurdyak, Lebenbaum, Patrikar, Lu, Scales, Guttmann); Centre for Addiction and Mental Health (Kurdyak); Institute of Health Policy Management and Evaluation (Kurdyak, Lebenbaum, Scales), and Departments of Psychiatry (Rivera) and Paediatrics (Guttmann), and Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont.
| | - Michael Lebenbaum
- ICES Central (Kurdyak, Lebenbaum, Patrikar, Lu, Scales, Guttmann); Centre for Addiction and Mental Health (Kurdyak); Institute of Health Policy Management and Evaluation (Kurdyak, Lebenbaum, Scales), and Departments of Psychiatry (Rivera) and Paediatrics (Guttmann), and Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont
| | - Aditi Patrikar
- ICES Central (Kurdyak, Lebenbaum, Patrikar, Lu, Scales, Guttmann); Centre for Addiction and Mental Health (Kurdyak); Institute of Health Policy Management and Evaluation (Kurdyak, Lebenbaum, Scales), and Departments of Psychiatry (Rivera) and Paediatrics (Guttmann), and Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont
| | - Laura Rivera
- ICES Central (Kurdyak, Lebenbaum, Patrikar, Lu, Scales, Guttmann); Centre for Addiction and Mental Health (Kurdyak); Institute of Health Policy Management and Evaluation (Kurdyak, Lebenbaum, Scales), and Departments of Psychiatry (Rivera) and Paediatrics (Guttmann), and Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont
| | - Hong Lu
- ICES Central (Kurdyak, Lebenbaum, Patrikar, Lu, Scales, Guttmann); Centre for Addiction and Mental Health (Kurdyak); Institute of Health Policy Management and Evaluation (Kurdyak, Lebenbaum, Scales), and Departments of Psychiatry (Rivera) and Paediatrics (Guttmann), and Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont
| | - Damon C Scales
- ICES Central (Kurdyak, Lebenbaum, Patrikar, Lu, Scales, Guttmann); Centre for Addiction and Mental Health (Kurdyak); Institute of Health Policy Management and Evaluation (Kurdyak, Lebenbaum, Scales), and Departments of Psychiatry (Rivera) and Paediatrics (Guttmann), and Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont
| | - Astrid Guttmann
- ICES Central (Kurdyak, Lebenbaum, Patrikar, Lu, Scales, Guttmann); Centre for Addiction and Mental Health (Kurdyak); Institute of Health Policy Management and Evaluation (Kurdyak, Lebenbaum, Scales), and Departments of Psychiatry (Rivera) and Paediatrics (Guttmann), and Edwin S.H. Leong Centre for Healthy Children (Guttmann), University of Toronto, Toronto, Ont
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Gong IY, Cheung MC, Chan KKW, Arya S, Faught N, Calzavara A, Liu N, Odejide OO, Abel G, Kurdyak P, Raphael MJ, Kuczmarski T, Prica A, Mozessohn L. Mortality among patients with diffuse large B-cell lymphoma and mental disorders: a population-based study. J Natl Cancer Inst 2023; 115:1194-1203. [PMID: 37531271 DOI: 10.1093/jnci/djad149] [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: 04/13/2023] [Revised: 07/04/2023] [Accepted: 07/28/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND Mental disorders have been reported in patients with diffuse large B-cell lymphoma (DLBCL), but studies examining their association with mortality are lacking. METHODS We conducted a population-based study using linked administrative health-care databases from Ontario, Canada. All patients with DLBCL 18 years of age or older treated with rituximab-based therapy between January 1, 2005, and December 31, 2017, were identified and followed until March 1, 2020. Mental disorders were defined as either preexisting or postdiagnosis (after lymphoma treatment initiation). Cox proportional hazards models were used to estimate the adjusted hazard ratio (HR) between mental disorders and 1-year and all-cause mortality while controlling for covariates. RESULTS We identified 10 299 patients with DLBCL. The median age of the cohort was 67 years; 46% of patients were female, and 28% had a preexisting mental disorder. At 1-year follow-up, 892 (9%) had a postdiagnosis mental disorder, and a total of 2008 (20%) patients died. Preexisting mental disorders were not associated with 1-year mortality (adjusted HR = 1.06, 95% confidence interval [CI] = 0.96 to 1.17, P = .25), but postdiagnosis disorders were (adjusted HR = 1.51, 95% CI = 1.26 to 1.82, P = .0001). During a median follow-up of 5.2 years, 2111 (22%) patients had a postdiagnosis mental disorder, and 4084 (40%) patients died. Both preexisting and postdiagnosis mental disorders were associated with worse all-cause mortality (preexisting adjusted HR = 1.12, 95% CI = 1.04 to 1.20, P = .0024; postdiagnosis adjusted HR = 1.63, 95% CI = 1.49 to 1.79, P < .0001). CONCLUSIONS Patients with DLBCL and mental disorders had worse short-term and long-term mortality, particularly those with postdiagnosis mental disorders. Further studies are needed to examine mental health service utilization and factors mediating the relationship between mental disorders and inferior mortality.
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Affiliation(s)
- Inna Y Gong
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Matthew C Cheung
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - Kelvin K W Chan
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Canadian Centre for Applied Research in Cancer Control, Vancouver, BC, Canada
| | - Sumedha Arya
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Neil Faught
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | | | - Ning Liu
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | | | | | - Paul Kurdyak
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
- Centre for Addition and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Michael J Raphael
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
| | - Thomas Kuczmarski
- University of Washington Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Anca Prica
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Lee Mozessohn
- Department of Medicine, University of Toronto, Toronto, ON, Canada
- Sunnybrook Odette Cancer Centre, Toronto, ON, Canada
- Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
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Crump C, Stattin P, Brooks JD, Sundquist J, Bill-Axelson A, Edwards AC, Sundquist K, Sieh W. Long-term Risks of Depression and Suicide Among Men with Prostate Cancer: A National Cohort Study. Eur Urol 2023; 84:263-272. [PMID: 37169640 PMCID: PMC10523908 DOI: 10.1016/j.eururo.2023.04.026] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 02/24/2023] [Accepted: 04/23/2023] [Indexed: 05/13/2023]
Abstract
BACKGROUND A diagnosis of prostate cancer (PC) may cause psychosocial distress that worsens quality of life; however, long-term mental health outcomes are unclear. OBJECTIVE To determine the long-term risks of major depression and death by suicide in a large population-based cohort. DESIGN, SETTING, AND PARTICIPANTS This was a national cohort study of 180 189 men diagnosed with PC during 1998-2017 and 1 801 890 age-matched, population-based, control men in Sweden. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Major depression and death by suicide were ascertained from nationwide outpatient, inpatient, and death records up to 2018. Cox regression was used to compute hazard ratios (HRs) adjusted for sociodemographic factors and comorbidities. Subanalyses assessed differences by PC treatment during 2005-2017. RESULTS AND LIMITATIONS Men diagnosed with high-risk PC had higher relative rates of major depression (adjusted HR [aHR] 1.82, 95% confidence interval [CI] 1.75-1.89) and death by suicide (aHR 2.43, 95% CI 2.01-2.95). These associations persisted for ≥10 yr after PC diagnosis. The relative increase in major depression was lower among those treated with radiation (aHR 1.44, 95% CI 1.31-1.57) or surgery (aHR 1.60, 95% CI 1.31-1.95) in comparison to androgen deprivation therapy (ADT) alone (aHR 2.02, 95% CI 1.89-2.16), whereas the relative rate of suicide death was higher only among those treated solely with ADT (aHR 2.83, 95% CI 1.80-4.43). By contrast, men with low- or intermediate-risk PC had a modestly higher relative rate of major depression (aHR 1.19, 95% CI 1.16-1.23) and higher relative rate of suicide death at 3-12 mo after PC diagnosis (aHR 1.88, 95% CI 1.11-3.18) but not across the entire follow-up period (aHR 1.02, 95% CI 0.84-1.25). This study was limited to Sweden and will need replication in other populations. CONCLUSIONS In this large cohort, high-risk PC was associated with substantially higher relative rates of major depression and death by suicide, which persisted for ≥10 yr after PC diagnosis. PC survivors need close follow-up for timely detection and treatment of psychosocial distress. PATIENT SUMMARY In a large Swedish population, men with aggressive prostate cancer had higher long-term relative rates of depression and suicide.
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Affiliation(s)
- Casey Crump
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Pär Stattin
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - James D Brooks
- Department of Urology, Stanford University School of Medicine, Stanford, CA, USA
| | - Jan Sundquist
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Anna Bill-Axelson
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - Alexis C Edwards
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Kristina Sundquist
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Weiva Sieh
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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9
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Peng M, Zhang YP, Wu Y, Li R. Analysis of the influential factors of the emotional health of patients with cancer based on the structural equation model: the role of social media and emotional support. Support Care Cancer 2023; 31:417. [PMID: 37354259 DOI: 10.1007/s00520-023-07877-2] [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: 01/20/2023] [Accepted: 06/10/2023] [Indexed: 06/26/2023]
Abstract
PURPOSE To explore the mental health status of patients with cancer and related influential factors and provide a scientific basis to reduce serious emotional problems, improve the quality of life of cancer survivors and adopt targeted interventions. METHODS A total of 517 patients who attended the oncology departments of six grade-A tertiary hospitals from July 2022 to September 2022 were selected by convenience sampling. The effects of emotional support, social media, patient-centred communication, health self-efficacy and cancer beliefs on the emotional well-being of patients with cancer were analysed based on the structural equation model. RESULTS A Spearman correlation analysis showed a significant positive correlation among the six latent variables (P<0.01). The structural equation model path analysis showed that health self-efficacy (β=0.374, P<0.001), cancer belief (β=0.214, P=0.003) and emotional support (β=0.104, P=0.031) all had positive effects on emotional health. The mediating effect results showed that cancer beliefs had a mediating effect on mental health in social media use (β=0.106, P=0.001), emotional support (β=0.028, P=0.002) and patient-centred communication (β=0.050, P=0.002). Further, health self-efficacy had mediating effects on mental health in emotional support (β=0.084, P=0.001) and patient-centred communication (β=0.098, P=0.001). CONCLUSION By constructing structural equation models, this study found that emotional support, cancer beliefs and health self-efficacy showed a positive effect on the emotional well-being of patients with cancer. Further, it found a mediating role of health cancer beliefs on the impact of emotional support, social media use and patient-centred communication on mental health. Additionally, health self-efficacy has a mediating role regarding the effects of emotional support and patient-centred communication on mental health.
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Affiliation(s)
- Min Peng
- Department of Traditional Chinese Medicine, Gansu Gem Flower Hospital, Lanzhou, 730060, China
- Health Science Center, Xi'an Jiaotong University, Xian, 710061, China
| | - Yin-Ping Zhang
- Health Science Center, Xi'an Jiaotong University, Xian, 710061, China
| | - Yidong Wu
- School of Journalism and Communication, Lanzhou University, No. 222, Tianshui South Road, Lanzhou City, 730000, Gansu, China.
| | - Ruoxi Li
- Faculty of Biology, Medicine and Health, The University of Manchester, M13 9PL, Manchester, UK
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10
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Peters M, Boersma HW, van Rossum PS, van Oort J, Cahn W, Verhoeff JJ. The impact of schizophrenia spectrum disorder, bipolar disorder and borderline personality disorder on radiotherapy treatment and overall survival in cancer patients: A matched pair analysis. Clin Transl Radiat Oncol 2023; 40:100618. [PMID: 37066114 PMCID: PMC10090213 DOI: 10.1016/j.ctro.2023.100618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023] Open
Abstract
Introduction The effect of a psychiatric disorder (PD) on the choice of radiotherapy regimens and subsequent cancer control outcomes is largely unknown. In this study, we evaluated differences in radiotherapy regimens and overall survival (OS) between cancer patients with a PD in comparison with a control population of patients without a PD. Methods Referred patients with a PD (i.e. schizophrenia spectrum disorder, bipolar disorder or borderline personality disorder) were included through a text-based search of the electronic patient database of all the patients that received radiotherapy between 2015 and 2019 at a single centre. Each patient was matched to a patient without a PD. Matching was based on cancer type, staging, performance score (WHO/KPS), non-radiotherapeutic cancer treatment, gender and age. Outcomes were the amount of fractions received, total dose, and OS. Results 88 patients with PD were identified; 44 patients with schizophrenia spectrum disorder, 34 with bipolar disorder, and 10 with borderline personality disorder. Matched patients without a PD showed similar baseline characteristics. No statistically significant difference was observed regarding the number of fractions with a median of 16 (interquartile range [IQR] 3-23) versus 16 (IQR 3-25), respectively (p = 0.47). Additionally, no difference in total dose was found. Kaplan-Meier curves showed a statistically significant difference in OS between the patients with a PD versus those without a PD, with 3-year OS rates of 47 % versus 61 %, respectively (hazard ratio 1.57, 95 % confidence interval 1.05-2.35, p = 0.03). No clear differences in causes of death were observed. Conclusion Cancer patients referred for radiotherapy with schizophrenia spectrum disorder, bipolar disorder or borderline personality disorder receive similar radiotherapy schedules for a variety of tumour types but attain worse survival.
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11
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Myran D, Friesen EL, Pugliese M, Milani C, Kurdyak P, Saraswat M, Tanuseputro P. Changes in health service use due to alcohol during the COVID-19 pandemic among individuals with and individuals without pre-existing alcohol-related medical diagnoses. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2023; 114:185-194. [PMID: 36719599 PMCID: PMC9888341 DOI: 10.17269/s41997-023-00739-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 01/05/2023] [Indexed: 02/01/2023]
Abstract
OBJECTIVE To compare changes in outpatient and acute care visits due to alcohol during the COVID-19 pandemic between individuals with and those without a history of alcohol-related health service use (AHSU). METHODS We conducted a cross-sectional analysis of health administrative data in Ontario, Canada. The Ontario population was stratified into those with and those without 1+ health service encounter(s) due to alcohol in the past 2 years. We compared age- and sex-standardized rates of alcohol-related outpatient visits, emergency department (ED) visits, and hospitalizations during the first 15 months of the pandemic (March 2020-May 2021) to those during the same 15-month period prior to the pandemic (March 2018-May 2019). RESULTS Of 13,450,750 eligible Ontarians on March 11, 2022, 129,434 (1.0%) had AHSU in the previous 2 years. Overall, rates of alcohol-related outpatient visits and hospitalizations increased, while rates of alcohol-related ED visits decreased during the pandemic. There was a similar relative increase in rates of alcohol-related outpatient visits and hospitalizations between those with and those without prior AHSU. However, the absolute increase in rates of alcohol-related outpatient visits and hospitalizations was higher among those with prior AHSU (outpatient rate difference (RD) per 10,000 population: 852.3, 95% confidence interval (CI): 792.7, 911.9; inpatient RD: 26.0, 95% CI: -2.3, 54.2) than among those without (outpatient RD: 6.5, 95% CI: 6.0, 6.9; inpatient RD: 0.4, 95% CI: 0.2, 0.7). CONCLUSION Rates of alcohol-related outpatient and inpatient care increased during the COVID-19 pandemic, and high rate of recurrent harm among individuals with pre-pandemic AHSU was an important contributor to this trend.
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Affiliation(s)
- Daniel Myran
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
- ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
| | - Erik Loewen Friesen
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michael Pugliese
- ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Christina Milani
- Division of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada
| | - Paul Kurdyak
- ICES Mental Health & Addictions Research Program, Toronto, Ontario, Canada
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Manu Saraswat
- Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Peter Tanuseputro
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- ICES uOttawa, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Division of Palliative Care, Bruyere Research Institute, Ottawa, Ontario, Canada
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12
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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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Shrivastava SP, Elhence A, Jinwala P, Bansal S, Chitalkar P, Bhatnagar S, Patidar R, Asati V, Reddy PK. Assessment of Psychological Distress Among Indian Adolescents and Young Adults with Solid Cancer Using the National Comprehensive Cancer Network Distress Thermometer. South Asian J Cancer 2022. [DOI: 10.1055/s-0042-1756184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose The incidence of cancer has increased in India with a visible impact on the young population (aged 15–39 years). The present study aims to evaluate psychological distress among Indian adolescents and young adults (AYAs) with solid cancer using the National Comprehensive Cancer Network (NCCN) distress thermometer.
Methods The demographic and clinical characteristics of AYAs patients (age 15–39 years) with cancer were recorded. Assessment of psychological distress of patients using the NCCN distress thermometer was performed at three time points over a period of 3 months. Distress thermometer scale and a self-administered questionnaire in English and Hindi languages was handed over to participants at three time points: at treatment commencement (T1), at 1 month, and 3 months (T2 and T3, respectively) into therapy.
Results Of the 259 patients, 63% were women and 37% men; the median age was 34 years. In total, 71 (27%) were ≤ 24 years old and 188 (73%) were>24 years old. Bone sarcoma (39%) was common cancer in AYA patients aged ≤ 24 years and breast cancer (21%) in >24 years of age. The distress scores in both the groups were the highest at diagnosis (T1) followed by that measured at 1 (T2) and 3 months (T3) after diagnosis. The distress score in the age ≤ 24 years was the highest (6.7) at T1, followed by those measured at T2 (2.6) and T3 (1.1) and among age>24 years was the highest (6.6) at T1, followed by those measured at T2 (2.6) and T3 (1.2). Among AYA patients>24 years old, worry, nervousness, sadness, transportation, and sleep were the top five identified problems and in ≤ 24 years old, the top identified problems were worry, financial support, sleep, nervousness, and sadness.
Conclusion Adolescents and young adults experience some level of distress associated with the cancer diagnosis, effects of the disease, treatment regardless of the stage and various transitions throughout the trajectory of the disease. The distress thermometer is an easy and useful tool for the assessment of psychological distress in AYA cancers. Early identification of distress burden with the distress thermometer leads to effective interventions in patients with cancer which could improve outcomes including survival in AYAs with cancer in India.
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Affiliation(s)
- Shiv Prasad Shrivastava
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Aditya Elhence
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Prutha Jinwala
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Shashank Bansal
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Prakash Chitalkar
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Shweta Bhatnagar
- Department of Radiology, CHL Hospital, Indore, Madhya Pradesh, India
| | - Rajesh Patidar
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Vikas Asati
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
| | - Pradeep Kumar Reddy
- Department of Medical Oncology, Sri Aurobindo Institute of Medical Sciences, Indore, Madhya Pradesh, India
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Kurdyak P, Friesen EL, Young JT, Borschmann R, Iqbal J, Huang A, Kouyoumdjian F. Prevalence of Mental Health and Addiction Service use Prior to and During Incarceration in Provincial Jails in Ontario, Canada: A Retrospective Cohort Study. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2022; 67:690-700. [PMID: 34792415 PMCID: PMC9449135 DOI: 10.1177/07067437211055414] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Individuals with mental illness and addiction are overrepresented in prisons. Few studies have assessed mental health and addiction (MHA)-related service use among individuals experiencing incarceration using health administrative data and most focus on service use after prison release. The objective of this study was to determine the prevalence of MHA-related service use in the 5 years prior to and during incarceration. METHODS We used linked correctional and administrative health data for people released from Ontario provincial jails in 2010. MHA-related service use in the 5 years prior to the index incarceration was categorized hierarchically into four mutually exclusive categories based on the type of service use: psychiatric hospitalization, MHA-related emergency department (ED) visit, MHA-related outpatient visit (from psychiatrist or primary care physician), and no MHA-related service use. Demographic, diagnostic, and incarceration characteristics were compared across the four service use categories. MHA-related service use during the index incarceration was assessed by category and length of incarceration. RESULTS A total of 48,917 individuals were included. Prior to incarceration, 6,116 (12.5%) had a psychiatric hospitalization, 8,837 (18.1%) had an MHA-related ED visit, and 15,866 (32.4%) had an MHA-related outpatient visit. Of the individuals with any MHA-related service prior to incarceration, 60.4% did not receive outpatient care from a psychiatrist prior to incarceration and 65.6% did not receive MHA-related care during incarceration. CONCLUSION Despite a high prevalence of mental illness and addiction among people experiencing incarceration, access to and use of MHA-related care prior to and during incarceration is poor. Increasing the accessibility and use of MHA-related services throughout the criminal justice pathway is warranted.
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Affiliation(s)
- Paul Kurdyak
- 7978Centre for Addiction and Mental Health, Toronto, ON, Canada.,ICES, Toronto, ON, Canada.,Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Erik L Friesen
- 7978Centre for Addiction and Mental Health, Toronto, ON, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Jesse T Young
- Justice Health Unit, Centre for Health Equity, 50066Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia.,National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - Rohan Borschmann
- Justice Health Unit, Centre for Health Equity, 50066Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Psychiatry; Warneford Hospital, University of Oxford, Oxford OX3 7JX, UK.,Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Fiona Kouyoumdjian
- ICES, Toronto, ON, Canada.,Department of Family Medicine, 3710McMaster University, Hamilton, ON, Canada
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15
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Friesen EL, Myran D, Yu W, Rosella L, Selby P, Kurdyak P. Rural-urban disparities in post-discharge outcomes following alcohol-related hospitalizations in Ontario, Canada: A retrospective cohort study. Drug Alcohol Depend 2022; 238:109568. [PMID: 35850027 DOI: 10.1016/j.drugalcdep.2022.109568] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 07/07/2022] [Accepted: 07/08/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Limited access to mental health and addiction (MHA) services in rural areas may increase the risk of recurrent alcohol-related harm among rural, relative to urban, residents. This study evaluated (1) rural-urban differences in clinical trajectories following alcohol-related hospitalizations and (2) whether limited access to MHA services mediates an increased risk of adverse post-discharge outcomes in rural areas. METHODS This was a population-based retrospective cohort study of individuals in Ontario, Canada, who experienced an alcohol-related hospitalization between 2016 and 2018. The primary exposure was rurality. The outcomes of interest were outpatient MHA care, alcohol-related emergency department visits, alcohol-related hospitalizations, and all-cause mortality within one-year of discharge from the index alcohol-related hospitalization. Data were collected using provincial health administrative databases. The associations between rurality and the time to each outcome were assessed using multivariable time-to-event regression. Mediation analyses were conducted using a counterfactual approach. RESULTS 46,657 individuals were included. 11.5% of the cohort died within one year of discharge from the index alcohol-related hospitalization. Relative to urban residents, rural residents were less likely to receive MHA outpatient care (adjusted hazard ratio (aHR): 0.80, 95% confidence interval (CI): 0.75-0.86) and more likely to die (aHR: 1.19, 95% CI: 1.06-1.34) in the year following discharge. The lower likelihood of post-discharge MHA-related care among rural residents mediated 31% (95% CI: 13-46%) of the increased risk of mortality. CONCLUSIONS A lack of follow-up MHA care mediates an increased risk of short-term mortality following alcohol-related hospitalizations in rural, relative to urban, communities.
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Affiliation(s)
- Erik Loewen Friesen
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; ICES, Toronto, ON, Canada.
| | - Daniel Myran
- ICES, Toronto, ON, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada; Department of Family Medicine, University of Ottawa, Ottawa, ON, Canada
| | | | - Laura Rosella
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; ICES, Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Peter Selby
- Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada; Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Paul Kurdyak
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Centre for Addiction and Mental Health (CAMH), Toronto, ON, Canada; ICES, Toronto, ON, Canada; Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Anderson D, Razzak AN, McDonald M, Cao D, Hasoon J, Viswanath O, Kaye AD, Urits I. Mental Health in Urologic Oncology. Health Psychol Res 2022; 10:37518. [DOI: 10.52965/001c.37518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This article is a systematic review of mental health in urologic oncology patients with prostate cancer (PCa), bladder cancer (BC), renal cell carcinoma (RCC), testicular cancer (TC), or penile cancer (PeCa). For all pathologies, a focus on increasing quality of life post-treatment demonstrated a positive impact in reducing Mental Health Illness (MHI) prevalence. Cancer specific mental health care may be given to patients to reduce suicide risk in BC patients and sexual identify and masculinity counseling may improve mental health for TC or PeCa patients. In order to better accommodate patient’s mental health needs when undergoing GU cancer treatment, we recommend incorporation of mental health metrics such as questionnaires to assess early treatment of MHI, a greater emphasis on psychosocial support with the patient’s loved ones, peers, and healthcare team, alongside advising healthy habits such as exercise which has been shown to drastically reduce MHI incidence across all pathologies. We hope that these measures conducted by urologists and oncologists, alongside possible coordination with psychiatrists and psychologists for psychotherapy, psychopharmacology, and neuro-stimulation treatment modems may be helpful in the long term to reduce MHI incidence in urology oncology patients. Given the higher incidence of MHI in oncology patients and in the patient population after the Covid-19 pandemic, MHI awareness in the sphere of urologic oncologic treatment continues to be crucial when creating a collaborative treatment platform for patients.
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Affiliation(s)
| | | | | | | | | | - Omar Viswanath
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School; Valley Anesthesiology and Pain Consultants, Envision Physician Services; Department of Anesthesiology, University of Arizona College of Medicine Phoenix;Department of Anesthesiology, Creighton University School of Medicine
| | | | - Ivan Urits
- Department of Anesthesia, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School; Department of Anesthesiology, Louisiana State University Health Shreveport
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Lazow MA, Salloum R, Pressey JG. Comorbidity Burden in a Cohort of Adolescent and Young Adult Patients Diagnosed with Central Nervous System Tumors and Sarcomas. J Adolesc Young Adult Oncol 2022; 12:215-223. [PMID: 35675692 DOI: 10.1089/jayao.2022.0006] [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: 11/12/2022] Open
Abstract
Purpose: Adolescent and young adult (AYA) oncology patients experience unique biological, behavioral, and socioeconomic challenges, for which provision of care must be tailored. AYAs with central nervous system (CNS) tumors and sarcomas represent a vulnerable population with worse outcomes and potential for serious sequelae from intense multimodal therapy. Comorbidity burden impacts treatment tolerance, adherence, and efficacy, yet has been understudied among these high-risk AYA patients. Methods: Utilizing a validated AYA oncology comorbidity index, we (1) measured comorbid conditions present at diagnosis in AYA-aged patients with CNS tumors and sarcomas and (2) compared baseline comorbidity burden across ascending AYA age groups (15-19, 20-29, and 30-39 years) and with pediatric patients (10-14 years). Results: The cohort included 131 AYAs and 50 pediatric patients. Mean comorbidity score significantly differed between pediatric (0.8) and AYA (1.7) patients, and across ascending age subgroups (0.8 [10-14] < 1.2 [15-19] < 1.7 [20-29] < 2.5 [30-39]). AYAs were significantly more likely than pediatric patients to have ≥2 or ≥3 comorbidities (47% vs. 18%, 24% vs. 6%), with increasing prevalence across ascending age subgroups. Frequency of overweight/obese status, smoking/substance use, obstetric/gynecologic conditions, and cardiovascular comorbidities increased with age. In multivariate analyses adjusting for sex, tumor type, and race, age remained a significant predictor of comorbidity score. Conclusions: AYAs with CNS tumors or sarcomas have a high burden of baseline comorbidities, which increase with age at diagnosis, conferring susceptibility to treatment-related toxicity and mortality. Improving the prognosis for AYAs requires appropriate identification of pre-existing comorbidities and tailoring therapeutic and supportive care accordingly.
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Affiliation(s)
- Margot A Lazow
- Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Pediatric Neuro-Oncology Program, Division of Hematology, Oncology, and BMT, Nationwide Children's Hospital, Columbus, Ohio, USA.,The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Ralph Salloum
- Pediatric Neuro-Oncology Program, Division of Hematology, Oncology, and BMT, Nationwide Children's Hospital, Columbus, Ohio, USA.,The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Joseph G Pressey
- Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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18
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He S, Wang Y, Zhao X, Xu F, Li J, Huang T, Sun P, Li L, Ai X, Xiao H, Xue G, He S. Factors Influencing Delayed Treatment in Patients With Breast Cancer During COVID-19 Pandemic. Front Public Health 2022; 10:808873. [PMID: 35570909 PMCID: PMC9099139 DOI: 10.3389/fpubh.2022.808873] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 04/04/2022] [Indexed: 12/15/2022] Open
Abstract
Background The outbreak of coronavirus disease 2019 (COVID-19) has endangered human health and life. This pandemic has changed people's lifestyle and affected the regular delivery of standard cancer treatment. In the present study, we aimed to explore the influencing factors of delayed treatment in patients with breast cancer during COVID-19 pandemic. Methods This study was a cross-sectional investigation, and the subjects were patients who were discharged from the department of burn and plastic surgery after February 2020. All participants completed this study's online questionnaire based on the WeChat and Wenjuanxing platforms. Levels of anxiety and depression were measured by the Hospital Anxiety and Depression Scale (HADS). Patients were divided into a delay group and non-delay group according to the occurrence of delayed treatment. Univariate analysis was performed by using the t test or chi-square test. A logistic regression model was employed to determine factors associated with delayed treatment. Results The present study included a total of 397 patients with breast cancer, among whom delayed treatment occurred in 76 patients, accounting for 19.1%. Scores on both the anxiety subscale and depression subscale in delay group were significantly higher than those in non-delay group. Compared with non-delay group, we found that patients in delay group usually had a higher level of education (P = 0.020), worse self-feeling (P = 0.030), poor compliance of medical order (P = 0.042), and a higher prevalence of anxiety (P = 0.004) and depression (P = 0.012). Traffic inconvenience was also an important relevant factor for delayed treatment (P = 0.001). The prevalence of recurrence in delay group was higher than that in non-delay group (P = 0.018). By using logistic multivariate regression analysis, the results revealed that level of education and traffic inconvenience were independent factors influencing delayed treatment in patients with breast cancer during COVID-19 pandemic. Conclusion The prevalence of delayed treatment in patients with breast cancer during COVID-19 pandemic is relatively high. Our findings reveal several influencing factors closely associated with delayed treatment, which is useful information that will be beneficial for patients to receive standardized therapy by taking targeted measures.
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Affiliation(s)
- Shengdong He
- Department of Burn and Plastic Surgery, The General Hospital of Western Theater Command, Chengdu, China
| | - Yanlin Wang
- Department of Burn and Plastic Surgery, The General Hospital of Western Theater Command, Chengdu, China
| | - Xiaoting Zhao
- Department of Burn and Plastic Surgery, The General Hospital of Western Theater Command, Chengdu, China
| | - Fangying Xu
- Department of General Medicine, The General Hospital of Western Theater Command, Chengdu, China
| | - Juncheng Li
- Department of Burn and Plastic Surgery, The General Hospital of Western Theater Command, Chengdu, China
| | - Tao Huang
- Department of Burn and Plastic Surgery, The General Hospital of Western Theater Command, Chengdu, China
| | - Peng Sun
- Department of Burn and Plastic Surgery, The General Hospital of Western Theater Command, Chengdu, China
| | - Lingfan Li
- Department of Burn and Plastic Surgery, The General Hospital of Western Theater Command, Chengdu, China
| | - Xiang Ai
- Department of Burn and Plastic Surgery, The General Hospital of Western Theater Command, Chengdu, China
| | - Hualin Xiao
- Department of Burn and Plastic Surgery, The General Hospital of Western Theater Command, Chengdu, China
| | - Gang Xue
- Department of Burn and Plastic Surgery, The General Hospital of Western Theater Command, Chengdu, China
| | - Siyi He
- Department of Cardiovascular Surgery, The General Hospital of Western Theater Command, Chengdu, China
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19
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Abstract
PURPOSE We aimed to compare patient-reported mental health outcomes for men undergoing treatment for localized prostate cancer longitudinally over 5 years. MATERIALS AND METHODS We conducted a prospective population-based analysis using the Comparative Effectiveness Analysis of Surgery and Radiation (CEASAR) study. Patient-reported depressive symptoms (Centers for Epidemiologic Studies Depression [CES-D]) and domains of the Medical Outcomes Study 36-item Short Form survey evaluating emotional well-being and energy/fatigue were assessed through 5 years after treatment with surgery, radiotherapy (with or without androgen deprivation therapy) and active surveillance. Regression models were adjusted for outcome-specific baseline function, demographic and clinicopathological characteristics, and treatment approach. RESULTS A total of 2,742 men (median [quartiles] age 64 [59-70]) met inclusion criteria. Baseline depressive symptoms, as measured by the CES-D, were low (median 4, quartiles 1-8) without differences between groups. We found no effect of treatment modality on depressive symptoms (p=0.78), though older age, poorer health, being unmarried and baseline CES-D score were associated with declines in mental health. There was no clinically meaningful association between treatment modality and scores for either emotional well-being (p=0.81) or energy/fatigue (p=0.054). CONCLUSIONS This prospective, population-based cohort study of men with localized prostate cancer showed no clinically important differences in mental health outcomes including depressive symptoms, emotional well-being, and energy/fatigue according to the treatment received (surgery, radiotherapy, or surveillance). However, we identified a number of characteristics associated with worse mental health outcomes including: older age, poorer health, being unmarried, and baseline CES-D score which may allow for early identification of patients most at risk of these outcomes following treatment.
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20
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Chen WC, Boreta L, Braunstein SE, Rabow MW, Kaplan LE, Tenenbaum JD, Morin O, Park CC, Hong JC. Association of mental health diagnosis with race and all-cause mortality after a cancer diagnosis: Large-scale analysis of electronic health record data. Cancer 2022; 128:344-352. [PMID: 34550601 PMCID: PMC8738115 DOI: 10.1002/cncr.33903] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 01/17/2023]
Abstract
BACKGROUND Disparity in mental health care among cancer patients remains understudied. METHODS A large, retrospective, single tertiary-care institution cohort study was conducted based on deidentified electronic health record data of 54,852 adult cancer patients without prior mental health diagnosis (MHD) diagnosed at the University of California, San Francisco between January 2012 and September 2019. The exposure of interest was early-onset MHD with or without psychotropic medication (PM) within 12 months of cancer diagnosis and primary outcome was all-cause mortality. RESULTS There were 8.2% of patients who received a new MHD at a median of 197 days (interquartile range, 61-553) after incident cancer diagnosis; 31.0% received a PM prescription; and 3.7% a mental health-related visit (MHRV). There were 62.6% of patients who were non-Hispanic White (NHW), 10.8% were Asian, 9.8% were Hispanic, and 3.8% were Black. Compared with NHWs, minority cancer patients had reduced adjusted odds of MHDs, PM prescriptions, and MHRVs, particularly for generalized anxiety (Asian odds ratio [OR], 0.66, 95% CI, 0.55-0.78; Black OR, 0.60, 95% CI, 0.45-0.79; Hispanic OR, 0.72, 95% CI, 0.61-0.85) and selective serotonin-reuptake inhibitors (Asian OR, 0.43, 95% CI, 0.37-0.50; Black OR, 0.51, 95% CI, 0.40-0.61; Hispanic OR, 0.79, 95% CI, 0.70-0.89). New early MHD with PM was associated with elevated all-cause mortality (12-24 months: hazard ratio [HR], 1.43, 95% CI, 1.25-1.64) that waned by 24 to 36 months (HR, 1.18, 95% CI, 0.95-1.45). CONCLUSIONS New mental health diagnosis with PM was a marker of early mortality among cancer patients. Minority cancer patients were less likely to receive documentation of MHDs or treatment, which may represent missed opportunities to identify and treat cancer-related mental health conditions.
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Affiliation(s)
- William C Chen
- Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA
| | - Lauren Boreta
- Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA
| | - Steve E Braunstein
- Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA
| | - Michael W Rabow
- Department of Internal Medicine, Division of Palliative Medicine, and Department of Urology, University of California San Francisco, California
| | - Lawrence E Kaplan
- Department of Psychiatry, University of California San Francisco, California
| | | | - Olivier Morin
- Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA
| | - Catherine C Park
- Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA
| | - Julian C Hong
- Department of Radiation Oncology, University of California, San Francisco, San Francisco, CA
- Bakar Computational Health Sciences Institute, University of California, San Francisco, San Francisco, CA
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21
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Sutradhar R, Li Q, Kurdyak P, Barbera L. The impact of symptom screening on survival among patients with cancer across varying levels of pre-diagnosis psychiatric care. Cancer Med 2021; 11:838-846. [PMID: 34931479 PMCID: PMC8817085 DOI: 10.1002/cam4.4479] [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: 02/25/2021] [Revised: 11/14/2021] [Accepted: 11/20/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Patients diagnosed with cancer often experience considerable challenges with mental health, and those who had more intense psychiatric care prior to their cancer diagnosis have a higher risk of mortality. As prior research demonstrated a survival benefit among patients screened for symptoms using the Edmonton symptom assessment system (ESAS), this study aims to examine the association between being ESAS-screened and the risk of mortality across varying intensity levels of pre-diagnosis psychiatric care utilization. METHODS We conducted a retrospective matched cohort study using population-wide administrative databases. All patients diagnosed with cancer in Ontario, Canada, from January 2007 to December 2015 were identified. Propensity score matching was used to pair ESAS-screened individuals to those not screened. Pairs were also hard matched on a pre-diagnosis psychiatric care utilization gradient. A multivariable Cox proportional hazards regression model was implemented to estimate the association between ESAS and mortality, for each intensity level of pre-diagnosis psychiatric care. RESULTS The matched cohort consisted of 119,806 patient pairs (ESAS-screened and not screened), of whom 54,468 (45.5%) pairs had prior outpatient psychiatric care and 2249 (1.8%) pairs had experienced emergency department visits or had been hospitalized for psychiatric care. Overall being exposed to ESAS was significantly associated with a 51% decrease in the hazard of mortality (HR 0.49, 95%CI 0.48-0.50, p-value <0.0001). This association was similar across all levels of prior psychiatric use, however, there was no evidence of a differential impact. CONCLUSION In addition to routinely monitoring symptom severity, including depression, among patients with cancer, it is also important to identify those with preexisting psychiatric comorbidities at the time of diagnosis. This information can be used to ensure that timely and appropriate psycho-oncology services and psycho-social supports are offered to help the patient and their family cope during the cancer disease trajectory.
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Affiliation(s)
- Rinku Sutradhar
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,ICES, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Qing Li
- ICES, Toronto, Ontario, Canada
| | - Paul Kurdyak
- ICES, Toronto, Ontario, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.,Institute for Mental Health Policy Research, Center for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Lisa Barbera
- ICES, Toronto, Ontario, Canada.,Department of Oncology, Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada
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22
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Benton JZ, Bergerot CD, Woodruff P, Williams SB, Wallis CJD, Klaassen Z. Mental health screening and diagnosis in cancer patients: Impact on mortality and suggestion of racial bias. Cancer 2021; 128:234-236. [PMID: 34550606 DOI: 10.1002/cncr.33901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/14/2021] [Accepted: 08/18/2021] [Indexed: 11/08/2022]
Affiliation(s)
| | - Cristiane D Bergerot
- Centro de Cancer de Brasilia (CETTRO), Instituto Unity de Ensino e Pesquisa, Brasilia, DF, Brazil
| | - Phillip Woodruff
- St. George's University School of Medicine, St. George's, Grenada
| | - Stephen B Williams
- Division of Urology, The University of Texas Medical Brach at Galveston, Galveston, Texas
| | - Christopher J D Wallis
- Department of Urological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Zachary Klaassen
- Department of Surgery, Section of Urology, Medical College of Georgia-Augusta University, Augusta, Georgia.,Georgia Cancer Center, Augusta, Georgia
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23
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Günther MP, Schulze JB, Jellestad L, Mehnert-Theuerkauf A, von Känel R, Euler S. Mental disorders, length of hospitalization, and psychopharmacy-New approaches to identify barriers to psychological support for patients with cancer. Psychooncology 2021; 30:1773-1781. [PMID: 34089283 DOI: 10.1002/pon.5743] [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: 02/10/2021] [Revised: 05/04/2021] [Accepted: 06/01/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND Despite abundant evidence that emotional distress is frequent in cancer patients and associated with adverse health outcomes, distress screening rates and adequate referrals to psychological support programs among those in need are insufficient in many cancer centers. We therefore aimed to analyze patient- and treatment-related barriers to distress screening and referrals to psychological support as a mandatory component of best-practice cancer care. METHOD In the present explorative study, latent class analysis was used to identify homogeneous subgroups among 4837 patients diagnosed with cancer between 2011 and 2019. RESULTS Four subgroups were identified. Patients with a mental disorder and psychopharmacology were least probable to be screened for distress. Together with patients aged 65 or older and male patients, they were also less likely to receive psychological support. Patients hospitalized for 28 days or longer were most likely to be both screened and to receive psychological support. CONCLUSIONS Clinicians and researchers are recommended not neglect patients with mental disorders and psychopharmacological treatment as well as male and elderly patients when screening for distress and providing access to psychological support.
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Affiliation(s)
- Moritz Philipp Günther
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jan Ben Schulze
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Lena Jellestad
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Anja Mehnert-Theuerkauf
- Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany
| | - Roland von Känel
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Sebastian Euler
- Department of Consultation-Liaison-Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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24
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Sverrisdóttir IS, Rögnvaldsson S, Thorsteinsdottir S, Gíslason GK, Aspelund T, Turesson I, Björkholm M, Gregersen H, Hveding Blimark C, Landgren O, Kristinsson SY. Comorbidities in multiple myeloma and implications on survival: A population-based study. Eur J Haematol 2021; 106:774-782. [PMID: 33565126 DOI: 10.1111/ejh.13597] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 02/04/2021] [Accepted: 02/08/2021] [Indexed: 12/20/2022]
Abstract
High proportion of patients with multiple myeloma suffer from comorbidities which may alter clinical management. Therefore, our aims were to evaluate the prevalence of comorbidities and their impact on survival. We included patients diagnosed with multiple myeloma 1990-2013 in Sweden and all diagnoses from each patient from 1985. A total of 13 656 patients with multiple myeloma were included in the study, thereof 7404 (54%) had comorbidity at diagnosis. The risk of death was increased for those with one comorbidity at diagnosis compared to those without any comorbidity (hazard ratio = 1.19; 95% confidence interval:1.14-1.25); this risk was higher for those with two (1.38; 1.30-1.47) and three or more comorbidities (1.72; 1.62-1.83). Furthermore, the risk of death was increased in patients with prior history of cancer, arrhythmia, heart failure, diabetes mellitus, cerebrovascular disease, chronic lung disease, psychological disease, peptic ulcer, neurological disease, peripheral vascular disease, chronic kidney disease, dementia, and inflammatory bowel disease. This large study shows that over 50% of multiple myeloma patients have a comorbidity at diagnosis and survival decreased with increasing numbers of comorbidities. This emphasizes the importance of comorbidities when evaluating patients and deciding on treatment strategies for individuals with multiple myeloma.
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Affiliation(s)
| | | | | | | | - Thor Aspelund
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | | | - Magnus Björkholm
- Division of Haematology, Department of Medicine, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Henrik Gregersen
- Department of Haematology, Aalborg University Hospital, Aalborg, Denmark
| | - Cecilie Hveding Blimark
- Department of Haematology, Sahlgrenska University Hospital and Institution of Internal Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Ola Landgren
- Myeloma Program, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA
| | - Sigurður Y Kristinsson
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland.,Department of Haematology, Landspitali National University Hospital, Reykjavik, Iceland
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25
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Harris JP, Kashyap M, Humphreys JN, Chang DT, Pollom EL. Longitudinal Analysis of Mental Disorder Burden Among Elderly Patients With Gastrointestinal Malignancies. J Natl Compr Canc Netw 2021; 19:163-171. [PMID: 33401234 DOI: 10.6004/jnccn.2020.7620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 07/14/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND Patients with cancer are at high risk for having mental disorders, resulting in widespread psychosocial screening efforts. However, there is a need for population-based and longitudinal studies of mental disorders among patients who have gastrointestinal cancer and particular among elderly patients. PATIENTS AND METHODS We used the SEER-Medicare database to identify patients aged ≥65 years with colorectal, pancreatic, gastric, hepatic/biliary, esophageal, or anal cancer. Earlier (12 months before or up to 6 months after cancer diagnosis) and subsequent mental disorder diagnoses were identified. RESULTS Of 112,283 patients, prevalence of an earlier mental disorder was 21%, 23%, 20%, 20%, 19%, and 26% for colorectal, pancreatic, gastric, hepatic/biliary, esophageal, and anal cancer, respectively. An increased odds of an earlier mental disorder was associated with pancreatic cancer (odds ratio [OR], 1.17; 95% CI, 1.11-1.23), esophageal cancer (OR, 1.10; 95% CI, 1.02-1.18), and anal cancer (OR, 1.17; 95% CI, 1.05-1.30) compared with colorectal cancer and with having regional versus local disease (OR, 1.09; 95% CI, 1.06-1.13). The cumulative incidence of a subsequent mental disorder at 5 years was 19%, 16%, 14%, 13%, 12%, and 10% for patients with anal, colorectal, esophageal, gastric, hepatic/biliary, and pancreatic cancer, respectively. There was an association with having regional disease (hazard ratio [HR], 1.08; 95% CI, 1.04-1.12) or distant disease (HR, 1.36; 95% CI, 1.28-1.45) compared with local disease and the development of a mental disorder. Although the development of a subsequent mental disorder was more common among patients with advanced cancers, there continued to be a significant number of patients with earlier-stage disease at risk. CONCLUSIONS This study suggests a larger role for incorporating psychiatric symptom screening and management throughout oncologic care.
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Affiliation(s)
- Jeremy P Harris
- 1Department of Radiation Oncology, University of California, Irvine, Orange
| | - Mehr Kashyap
- 2Department of Radiation Oncology, Stanford University, Stanford; and
| | - Jessi N Humphreys
- 3Division of Palliative Medicine, Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Daniel T Chang
- 2Department of Radiation Oncology, Stanford University, Stanford; and
| | - Erqi L Pollom
- 2Department of Radiation Oncology, Stanford University, Stanford; and
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Hiffa A, Wallis CJD, Klaassen Z. EDITORIAL COMMENT. Urology 2021; 147:160-161. [PMID: 33390200 DOI: 10.1016/j.urology.2020.05.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Anthony Hiffa
- Division of Urology, Department of Surgery, Medical College of Georgia - Augusta University, Augusta, GA
| | | | - Zachary Klaassen
- Division of Urology, Department of Surgery, Medical College of Georgia - Augusta University, Augusta, GA; Georgia Cancer Center, Augusta, GA
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27
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Klaassen Z, Wallis CJD. Addressing Mental Health in Urology Patients: The Time is Now. Eur Urol Focus 2020; 6:1137-1139. [PMID: 32891584 PMCID: PMC7468339 DOI: 10.1016/j.euf.2020.08.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 08/25/2020] [Indexed: 10/29/2022]
Affiliation(s)
- Zachary Klaassen
- Division of Urology, Department of Surgery, Medical College of Georgia, Augusta University, Augusta, GA, USA; Georgia Cancer Center, Augusta, GA, USA.
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The Impact of the COVID-19 Pandemic on Genitourinary Cancer Care: Re-envisioning the Future. Eur Urol 2020; 78:731-742. [PMID: 32893062 PMCID: PMC7471715 DOI: 10.1016/j.eururo.2020.08.030] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 08/20/2020] [Indexed: 12/14/2022]
Abstract
CONTEXT The coronavirus disease 2019 (COVID-19) pandemic necessitated rapid changes in medical practice. Many of these changes may add value to care, creating opportunities going forward. OBJECTIVE To provide an evidence-informed, expert-derived review of genitourinary cancer care moving forward following the initial COVID-19 pandemic. EVIDENCE ACQUISITION A collaborative narrative review was conducted using literature published through May 2020 (PubMed), which comprised three main topics: reduced in-person interactions arguing for increasing virtual and image-based care, optimisation of the delivery of care, and the effect of COVID-19 in health care facilities on decision-making by patients and their families. EVIDENCE SYNTHESIS Patterns of care will evolve following the COVID-19 pandemic. Telemedicine, virtual care, and telemonitoring will increase and could offer broader access to multidisciplinary expertise without increasing costs. Comprehensive and integrative telehealth solutions will be necessary, and should consider patients' mental health and access differences due to socioeconomic status. Investigations and treatments will need to maximise efficiency and minimise health care interactions. Solutions such as one stop clinics, day case surgery, hypofractionated radiotherapy, and oral or less frequent drug dosing will be preferred. The pandemic necessitated a triage of those patients whose treatment should be expedited, delayed, or avoided, and may persist with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in circulation. Patients whose demographic characteristics are at the highest risk of complications from COVID-19 may re-evaluate the benefit of intervention for less aggressive cancers. Clinical research will need to accommodate virtual care and trial participation. Research dissemination and medical education will increasingly utilise virtual platforms, limiting in-person professional engagement; ensure data dissemination; and aim to enhance patient engagement. CONCLUSIONS The COVID-19 pandemic will have lasting effects on the delivery of health care. These changes offer opportunities to improve access, delivery, and the value of care for patients with genitourinary cancers but raise concerns that physicians and health administrators must consider in order to ensure equitable access to care. PATIENT SUMMARY The coronavirus disease 2019 (COVID-19) pandemic has dramatically changed the care provided to many patients with genitourinary cancers. This has necessitated a transition to telemedicine, changes in threshold or delays in many treatments, and an opportunity to reimagine patient care to maintain safety and improve value moving forward.
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29
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Boehmer U, Clark MA, Ozonoff A, Winter M, Potter J. Survivors' Perceptions of Quality of Colorectal Cancer Care by Sexual Orientation. Am J Clin Oncol 2020; 43:660-666. [PMID: 32889837 PMCID: PMC8011297 DOI: 10.1097/coc.0000000000000732] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE The objective of this study was to assess sexual minority and heterosexual survivors' perceived quality of cancer care and identify demographic, clinical, and psychosocial characteristics associated with patient-centered quality of care. MATERIALS AND METHODS Four cancer registries provided data on 17,849 individuals who were diagnosed with stage I, II, or III colorectal cancer an average of 3 years prior and resided in predetermined diverse geographic areas. A questionnaire, which queried about sexual orientation and other eligibility criteria was mailed to all cancer survivors. Of these, 480 eligible survivors participated in a telephone survey. Quality of cancer care was defined by 3 measures of interpersonal care (physician communication, nursing care, and coordination of care) and by rating cancer care as excellent. We used generalized linear models and logistic regression with forward selection to obtain models that best explained each quality of care measure. RESULTS Sexual minority survivors rated physician communication, nursing care, and coordination of care similarly to heterosexual survivors, yet a significantly higher percentage of sexual minority survivors rated the overall quality of their cancer care as excellent (59% vs. 49%). Sexual minority survivors' greater likelihood of reporting excellent care remained unchanged after adjusting for demographic, clinical, and psychosocial characteristics. CONCLUSIONS Sexual minority survivors' ratings of quality of colorectal cancer care were comparable or even higher than heterosexual survivors. Sexual minority survivors' reports of excellent care were not explained by their interpersonal care experiences.
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Affiliation(s)
- Ulrike Boehmer
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA
| | - Melissa A. Clark
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA
| | - Al Ozonoff
- Harvard Medical School, Boston, MA
- Boston Children’s Hospital, Boston, MA
| | - Michael Winter
- Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA
| | - Jennifer Potter
- Harvard Medical School, Boston, MA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA
- The Fenway Institute, Boston, MA
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30
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Bhandari NR, Ounpraseuth ST, Kamel MH, Kent EE, McAdam-Marx C, Tilford JM, Payakachat N. Changes in health-related quality of life outcomes in older patients with kidney cancer: A longitudinal cohort analysis with matched controls. Urol Oncol 2020; 38:852.e11-852.e20. [PMID: 32863123 DOI: 10.1016/j.urolonc.2020.08.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 07/21/2020] [Accepted: 08/05/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Current evidence regarding health-related quality of life (HRQoL) changes among patients with kidney cancer (KC) is limited. We characterized HRQoL changes from before (baseline) to after (follow-up) diagnosis of KC in older Americans relative to matched controls, and identified sociodemographic and clinical factors associated with HRQoL changes in older patients with KC. MATERIALS AND METHODS This longitudinal, population-based, retrospective cohort study used data from Surveillance, Epidemiology and End Results linked with Medicare Health Outcomes Survey, 1998-2013. Participants aged ≥65 years with baseline and follow-up survey data were identified. Those with primary KC (n = 186) were matched to adults without cancer (n = 558). HRQoL (physical component summary and mental component summary [MCS]) changes in KC patients were compared using generalized linear mixed-effects models to those of controls. Regression models were used to identify baseline factors associated with HRQoL changes. RESULTS The adjusted least squares mean (95% confidence interval) reduction in physical component summary from baseline to follow-up was greater in KC patients vs. controls (-4.1 [-5.6, -2.7] vs. -2.3 [-3.1, -1.4], P = 0.025). While the reduction in MCS was similar in both groups (-2.4 [-3.9, -0.8] vs. -1.5 [-2.4, -0.6], P = 0.338). Lower income and distant stage KC predicted greater declines in MCS among KC patients. CONCLUSION KC significantly affects overall general health in older patients, with sociodemographic factors and distant KC predicting greater reductions in HRQoL. Findings may help clinicians set patient expectations about their HRQoL post-diagnosis and increase clinician awareness of risk factors for HRQoL deterioration.
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Affiliation(s)
- Naleen Raj Bhandari
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR
| | | | - Mohamed H Kamel
- Department of Urology, UAMS, Little Rock, AR; Department of Urology, Ain Shams University, Cairo, Egypt
| | - Erin E Kent
- Department of Health Policy and Management, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Carrie McAdam-Marx
- Department of Pharmacy Practice and Science, University of Nebraska Medical Center, Omaha, NE
| | - J Mick Tilford
- Department of Health Policy and Management, UAMS, Little Rock, AR
| | - Nalin Payakachat
- Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences (UAMS), Little Rock, AR.
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31
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Agyapong VIO, Hrabok M, Shalaby R, Mrklas K, Vuong W, Gusnowski A, Surood S, Greenshaw AJ, Nkire N. Closing the COVID-19 Psychological Treatment Gap for Cancer Patients in Alberta: Protocol for the Implementation and Evaluation of Text4Hope-Cancer Care. JMIR Res Protoc 2020; 9:e20240. [PMID: 32750012 PMCID: PMC7450377 DOI: 10.2196/20240] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/14/2020] [Accepted: 07/26/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Cancer diagnoses and treatments usually engender significant anxiety and depressive symptoms in patients, close relatives, and caregivers. Providing psychological support during the coronavirus disease (COVID-19) pandemic presents additional challenges due to self-isolation and social or physical distancing measures in place to limit viral spread. This protocol describes the use of text messaging (Text4Hope-Cancer Care) as a convenient, cost-effective, and accessible population-level mental health intervention. As demonstrated in previous research, this evidence-based program supports good outcomes and high user satisfaction. OBJECTIVE We will implement daily supportive text messaging as a way of reducing and managing anxiety and depression related to cancer diagnosis and treatment in Alberta, Canada. Prevalence of anxiety and depressive symptoms, their demographic correlates, and Text4Hope-Cancer Care-induced changes in anxiety and depression will be evaluated. METHODS Alberta residents with a cancer diagnosis and the close relatives of those dealing with a cancer diagnosis can self-subscribe to the Text4Hope-Cancer Care program by texting "CancerCare" to a dedicated text number. Self-administered, anonymous, online questionnaires will be used to assess anxiety and depressive symptoms using the Hospital Anxiety and Depression Scale (HADS). Data will be collected at onset from individuals receiving text messages, and at the mid- and endpoints of the program (ie, at 6 and 12 weeks, respectively). Data will be analyzed with parametric and nonparametric statistics for primary outcomes (ie, anxiety and depressive symptoms) and usage metrics, including the number of subscribers and user satisfaction. In addition, data mining and machine learning analysis will focus on determining subscriber characteristics that predict high levels of symptoms of mental disorders, and may subsequently predict changes in those measures in response to the Text4Hope-Cancer Care program. RESULTS The first research stage, which was completed in April 2020, involved the creation and review of the supportive text messages and uploading of messages into a web-based text messaging service. The second stage, involving the launch of the Text4Hope-Cancer Care program, occurred in May 2020. CONCLUSIONS Text4Hope-Cancer Care has the potential to provide key information regarding the prevalence rates of anxiety and depressive symptoms in patients diagnosed or receiving care for cancer and their caregivers. The study will generate demographic correlates of anxiety and depression, and outcome data related to this scalable, population-level intervention. Information from this study will be valuable for health care practitioners working in cancer care and may help inform policy and decision making regarding psychological interventions for cancer care. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/20240.
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Affiliation(s)
- Vincent Israel Opoku Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Marianne Hrabok
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Reham Shalaby
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Kelly Mrklas
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Edmonton, AB, Canada
- Strategic Clinical Networks, Provincial Clinical Excellence, Alberta Health Services, Calgary, AB, Canada
| | - Wesley Vuong
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - April Gusnowski
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Shireen Surood
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Andrew James Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- APEC Digital Hub for Mental Health, Edmonton, AB, Canada
| | - Nnamdi Nkire
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
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32
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Sayyid RK, Wallis CJD, Dymanus K, Jazzar U, Goldberg H, Williams SB, Klaassen Z. Elevated suicide risk among patients with urologic malignancies: highlighting at-risk populations. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:272. [PMID: 32355716 PMCID: PMC7186707 DOI: 10.21037/atm.2020.02.73] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Rashid K Sayyid
- Section of Urology, Department of Surgery, Medical College of Georgia-Augusta University, Augusta, GA, USA
| | - Christopher J D Wallis
- Department of Urologic Surgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | | | - Usama Jazzar
- Division of Urology, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Hanan Goldberg
- Department of Urology, State University of New York - Upstate, Syracuse, NY, USA
| | - Stephen B Williams
- Division of Urology, The University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Zachary Klaassen
- Section of Urology, Department of Surgery, Medical College of Georgia-Augusta University, Augusta, GA, USA.,Georgia Cancer Center, Augusta, GA, USA
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33
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Age Differences in Patient-reported Psychological and Physical Distress Symptoms in Bladder Cancer Patients – A Cross Sectional Study. Urology 2019; 134:154-162. [DOI: 10.1016/j.urology.2019.08.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 07/12/2019] [Accepted: 08/05/2019] [Indexed: 10/26/2022]
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34
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Niedzwiedz CL, Knifton L, Robb KA, Katikireddi SV, Smith DJ. Depression and anxiety among people living with and beyond cancer: a growing clinical and research priority. BMC Cancer 2019; 19:943. [PMID: 31604468 PMCID: PMC6788022 DOI: 10.1186/s12885-019-6181-4] [Citation(s) in RCA: 318] [Impact Index Per Article: 63.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 09/20/2019] [Indexed: 12/24/2022] Open
Abstract
Background A cancer diagnosis can have a substantial impact on mental health and wellbeing. Depression and anxiety may hinder cancer treatment and recovery, as well as quality of life and survival. We argue that more research is needed to prevent and treat co-morbid depression and anxiety among people with cancer and that it requires greater clinical priority. For background and to support our argument, we synthesise existing systematic reviews relating to cancer and common mental disorders, focusing on depression and anxiety. We searched several electronic databases for relevant reviews on cancer, depression and anxiety from 2012 to 2019. Several areas are covered: factors that may contribute to the development of common mental disorders among people with cancer; the prevalence of depression and anxiety; and potential care and treatment options. We also make several recommendations for future research. Numerous individual, psychological, social and contextual factors potentially contribute to the development of depression and anxiety among people with cancer, as well as characteristics related to the cancer and treatment received. Compared to the general population, the prevalence of depression and anxiety is often found to be higher among people with cancer, but estimates vary due to several factors, such as the treatment setting, type of cancer and time since diagnosis. Overall, there are a lack of high-quality studies into the mental health of people with cancer following treatment and among long-term survivors, particularly for the less prevalent cancer types and younger people. Studies that focus on prevention are minimal and research covering low- and middle-income populations is limited. Conclusion Research is urgently needed into the possible impacts of long-term and late effects of cancer treatment on mental health and how these may be prevented, as increasing numbers of people live with and beyond cancer.
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Affiliation(s)
- Claire L Niedzwiedz
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland, UK.
| | - Lee Knifton
- University of Strathclyde, Centre for Health Policy, Glasgow, Scotland, UK.,Mental Health Foundation, Glasgow, Scotland, UK
| | - Kathryn A Robb
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland, UK
| | | | - Daniel J Smith
- Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland, UK
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35
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Braillon A. Comment on: “The impact of psychiatric utilisation prior to cancer diagnosis on survival of solid organ malignancies”. Br J Cancer 2019; 121:193-194. [PMID: 31178589 PMCID: PMC6738038 DOI: 10.1038/s41416-019-0493-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 04/16/2019] [Accepted: 04/18/2019] [Indexed: 11/09/2022] Open
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36
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Klaassen Z, Wallis CJD, Kurdyak P, Kulkarni GS. Reply to Comment on: "The impact of psychiatric utilisation prior to cancer diagnosis on survival of solid organ malignancies''. Br J Cancer 2019; 121:195-196. [PMID: 31178590 PMCID: PMC6738033 DOI: 10.1038/s41416-019-0494-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 05/10/2019] [Accepted: 05/15/2019] [Indexed: 11/09/2022] Open
Affiliation(s)
- Zachary Klaassen
- Division of Urology, Medical College of Georgia - Augusta University, Augusta, GA, USA.,Georgia Cancer Center, Augusta, GA, USA
| | - Christopher J D Wallis
- Department of Surgery, Division of Urology, University of Toronto, University Health Network, Princess Margaret Cancer Centre, Toronto, ON, Canada
| | - Paul Kurdyak
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.,Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Girish S Kulkarni
- Department of Surgery, Division of Urology, University of Toronto, University Health Network, Princess Margaret Cancer Centre, Toronto, ON, Canada. .,Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada. .,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
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