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Zhou J, Tian M, Zhang X, Xiong L, Huang J, Xu M, Xu H, Yin Z, Wu F, Hu J, Liang X, Wei S. Suicide among lymphoma patients. J Affect Disord 2024; 360:97-107. [PMID: 38821367 DOI: 10.1016/j.jad.2024.05.158] [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: 12/06/2023] [Revised: 05/22/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024]
Abstract
BACKGROUND Higher suicide rates were observed in patients diagnosed with lymphoma. In this study, we accurately identified patients with high-risk lymphoma for suicide by constructing a nomogram with a view to effective interventions and reducing the risk of suicide. METHODS 235,806 patients diagnosed with lymphoma between 2000 and 2020 were picked from the Surveillance, Epidemiology, and End Results (SEER) database and randomly divided into training (N = 165,064) and validation set (N = 70,742). A combination of the Least absolute shrinkage and selection operator (LASSO) and Cox proportional hazards regression identified the predictors that constructed the nomogram. To assess the discrimination, calibration, clinical applicability, and generalization of this nomogram, we implemented receiver operating characteristic curves (ROC), calibration curves, decision curve analysis (DCA), and internal validation. The robustness of the results was assessed by the competing risks regression model. RESULTS Age at diagnosis, gender, ethnicity, marital status, stage, surgery, radiotherapy, and annual household income were key predictors of suicide in lymphoma patients. A nomogram was created to visualize the risk of suicide after a lymphoma diagnosis. The c-index for the training set was 0.773, and the validation set was 0.777. The calibration curve for the nomogram fitted well with the diagonal and the clinical decision curve indicated its clinical benefit. LIMITATION The effects of unmeasured and unnoticed biases and confounders were difficult to eliminate due to retrospective studies. CONCLUSION A convenient and reliable model has been constructed that will help to individualize and accurately quantify the risk of suicide in patients diagnosed with lymphoma.
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Affiliation(s)
- Jie Zhou
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Wuhan, Wuhan 430079, Hubei, China
| | - Mengjie Tian
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Wuhan, Wuhan 430079, Hubei, China; Department of Abdominal Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei, China
| | - Xiangchen Zhang
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Wuhan, Wuhan 430079, Hubei, China
| | - Lingyi Xiong
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Wuhan, Wuhan 430079, Hubei, China; Department of Abdominal Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei, China
| | - Jinlong Huang
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Wuhan, Wuhan 430079, Hubei, China
| | - Mengfan Xu
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Wuhan, Wuhan 430079, Hubei, China; Department of Abdominal Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei, China
| | - Hongli Xu
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Wuhan, Wuhan 430079, Hubei, China; Department of Abdominal Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei, China
| | - Zhucheng Yin
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Wuhan, Wuhan 430079, Hubei, China; Department of Abdominal Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei, China
| | - Fengyang Wu
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Wuhan, Wuhan 430079, Hubei, China; Department of Abdominal Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei, China
| | - Junjie Hu
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Wuhan, Wuhan 430079, Hubei, China
| | - Xinjun Liang
- Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Wuhan, Wuhan 430079, Hubei, China; Department of Abdominal Oncology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei, China.
| | - Shaozhong Wei
- Department of Gastrointestinal Oncology Surgery, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Hubei Province, Wuhan 430079, Hubei, China; Colorectal Cancer Clinical Research Center of Wuhan, Wuhan 430079, Hubei, China.
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Qi H, Liu R, Dong CC, Zhu XQ, Feng Y, Wang HN, Li L, Chen F, Wang G, Yan F. Identifying influencing factors of metabolic syndrome in patients with major depressive disorder: A real-world study with Bayesian network modeling. J Affect Disord 2024; 362:308-316. [PMID: 38971193 DOI: 10.1016/j.jad.2024.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 06/13/2024] [Accepted: 07/03/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND The bidirectional relationships between metabolic syndrome (MetS) and major depressive disorder (MDD) were discovered, but the influencing factors of the comorbidity were barely investigated. We aimed to fully explore the factors and their associations with MetS in MDD patients. METHODS The data were retrieved from the electronic medical records of a tertiary psychiatric hospital in Beijing from 2016 to 2021. The influencing factors were firstly explored by univariate analysis and multivariate logistic regressions. The propensity score matching was used to reduce the selection bias of participants. Then, the Bayesian networks (BNs) with hill-climbing algorithm and maximum likelihood estimation were preformed to explore the relationships between influencing factors with MetS in MDD patients. RESULTS Totally, 4126 eligible subjects were included in the data analysis. The proportion rate of MetS was 32.6 % (95 % CI: 31.2 %-34.1 %). The multivariate logistic regression suggested that recurrent depression, uric acid, duration of depression, marriage, education, number of hospitalizations were significantly associated with MetS. In the BNs, number of hospitalizations and uric acid were directly connected with MetS. Recurrent depression and family history psychiatric diseases were indirectly connected with MetS. The conditional probability of MetS in MDD patients with family history of psychiatric diseases, recurrent depression and two or more times of hospitalizations was 37.6 %. CONCLUSION Using the BNs, we found that number of hospitalizations, recurrent depression and family history of psychiatric diseases contributed to the probability of MetS, which could help to make health strategies for specific MDD patients.
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Affiliation(s)
- Han Qi
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Rui Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Cheng-Cheng Dong
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xue-Quan Zhu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yuan Feng
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Hai-Ning Wang
- Department of Endocrinology and Metabolic Disease, Peking University Third Hospital, Beijing, China
| | - Lei Li
- Department of Cardiology, Peking University Third Hospital, Beijing, China; State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China; NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Peking University, Beijing, China; Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, China
| | - Fei Chen
- Graduate School of Peking University Health Science Center, Peking University, Beijing, China
| | - Gang Wang
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
| | - Fang Yan
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China; Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China.
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Zhang Z, Lao J, Liu M, Zheng S, Zhao M, Zhang M. Symptom cluster among cancer survivors from a nationally representative survey: a network analysis. Support Care Cancer 2024; 32:333. [PMID: 38713314 DOI: 10.1007/s00520-024-08531-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 04/27/2024] [Indexed: 05/08/2024]
Abstract
PURPOSE To identify the symptom cluster among cancer survivors and examine their subgroup differences via network analysis based on nationally representative data. METHODS This cross-sectional study included 2966 survivors participating in the 2020 National Health Interview Survey (NHIS). Participants self-reported the presence of 14 symptoms capturing four clusters (physical, somatic, sleep, and psychologic problems). Network analysis models were used to reveal the relationships between symptoms and those interactions. Network comparison tests were applied to compare subgroups. RESULTS The core symptoms of the symptom cluster were fatigue (Bet = 33, Clo = 0.0067, Str = 0.9397), pain (Bet = 11, Clo = 0.0060, Str = 0.9226), wake up well rested (Bet = 25, Clo = 0.0057, Str = 0.8491), and anxiety (Bet = 5, Clo = 0.0043, Str = 0.9697) among cancer survivors. The core symptoms, network structure, and global strength were invariant between time since diagnoses (< 2 years vs. ≥ 2 years) or between numbers of cancers (1 vs. ≥ 2), yet varied between the comorbidity group and non-comorbidity group (≥ 1 vs. 0). CONCLUSIONS Fatigue would be a potential target for alleviating other symptoms through a negative feedback loop of other related symptoms of cancer survivors. In particular, cancer survivors with other chronic diseases should be the focus of attention and strengthen targeted intervention.
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Affiliation(s)
- Zhen Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Emergency, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Jiahui Lao
- The First Affiliated Hospital of Shandong First Medical University and Shandong Provincial Qianfoshan Hospital, Jinan, Shandong, China
| | - Mingming Liu
- Department of Emergency, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Shenglong Zheng
- Department of Emergency, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Ming Zhao
- Department of Emergency, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Min Zhang
- Department of Nursing, Qilu Hospital, Shandong University, Jinan, China.
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Yildirim D, Çiriş Yildiz C, Ozdemir FA, Harman Özdoğan M, Can G. Effects of a Mindfulness-Based Stress Reduction Program on Stress, Depression, and Psychological Well-being in Patients With Cancer: A Single-Blinded Randomized Controlled Trial. Cancer Nurs 2024; 47:E84-E92. [PMID: 36480346 DOI: 10.1097/ncc.0000000000001173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND A mindfulness-based stress reduction program combined with music therapy is one of the interventions designed to help patients cope with stress and depression. OBJECTIVE The aim of this study was to examine the effects of an online mindfulness-based stress reduction program combined with music therapy on stress, depression, and psychological well-being in adult patients with cancer. METHODS This study was a single-blinded, prospective, randomized-controlled experimental design. One hundred twenty cancer patients were recruited (60 each in the intervention and control groups). Patients in the intervention group received a 10-day mindfulness-based stress reduction program combined with music therapy. Stress was measured with the State Trait Anxiety Inventory-State, psychological well-being was measured with the Psychological Well-being Scale, and depression was measured with the Beck Depression Inventory at baseline and the end of the study. RESULTS The intervention group showed significantly lower stress and depression scores than the control group in the total scores at 10 days ( P < .05). The intervention group had significantly higher scores in the psychological well-being ( P < .001) than the control group at 10 days. Intragroup comparison of the stress and depression scores showed that posttest score of the intervention group was significantly lower than its pretest score ( P < .05). CONCLUSION Mindfulness-based stress reduction program combined with music therapy reduced the levels of stress and depressive symptoms and improved psychological well-being in cancer patients. IMPLICATIONS FOR PRACTICE A nurse-led mindfulness-based stress reduction program combined with music therapy is an innovative and effective psychological intervention that may be integrated with regular patient care for adults receiving treatment of cancer.
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Affiliation(s)
- Dilek Yildirim
- Author Affiliations: Department of Nursing, Faculty of Health Sciences, Istanbul Aydin University (Drs Yildirim and Çiriş Yildiz); Fethiye Faculty of Nursing, Mugla Sıtkı Koçman University (Dr Akyuz Ozdemir); Dialysis Programme, Department of Medical Services and Techniques, Vocational School of Health Services, Sinop University (Ms Harman Özdoğan); and Florence Nightingale Faculty of Nursing, Istanbul University-Cerrahpaşa (Dr Can), Turkey
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Jiang Y, Hu Y, Yang Y, Yan R, Zheng L, Fu X, Xiao C, You F. Tong-Xie-Yao-Fang promotes dendritic cells maturation and retards tumor growth in colorectal cancer mice with chronic restraint stress. JOURNAL OF ETHNOPHARMACOLOGY 2024; 319:117069. [PMID: 37619860 DOI: 10.1016/j.jep.2023.117069] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 08/10/2023] [Accepted: 08/20/2023] [Indexed: 08/26/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Depression is one of the important risk factors that accelerate the progression of colorectal cancer (CRC). Tong-Xie-Yao-Fang (TXYF) is a widely used classical formula for treating psychiatric-related intestinal diseases in traditional Chinese medicine, that is composed of four different herbs: Atractylodes macrocephala Koidz. (Baizhu), Paeonia lactiflora Pall. (Baishaoyao), Citrus reticulata Blanco (Chenpi), Saposhnikovia divaricata (Turcz.) Schischk (Fangfeng). TXYF has over a hundred years of history and can significantly improve depression and reduce intestinal symptoms. However, the intervention effect and mechanism of TXYF on colorectal cancer accompanied by psychological stress are not still clear. AIM OF STUDY This study investigated the therapeutic effect of TXYF on CRC mice with chronic restraint stress (CRS) and to explore its mechanism. MATERIALS AND METHODS We constructed a mouse model of chronic stress by CRS and subcutaneous injection of CT26-Luc cells, and administered TXYF by gavage. We measured the body weight, tumor size, and tumor weight of each group of mice. The tumor growth was monitored dynamically of by vivo bioluminescence analysis. The depressive state of each group of mice were evaluated by tail suspension test, forced swimming test, and hormone level changes. We used flow cytometry to detect the ratio of CD4+ T cells, CD8+ T cells, Th1 cells, Th2 cells, and dendritic cells (DCs) phenotype (MHC II, CD80, and CD86) and chemotaxis ability (CXCR4 and CCR7) of in peripheral blood and tumor tissue. the levels of IL-12, IL-18, Th1 cytokines, and Th2 cytokines in the serum of each group of mice were determined by ELISA. RESULTS TXYF can improve the body weight of CRC mice with CRS, inhibit tumor volume and weight, alleviate depressive state, upregulate 5-HT levels, and inhibit HPA axis hormone secretion. The results of flow cytometry showed that TXYF can promote the maturation of DCs phenotype and function, enhance antigen presentation ability, increase the ratio of CD4+ T cells and CD4+/CD8+ T cells, and shift Th1/Th2 balance towards Th1 cells, thus increasing serum levels of IFN-γ, IL-18, IL-2, and IL-12, while decreasing serum levels of IL-4 and IL-10, and effectively triggering T cell-mediated immune response. CONCLUSIONS This study shows that TXYF inhibits the growth of tumors in CRC mice with CRS by stimulating immune response. The mechanism may be inhibiting the HPA axis and promoting DCs maturation, thus activating T cells and enhancing anti-tumor immune response, ultimately preventing the progression of CRC.
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Affiliation(s)
- Yifang Jiang
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Yane Hu
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Yi Yang
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Ran Yan
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Lili Zheng
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Xi Fu
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Chong Xiao
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China
| | - Fengming You
- TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, 610072, Sichuan, China.
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Liu JY, Zheng JQ, Yin CL, Tang WP, Zhang JN. Hotspots and frontiers of the relationship between gastric cancer and depression: A bibliometric study. World J Gastroenterol 2023; 29:6076-6088. [PMID: 38130743 PMCID: PMC10731158 DOI: 10.3748/wjg.v29.i46.6076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/02/2023] [Accepted: 12/02/2023] [Indexed: 12/13/2023] Open
Abstract
BACKGROUND A significant relationship between gastric cancer (GC) and depression has been found in the last 20 years. However, there is no comprehensive information that helps researchers find popular and potential research directions on GC and depression. AIM To determine the research status and hotspots by bibliometric analysis of relevant publications on the relationship between GC and depression. METHODS We used the Web of Science Core Collection to search and collate the literature on GC and depression from 2000 to 2022 on 31 May, 2023. Then, visualization analysis was performed using VOSviewer software (version 1.6.19) and the Bibliometrix package in R software. RESULTS We retrieved 153 pertinent publications from 2000 to 2022. The annual publication count showed an overall upward trend. China had the most prominent publications and significant contributions to this field (n = 64, 41.83%). Before 2020, most studies focused on "the effect of GC on the development and progression of depression in patients." The latest research trends indicate that "the effect of depression on the occurrence and development of GC and its mechanism" will receive more attention in the future. CONCLUSION The study of "the effect of depression on the occurrence and development of GC and its mechanism" has emerged as a novel research theme over the past two years, which may become a research hotspot in this field. This study provides new insights into the hotpots and frontiers of the relationship between GC and depression, potentially guiding researchers toward hot research topics in the future.
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Affiliation(s)
- Jia-Yu Liu
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
| | - Ji-Qi Zheng
- School of Health Humanities, Peking University, Beijing 100191, China
| | - Cheng-Liang Yin
- Medical Big Data Research Center, Medical Innovation Research Division of Chinese PLA General Hospital, Beijing 100853, China
- National Engineering Research Center for Medical Big Data Application Technology, Chinese PLA General Hospital, Beijing 100853, China
| | - Wen-Pei Tang
- School of Health Humanities, Peking University, Beijing 100191, China
| | - Jian-Ning Zhang
- Department of Neurosurgery, The First Medical Centre, Chinese PLA General Hospital, Beijing 100853, China
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Madrigal J, Tie EK, Verma A, Benharash P, Rapkin DA, St John MA. The Increasing Burden of Depression in Patients Undergoing Head and Neck Cancer Operations. Laryngoscope 2023; 133:3396-3402. [PMID: 37161918 DOI: 10.1002/lary.30735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/30/2023] [Accepted: 04/19/2023] [Indexed: 05/11/2023]
Abstract
OBJECTIVE Depression remains prevalent in patients undergoing head and neck cancer (HNCA) operations. The present study aimed to assess the impact of depression on perioperative and readmission outcomes following HNCA resection. METHODS All elective hospitalizations involving HNCA resection were identified from the 2010-2019 Nationwide Readmissions Database. Patients were stratified by history of depression. To perform risk-adjustment in assessing perioperative and readmission outcomes, 3:1 nearest neighbor matching was performed. A subpopulation analysis was also conducted to assess interval development of depression in the postoperative period. RESULTS Of an estimated 133,018 patients undergoing HNCA operations, 8.9% (n = 11,855) had comorbid depression. Over the decade-long study period, the prevalence of depression in this population increased (7.8% in 2010 vs. 10.0% in 2019, NPTrend<0.001). Among 24,938 propensity matched patients, those with depression had similar incidence of in-hospital mortality (0.4 vs. 0.7%, p = 0.14) as well as perioperative medical (22.0 vs. 21.9%, p = 0.93) and surgical (10.2 vs. 10.3, p = 0.84) complications, though had higher rates of non-home discharge (16.9 vs. 13.5%, p < 0.001) and 30-day readmission (13.6 vs. 11.8%, p = 0.030). Predictors of depression in the postoperative period included primary coverage by Medicare or Medicaid as well as comorbid anxiety or drug use disorder. CONCLUSION The prevalence of depression in HNCA patients continues to increase. Although depression was not associated with increased in-hospital mortality and complications, it did impact rates of rehospitalization as well as non-routine discharge. Screening and therapeutic interventions addressing such postoperative events may serve to improve long-term clinical and financial outcomes in this at-risk population. LEVEL OF EVIDENCE 3-Retrospective cohort study Laryngoscope, 133:3396-3402, 2023.
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Affiliation(s)
- Josef Madrigal
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA
- Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Edward K Tie
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, California, USA
| | - Arjun Verma
- Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Peyman Benharash
- Cardiovascular Outcomes Research Laboratories (CORELAB), Division of Cardiac Surgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - David A Rapkin
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Maie A St John
- Department of Head and Neck Surgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA
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Wang B, Pan L, Chen M, Ma Y, Gao J, Tang D, Jiang Z. SIRP-alpha-IL-6 axis induces immunosuppressive macrophages in non-small-cell lung cancer. Biochem Biophys Res Commun 2023; 682:386-396. [PMID: 37844448 DOI: 10.1016/j.bbrc.2023.10.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 09/28/2023] [Accepted: 10/09/2023] [Indexed: 10/18/2023]
Abstract
Signal regulatory protein-alpha (SIRPα) and IL-6 participate in the induction of tumor immune suppressive environment and facilitate tumor growth. In this study, we found that SIRPα was significantly elevated in macrophages of non-small cell lung cancer (NSCLC) tissues, which was positively correlated to the expression of CD163, PD-1, IL-6, and lung cancer progression. SIRPα in peripheral blood mononuclear cells (PBMCs) of NSCLC patients was also associated with CD163, PD-1, and plasma IL-6. Blockade of SIRPα signaling in SIRPα ± and SIRPα-/- mice attenuated lung cancer growth and reduced IL-6 expression in LLC cells-transplanted murine lung cancer model. Co-targeting SIRPα and IL-6 additively suppressed the expression of IL-6 and activation of STAT3, accompanied with a reduced population of pro-tumorigenic CD206+ M2 subtype of macrophages, PD-1+ tumor-associated macrophages (TAMs), and PD-1+CD8+ T cells in tumor tissues of anti-IL-6 antibody (aIL-6)-treated mice deficient in SIRPα. Further in vitro studies showed that blockade of SIRPα signaling by anti-SIRPα effectively improved phagocytosis of human PBMCs. IL-6 treatment improved polarization of M2 subtypes and the expression of PD-1 in bone marrow-derived macrophages (BMDMs); whereas both aIL-6 and STAT3 inhibitor C188-9 suppressed the expression of PD-1 and SIRPα in BMDMs. M2 cell-biased polarization was also reduced in aIL-6 or C188-9 treated BMDMs. Thereby, SIRPα and IL-6 form a positive feedback loop and regulate each other through STAT3 signaling in macrophages. The increased SIRPα/IL-6 axis may promote immune suppressive environment and lung cancer growth, which may be a potential target for clinical treatment.
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Affiliation(s)
- Bin Wang
- Cancer Center, Department of Thoracic Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, Zhejiang, China; Department of Thoracic Surgery, Huadong Hospital, Fudan University, Shanghai, China
| | - Linyue Pan
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mengjie Chen
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuan Ma
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jiameng Gao
- Department of Pulmonary Medicine, Minhang Hospital, Fudan University, Shanghai, China
| | - Dongfang Tang
- Department of Thoracic Surgery, Huadong Hospital, Fudan University, Shanghai, China
| | - Zhilong Jiang
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
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Moessinger H, Jacob L, Smith L, Koyanagi A, Kostev K. Psychiatric disorder and its association with gastrointestinal cancer: a retrospective cohort study with 45,842 patients in Germany. J Cancer Res Clin Oncol 2023; 149:14509-14518. [PMID: 37573275 DOI: 10.1007/s00432-023-05229-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 07/29/2023] [Indexed: 08/14/2023]
Abstract
PURPOSE Psychiatric disorders and cancer are both common, and comorbidity has detrimental impacts on cancer outcomes. Previous studies focus on affective disorders which arise after cancer diagnosis, not on the impact of psychiatric disorders on cancer risk. We investigate the association between psychiatric disorders and subsequent gastrointestinal cancer in a large cohort in Germany. METHODS This case-control study used secondary data (electronic medical records) from the national IQVIA Disease Analyzer database. We evaluated the association between previous psychiatric diagnosis in 44,582 matched patients with and without gastrointestinal (GI) cancer. Regression analyses were stratified by psychiatric diagnosis and adjusted by chronic comorbidities and previous psychiatric treatments. RESULTS No association between any previous psychiatric disease and GI cancers was found (OR = 0.98 (0.95-1.02 95%CL, p = 0.39). Previous psychosomatic disorder and GI cancer showed a significant negative association (OR: 0.86, 0.81-0.90 95%CL, p < 0.0001). No association was found between previous diagnosis with depression or PTSD and GI cancer. These results remained consistent when including previous psychiatric treatments in the regression analyses. CONCLUSION Psychiatric disease was not associated with GI cancer risk. Further investigation into the pathways linking psychiatric disease and cancer needs to be conducted, taking into consideration psychiatric treatments administered, to enhance our understanding of the relationship between these two common and devastating diseases.
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Affiliation(s)
| | - Louis Jacob
- Department of Physical Medicine and Rehabilitation, Université Paris Cité, AP-HP, Lariboisière-Fernand Widal Hospital, Paris, France
- Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases (EpiAgeing), Université Paris Cité, Paris, France
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, Barcelona, Spain
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, Dr. Antoni Pujadas, Barcelona, Spain
- Institució Catalana de Recerca I Estudis Avançats (ICREA), Pg. Lluis Companys 23, Barcelona, Spain
| | - Karel Kostev
- Epidemiology, IQVIA, Frankfurt, Germany.
- Department of Gynecology and Obstetrics, University Hospital Marburg, Philipps-University Marburg, Baldingerstraße, 35043, Marburg, Germany.
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10
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Yang LS, Zhang ZY, Yan LJ, Yan YC, Tan SY, Wang DX, Dong ZR, Li T. Caffeine intake is associated with less severe depressive symptoms in noncancer populations: an analysis based on NHANES 2007-2016. Nutr Res 2023; 118:1-11. [PMID: 37531810 DOI: 10.1016/j.nutres.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 07/16/2023] [Accepted: 07/16/2023] [Indexed: 08/04/2023]
Abstract
Depression and cancer are both prevalent diseases worldwide. Numerous cancer patients experience psychological illnesses, especially depression, following a malignancy's dismal prognosis. Although some research has suggested that caffeine may be protective against depressive symptoms, it is still unclear how caffeine and cancer patients are related. Thus, we hypothesized that moderate daily caffeine intake may reduce the risk of depression in both the cancer and noncancer populations. Data were extracted and combined from the National Health and Nutrition Examination Survey from 2007 to 2016. After controlling for potential confounding factors, interaction effects analysis was used to clarify the interaction between caffeine and cancer on depressive symptoms. Linear regression analysis and restricted cubic splines were used to further analyze the relationship between caffeine and depression in cancer and noncancer populations. A total of 24,145 participants were included in the analysis. In the noncancer population, the quartile 3 group of caffeine intake showed a negative association between caffeine intake and Patient Health Questionnaire-9 (PHQ-9) scores (β = -0.23, 95% confidence interval, -0.45 to -0.01; P = .041). No association between caffeine intake and PHQ-9 scores was observed in the cancer population. In both cancer and noncancer populations, restricted cubic splines indicated a nonlinear trend between caffeine and PHQ-9 scores, with the lowest PHQ-9 scores when caffeine intake was 119.52 mg. In the noncancer population, moderate daily caffeine intake (quartile 3 group; range, 119.5-236.5 mg) was associated with reduced depressive symptoms, whereas in the cancer population, no association was found between caffeine intake and depression.
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Affiliation(s)
- Long-Shan Yang
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, P.R. China
| | - Ze-Yi Zhang
- Department of Nursing, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, P.R. China; School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, 250012, P.R. China
| | - Lun-Jie Yan
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, P.R. China
| | - Yu-Chuan Yan
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, P.R. China
| | - Si-Yu Tan
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, P.R. China
| | - Dong-Xu Wang
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, P.R. China
| | - Zhao-Ru Dong
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, P.R. China
| | - Tao Li
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan, 250012, P.R. China.
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11
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Ganguly A, Bengtsen E. Pancreatic cancer, depression, and spirituality in therapy: "Unio Mystica" and "Achrayut," 2 case reports. Palliat Support Care 2023; 21:953-956. [PMID: 37334481 DOI: 10.1017/s1478951523000767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
OBJECTIVES Pancreatic cancer is a major site of gastrointestinal tumors and remains a leading cause of cancer death in adults in the United States. There is also a strong association between pancreatic cancer and depression. When struggling with cancer, along the different phases of illness, a human being is confronted with manifold issues, which might profoundly interfere with their sense of meaning and purpose. METHODS From this standpoint, several different therapeutic techniques have been designed to manage the psychological needs of the patients. Here we provide 2 clinical scenarios, where there was a strong religious correlation to the therapeutic techniques employed with patients suffering from pancreatic cancer. RESULTS The 2 cases described showed some improvement in their overall life view and could recalibrate their expectations based on a strong religious foundation. SIGNIFICANCE OF RESULTS The role of religion and spirituality in health has also received increasing attention in literature. Religion and spirituality can help patients with cancer find meaning in their illness, provide comfort in the face of existential fears, and receive support from a community of like-minded individuals. In effect, they also provide evidence toward the scope of and integrating the domain of spirituality into holistic cancer care.
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Affiliation(s)
- Amvrine Ganguly
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Erik Bengtsen
- Department of Psychiatry, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medical College, New York, NY, USA
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12
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Sun H, Sudip T, Fu X, Wen S, Liu H, Yu S. Cachexia is associated with depression, anxiety and quality of life in cancer patients. BMJ Support Palliat Care 2023; 13:e129-e135. [PMID: 32917649 DOI: 10.1136/bmjspcare-2019-002176] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 05/17/2020] [Accepted: 06/14/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVES This study aimed to compare depression, anxiety and quality of life (QoL) between cachexia and non-cachexia patients, and explore the relationship between cachexia and depression, anxiety and QoL in patients with cancer. METHODS A total of 528 patients from cancer centres of four hospitals were enrolled in this cross-sectional study. All patients were divided into cachexia and non-cachexia according to international consensus definition of cachexia. Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7) and Quality of Life Questionnaire-Cancer 30 (QLQ-C30) were used to evaluate depression, anxiety and QoL. RESULTS 285 patients (53.98%) were classified as cachexia. The prevalence of depression, anxiety, severe depression and severe anxiety in cachexia was 30.2%, 18.6%, 6.7% and 8.4%, respectively, which were significantly higher than in non-cachexia (all p<0.01). Patients with cachexia obviously acquired poorer physical function (PF), role function (RF), cognitive function (CF), emotional function (EF), social function (SF) and overall QoL than non-cachexia patients (all p<0.01). Cachexia was positively associated with depression (unstandardised coefficient (B)=2.123, p<0.001) and anxiety (B=1.123, p=0.024), and had a negative relationship with PF, CF, EF, SF and overall QoL (all B<0, all p<0.05). CONCLUSIONS Cachexia was associated with greater depression and anxiety and poorer QoL in patients with cancer, which emphasised the importance of timely identification and management of cachexia to improve the psychological problems and QoL among patients with cancer.
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Affiliation(s)
- Huihui Sun
- Cancer center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Thapa Sudip
- Cancer center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaofen Fu
- Cancer center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Su Wen
- Cancer center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Huiquan Liu
- Cancer center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shiying Yu
- Cancer center, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei, China
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13
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Lin H, Zhang X, Zhang Y, Cui W, Jia F, Wang J. Association between Chinese herbal medicine (CHM) treatment and depression among cancer patients in China: An outpatient-based cross-sectional study. Medicine (Baltimore) 2023; 102:e34695. [PMID: 37653736 PMCID: PMC10470751 DOI: 10.1097/md.0000000000034695] [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: 01/29/2023] [Revised: 06/02/2023] [Accepted: 07/20/2023] [Indexed: 09/02/2023] Open
Abstract
Depression is a prevalent condition among cancer patients and significantly impacts their quality of life. Traditional Chinese Medicine, particularly Chinese Herbal Medicine (CHM), has shown potential in both anti-tumor and anti-depressive effects. However, there is a dearth of scientific literature exploring the association between CHM treatment and depression in cancer patients. This study aims to investigate the relationship between CHM treatment and depression in cancer patients. A cross-sectional study was conducted among cancer outpatients at Longhua Hosiptal, Shanghai University of Traditional Chinese Medicine, from June 2020 to April 2021 (Ethical approval number: 2020LCSY057). All patients signed informed consent and completed The European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (EORTC QLQ-C30). Hamilton depression scale was evaluated depression by psychiatrists. The power of the sample size was determined using Gpower statistical and SPSS were used for statistical analysis. A total of 809 completed the study. Gender, medical insurance, the classification of time since diagnosis, ECOG, cancer stage, metastasis, gene mutation, treatment plan and CHM treatment were an important factor affecting depression (P < .05). Further analysis investigated the impact of CHM treatment on depression. There were 374 enrolled in CHM group and 435 enrolled in Non-CHM group. The assessment results of Hamilton depression scale and EORTC QLQ-C30 in CHM group were superior to those in Non-CHM group. The morbidity of depression is 50.27% in CHM group and 66.44% in Non-CHM group. After adjusting for potential confounders (gender, medical insurance, cancer stage, etc.), CHM treatment indicated negative correlation with depression (Odds ratio (OR) = 0.7, 95% confidence interval (CI): 0.5-0.9, P = .020). The interaction effects within each subgroup were no significantly affect the relationship between CHM treatment and depression (P > .05). CHM treatment was an independent protective factor for depression in cancer patients, and lead to better quality of life for cancer patients.
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Affiliation(s)
- Huiyue Lin
- Oncology Department, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xueting Zhang
- Oncology Department, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yi Zhang
- Oncology Department, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wenjing Cui
- Oncology Department, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Fang Jia
- Oncology Department, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Juyong Wang
- Oncology Department, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China
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14
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Li X, Wang Y, Wu L, Zhao X, Zhu T. Acupuncture for tumor-related depression: a systematic review and meta-analysis. Front Oncol 2023; 13:1198286. [PMID: 37614513 PMCID: PMC10442935 DOI: 10.3389/fonc.2023.1198286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/13/2023] [Indexed: 08/25/2023] Open
Abstract
Introduction Tumor-related depression is a series of symptoms or states triggered by a tumor as the basic disease. It does not belong to psychiatric depression but dramatically affects individuals' quality of life. Acupuncture is extensively used to treat tumor-related depression, but the effect of body acupuncture on tumor-related depression is still unsubstantiated. This work, therefore, set out to assess the effect of acupuncture on tumor-related depression. Methods Eight databases were searched from inception to October 2022 for randomized controlled trials (RCTs). Two researchers separately implemented the database search, study selection, data extraction, and quality assessment. All analyses were performed by using Review Manager 5.3. Results A total of 10 studies, including 725 participants, were included. A majority of studies recruited patients diagnosed with various tumor types and statuses. Meta-analysis revealed that acupuncture had a beneficial effect compared with usual care on the Hamilton depression scale (HAMD) (mean difference (MD) = -2.23, 95% CI [-4.43, -0.03], p = 0.05), self-rating depression scale (SDS) (MD= -6.22, 95% CI [-10.67, -1.78], p = 0.006), effective rate (RR = 1.23, 95% CI [1.06, 1.43], p = 0.006), and quality-of-life questionnaire (QLQ-C30) (MD = 6.08, 95% CI [3.72, 8.43], p<0.0001). In the dimension of the HAMD (MD = -4.41, 95% CI [-6.77, -2.05], p = 0.0002) and SDS (MD = -9.19, 95% CI [-13.14, -5.24], p <0.00001), subgroup analysis also highlighted that acupuncture combined with usual care had an advantage over usual care. However, there was no superiority in acupuncture itself compared to usual care on the HAMD (MD = -1.25, 95% CI [-4.34, -1.84], p = 0.43) and SDS (MD = -3.08, 95% CI [-11.14, 4.98], p = 0.45). Acupuncture also reduced the incidence of adverse effects (RR=0.43, 95% CI [0.23, 0.80], p = 0.008). Conclusion Acupuncture is a safe and effective complementary therapy for tumor-related depression. This technique can provide clinical references for the medical field. Systematic review registration https://www.crd.york.ac.uk/PROSPERO, identifier CRD42022372513.
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Affiliation(s)
- Xiaoyi Li
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yang Wang
- School of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Liu Wu
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xinyu Zhao
- School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tianmin Zhu
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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15
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Tsai TC, Lee GG, Ting A, Antoni MH, Mendez A, Carver CS, Kim Y. Roles of benefit finding in psychological and inflammatory adjustments in persons with colorectal cancer: a prospective analysis on the multidimensionality of benefit finding. Psychol Health 2023:1-19. [PMID: 37488833 PMCID: PMC10805970 DOI: 10.1080/08870446.2023.2238280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 05/03/2023] [Accepted: 07/14/2023] [Indexed: 07/26/2023]
Abstract
OBJECTIVE This study examined the unique associations of different dimensions of the resilience factor, benefit finding, on concurrent and prospective psychological and biological adjustment outcomes over the first year after a colorectal cancer diagnosis. METHODS AND MEASURES Individuals newly diagnosed with colorectal cancer (n = 133, mean age = 56 years old, 59% female, 46% Hispanic) completed questionnaires assessing the multidimensional aspects of benefit finding around 4 months post-diagnosis (T1). Psychological (depressive symptoms and life satisfaction) and biological [C-reactive protein (CRP) and interleukin-10 (IL-10)] adjustments were assessed at T1 and one-year post-diagnosis (T2). RESULTS Structural equation modeling revealed that at T1, greater reprioritization was concurrently related to higher depressive symptoms (p=.020). Lower acceptance, lower empathy, and greater positive self-view predicted higher life satisfaction at T2 (ps<.010). Additionally, lower empathy and greater family valuation predicted higher CRP at T2 (ps<.004), whereas greater positive self-view predicted higher IL-10 at T2 (p=.039). Greater overall benefit finding was associated with lower IL-10 at T1 (p=.013). CONCLUSION Various aspects of benefit finding differentially relate to psychological and inflammatory markers during the first year after diagnosis in persons with colorectal cancer. Interventions designed to specifically enhance positive self-view may promote both the psychological and biological health of individuals with cancer.
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Affiliation(s)
- Thomas C. Tsai
- University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, United States 33146
| | - Gabriela G. Lee
- University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, United States 33146
| | - Amanda Ting
- VA Palo Alto Health Care, 3801 Miranda Ave., Palo Alto, CA 94304
| | - Michael H. Antoni
- University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, United States 33146
| | - Armando Mendez
- University of Miami Miller School of Medicine, 1600 NW 10 Ave., Miami, FL, United States 33136
| | - Charles S. Carver
- University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, United States 33146
| | - Youngmee Kim
- University of Miami, 5665 Ponce de Leon Blvd., Coral Gables, FL, United States 33146
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16
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Finze A, Deleanu L, Weiss C, Ratliff M, Seiz-Rosenhagen M. Depression in brain tumor patients-early detection and screening. Support Care Cancer 2023; 31:339. [PMID: 37191815 DOI: 10.1007/s00520-023-07785-5] [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: 01/12/2023] [Accepted: 04/27/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Depres sion is reported in up to 90% of cancer patients but to this date, a standardized screening tool for depression specifically modified for patients diagnosed with brain tumors is lacking. Thus, this study aims to develop an adapted screening tool and identify a suitable time slot for screening. METHODS Sixty-one patients with brain lesions were interviewed prior to neurosurgical resection. For screening purposes, established depression scores were used. A study-specific questionnaire (SSQ) was developed based on patient interviews prior to the trial. Two subgroups were analyzed: patients with benign and patients with malignant tumors (including brain metastases). As a subgroup within malignant lesions, patients with glioblastoma (GBM) were also analyzed separately. RESULTS Of patients, 87.5% with GBM presented with results > 16 points on the Center for Epidemiologic Studies Depression Scale (CES-D) after surgery. A decline in patients with benign brain tumors (p = 0.0058) and an increase in patients with malignant tumors (p = 0.0491) could be shown over time for CES-D scores. In this study, we established a new prototype screening tool for depression. In patients diagnosed with GBM, the number of patients needed to screen for identification of symptoms of depression was 1.59. Best time for screening was 35 days after surgery. CONCLUSIONS Considering the high prevalence and low number needed to screen of depression in patients diagnosed with GBM, we strongly encourage their routine screening during follow-up appointments (35 days after surgery). We encourage a plan to further establish the questionnaire developed in this pilot study.
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Affiliation(s)
- Alida Finze
- Department of Surgery, University Hospital Mannheim, Medical Faculty of Heidelberg, Theodor-Kutzer-Ufer 1-3, Mannheim, 68167, Germany.
| | - Laura Deleanu
- Department of Surgery, University Hospital Mannheim, Medical Faculty of Heidelberg, Theodor-Kutzer-Ufer 1-3, Mannheim, 68167, Germany
| | - Christel Weiss
- Department of Medical Statistics and Biomathematics, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Miriam Ratliff
- Department of Neurosurgery, Municipal Hospital Memmingen, Memmingen, Germany
| | - Marcel Seiz-Rosenhagen
- Department of Neurosurgery, University Hospital Mannheim, Medical Faculty of Heidelberg, Mannheim, Germany
- Department of Neurosurgery, Municipal Hospital Memmingen, Memmingen, Germany
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17
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Vita G, Compri B, Matcham F, Barbui C, Ostuzzi G. Antidepressants for the treatment of depression in people with cancer. Cochrane Database Syst Rev 2023; 3:CD011006. [PMID: 36999619 PMCID: PMC10065046 DOI: 10.1002/14651858.cd011006.pub4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
BACKGROUND Major depression and other depressive conditions are common in people with cancer. These conditions are not easily detectable in clinical practice, due to the overlap between medical and psychiatric symptoms, as described by diagnostic manuals such as the Diagnostic and Statistical Manual of Mental Disorders (DSM) and International Classification of Diseases (ICD). Moreover, it is particularly challenging to distinguish between pathological and normal reactions to such a severe illness. Depressive symptoms, even in subthreshold manifestations, have a negative impact in terms of quality of life, compliance with anticancer treatment, suicide risk and possibly the mortality rate for the cancer itself. Randomised controlled trials (RCTs) on the efficacy, tolerability and acceptability of antidepressants in this population are few and often report conflicting results. OBJECTIVES To evaluate the efficacy, tolerability and acceptability of antidepressants for treating depressive symptoms in adults (aged 18 years or older) with cancer (any site and stage). SEARCH METHODS We used standard, extensive Cochrane search methods. The latest search date was November 2022. SELECTION CRITERIA We included RCTs comparing antidepressants versus placebo, or antidepressants versus other antidepressants, in adults (aged 18 years or above) with any primary diagnosis of cancer and depression (including major depressive disorder, adjustment disorder, dysthymic disorder or depressive symptoms in the absence of a formal diagnosis). DATA COLLECTION AND ANALYSIS We used standard Cochrane methods. Our primary outcome was 1. efficacy as a continuous outcome. Our secondary outcomes were 2. efficacy as a dichotomous outcome, 3. Social adjustment, 4. health-related quality of life and 5. dropouts. We used GRADE to assess certainty of evidence for each outcome. MAIN RESULTS We identified 14 studies (1364 participants), 10 of which contributed to the meta-analysis for the primary outcome. Six of these compared antidepressants and placebo, three compared two antidepressants, and one three-armed study compared two antidepressants and placebo. In this update, we included four additional studies, three of which contributed data for the primary outcome. For acute-phase treatment response (six to 12 weeks), antidepressants may reduce depressive symptoms when compared with placebo, even though the evidence is very uncertain. This was true when depressive symptoms were measured as a continuous outcome (standardised mean difference (SMD) -0.52, 95% confidence interval (CI) -0.92 to -0.12; 7 studies, 511 participants; very low-certainty evidence) and when measured as a proportion of people who had depression at the end of the study (risk ratio (RR) 0.74, 95% CI 0.57 to 0.96; 5 studies, 662 participants; very low-certainty evidence). No studies reported data on follow-up response (more than 12 weeks). In head-to-head comparisons, we retrieved data for selective serotonin reuptake inhibitors (SSRIs) versus tricyclic antidepressants (TCAs) and for mirtazapine versus TCAs. There was no difference between the various classes of antidepressants (continuous outcome: SSRI versus TCA: SMD -0.08, 95% CI -0.34 to 0.18; 3 studies, 237 participants; very low-certainty evidence; mirtazapine versus TCA: SMD -4.80, 95% CI -9.70 to 0.10; 1 study, 25 participants). There was a potential beneficial effect of antidepressants versus placebo for the secondary efficacy outcomes (continuous outcome, response at one to four weeks; very low-certainty evidence). There were no differences for these outcomes when comparing two different classes of antidepressants, even though the evidence was very uncertain. In terms of dropouts due to any cause, we found no difference between antidepressants compared with placebo (RR 0.85, 95% CI 0.52 to 1.38; 9 studies, 889 participants; very low-certainty evidence), and between SSRIs and TCAs (RR 0.83, 95% CI 0.53 to 1.22; 3 studies, 237 participants). We downgraded the certainty of the evidence because of the heterogeneous quality of the studies, imprecision arising from small sample sizes and wide CIs, and inconsistency due to statistical or clinical heterogeneity. AUTHORS' CONCLUSIONS Despite the impact of depression on people with cancer, the available studies were few and of low quality. This review found a potential beneficial effect of antidepressants against placebo in depressed participants with cancer. However, the certainty of evidence is very low and, on the basis of these results, it is difficult to draw clear implications for practice. The use of antidepressants in people with cancer should be considered on an individual basis and, considering the lack of head-to-head data, the choice of which drug to prescribe may be based on the data on antidepressant efficacy in the general population of people with major depression, also taking into account that data on people with other serious medical conditions suggest a positive safety profile for the SSRIs. Furthermore, this update shows that the usage of the newly US Food and Drug Administration-approved antidepressant esketamine in its intravenous formulation might represent a potential treatment for this specific population of people, since it can be used both as an anaesthetic and an antidepressant. However, data are too inconclusive and further studies are needed. We conclude that to better inform clinical practice, there is an urgent need for large, simple, randomised, pragmatic trials comparing commonly used antidepressants versus placebo in people with cancer who have depressive symptoms, with or without a formal diagnosis of a depressive disorder.
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Affiliation(s)
- Giovanni Vita
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Beatrice Compri
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Faith Matcham
- School of Psychology, University of Sussex, Brighton, UK
| | - Corrado Barbui
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Giovanni Ostuzzi
- Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
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18
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Adekkanattu P, Olfson M, Susser LC, Patra B, Vekaria V, Coombes BJ, Lepow L, Fennessy B, Charney A, Ryu E, Miller KD, Pan L, Yangchen T, Talati A, Wickramaratne P, Weissman M, Mann J, Biernacka JM, Pathak J. Comorbidity and healthcare utilization in patients with treatment resistant depression: A large-scale retrospective cohort analysis using electronic health records. J Affect Disord 2023; 324:102-113. [PMID: 36529406 PMCID: PMC10327872 DOI: 10.1016/j.jad.2022.12.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/09/2022] [Accepted: 12/11/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Medical comorbidity and healthcare utilization in patients with treatment resistant depression (TRD) is usually reported in convenience samples, making estimates unreliable. There is only limited large-scale clinical research on comorbidities and healthcare utilization in TRD patients. METHODS Electronic Health Record data from over 3.3 million patients from the INSIGHT Clinical Research Network in New York City was used to define TRD as initiation of a third antidepressant regimen in a 12-month period among patients diagnosed with major depressive disorder (MDD). Age and sex matched TRD and non-TRD MDD patients were compared for anxiety disorder, 27 comorbid medical conditions, and healthcare utilization. RESULTS Out of 30,218 individuals diagnosed with MDD, 15.2 % of patients met the criteria for TRD (n = 4605). Compared to MDD patients without TRD, the TRD patients had higher rates of anxiety disorder and physical comorbidities. They also had higher odds of ischemic heart disease (OR = 1.38), stroke/transient ischemic attack (OR = 1.57), chronic kidney diseases (OR = 1.53), arthritis (OR = 1.52), hip/pelvic fractures (OR = 2.14), and cancers (OR = 1.41). As compared to non-TRD MDD, TRD patients had higher rates of emergency room visits, and inpatient stays. In relation to patients without MDD, both TRD and non-TRD MDD patients had significantly higher levels of anxiety disorder and physical comorbidities. LIMITATIONS The INSIGHT-CRN data lack information on depression severity and medication adherence. CONCLUSIONS TRD patients compared to non-TRD MDD patients have a substantially higher prevalence of various psychiatric and medical comorbidities and higher health care utilization. These findings highlight the challenges of developing interventions and care coordination strategies to meet the complex clinical needs of TRD patients.
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Affiliation(s)
| | - Mark Olfson
- Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | | | | | | | | | - Lauren Lepow
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Brian Fennessy
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | - Lifang Pan
- Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Tenzin Yangchen
- Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Ardesheer Talati
- Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Priya Wickramaratne
- Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Myrna Weissman
- Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - John Mann
- Columbia University and New York State Psychiatric Institute, New York, NY, USA
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Ding X, Wu M, Zhang Y, Liu Y, Han Y, Wang G, Xiao G, Teng F, Wang J, Chen J, Zhang W, Cai M, Zhang Y, Zhou S, Hu D. The prevalence of depression and suicidal ideation among cancer patients in mainland China and its provinces, 1994-2021: A systematic review and meta-analysis of 201 cross-sectional studies. J Affect Disord 2023; 323:482-489. [PMID: 36496103 DOI: 10.1016/j.jad.2022.12.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 12/01/2022] [Accepted: 12/03/2022] [Indexed: 12/12/2022]
Abstract
To evaluate the national prevalence depression of Chinese cancer patients and clarify its potential associated factors. Twelve databases were searched from database inception through October 31, 2022 for relevant studies published in English (PubMed MEDLINE, Ovid MEDLINE, Embase, Scopus, PsycINFO, and Cochrane and Web of Science) and Chinese (China National Knowledge Infrastructure, Wanfang, Weipu, Chinese Biomedical Literature Service System, Duxiu) that estimated point or period prevalence of depression, depressive disorder, or suicidal ideation as assessed by self-report scale or structured interview. 201 studies were eligible for inclusion in our meta-analyses. We found the national pooled prevalence rates of depression and suicidal ideation were 44.63 % (95 % CI 42.24 %-47.01 %) and 24.95 % (95 % CI 10.96 %-38.95 %), respectively. The pooled prevalence of depression was associated with study location, cancer type, comorbid chronic disease, and female sex (all P < 0.05). The distribution of the depression prevalence among cancer patients in mainland China was characterized by significant geographical variation and clustering. The highest pooled prevalence of depression was among gynecologic oncology patients. We recommend that more attention and resources be given to mental health problems such as depression and suicidal ideation among Chinese cancer patients, and that prevention programs be developed, especially in areas with a high prevalence of depression.
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Affiliation(s)
- Xiaoping Ding
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Minge Wu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yingying Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yilan Liu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yanhong Han
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Gang Wang
- Wuhan Mental Health Center, Wuhan 430010, China
| | - Guangqin Xiao
- Department of Oncology Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Fen Teng
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Jiaqing Wang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jie Chen
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Wei Zhang
- Department of Nursing, School of Medicine, Yangtze University, Jingzhou 434022, China
| | - Meijie Cai
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China
| | - Yan Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Su Zhou
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Deying Hu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China.
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Almeida SS, Oliveira MA, Medeiros R, Guerra MP, Pariante CM, Fernandes L. Emotional, inflammatory, and genetic factors of resilience and vulnerability to depression in patients with premenopausal breast cancer: A longitudinal study protocol. PLoS One 2023; 18:e0279344. [PMID: 36787313 PMCID: PMC9928105 DOI: 10.1371/journal.pone.0279344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 12/06/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND Psychosocial stress and depressive disorder have been associated with cancer as putative contributors to worse prognosis. On the other hand, cancer diagnosis is a recognised life event that can contribute to distress and depressive states. Humoral and cellular inflammation can promote depressive disorder by means of decreased monoamine synthesis, glutamate neurotoxicity, neurogenesis and neuroplasticity, dysregulated hypothalamic-pituitary-adrenal axis, and glucocorticoid resistance. This protocol objectives are to observe the interactions between psychosocial variables and biochemical and immunological biomarkers in a longitudinal, prospective design; to identify inflammation-related depression endophenotypes in breast cancer patients and to understand if early diagnosed and treated depression in this population will translate in better inflammation status and better global prognosis. METHODS Prospective observational cohort, composed by 100 consecutive premenopausal patients, diagnosed with non-distant metastatic breast carcinoma and with no history of major psychopathology or other organic illness. The participants will have an in-person assessment in three different moments, along illness treatment and follow-up, with respect to cytometric, immunologic, and psychosocial parameters and will be tested for depression vulnerability and resilience inflammation-related functional genetic polymorphisms. Additionally, at years 5 and 10 post enrollment, patients`medical records will be assessed. As a control cohort, all patients excluded due to psychiatric history or past psychiatric treatments will have their clinical records assessed at years 5 and 10 after admission. All the data will be managed with the SPSS® software. DISCUSSION AND CONCLUSION This study is an original longitudinal cohort of breast cancer premenopausal patients, with a comprehensive approach to psychosocial, clinical, inflammatory, and genetic variables. It expects to provide evidence regarding the links between genetic, cytometric, immunologic, and psychosocial factors, their potential contribution to the pathophysiology of depressive disorder, breast cancer course, progression, and prognosis. It may further contribute with data to better efficacy of the psycho-oncological interventions. TRIAL REGISTRATION National Commission of Data Protection (CNPD) 13413/2017; Ethics Committee of IPOP project code CI-IPOP81/2017.
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Affiliation(s)
- Susana S. Almeida
- Psychiatry Service, Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
- Psychiatry and Psychology Service, CUF Porto Hospital, Porto, Portugal
| | - Magda A. Oliveira
- Psychiatry and Psychology Service, CUF Porto Hospital, Porto, Portugal
- Psychology Service, Portuguese Oncology Institute of Porto (IPO Porto), Porto, Portugal
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
| | - Rui Medeiros
- Molecular Oncology and Viral Pathology Group, Research Center of IPO Porto (CI-IPOP)/RISE@CI-IPOP (Health Research Network), Portuguese Oncology Institute of Porto (IPO Porto) /Porto Comprehensive Cancer Center (Porto.CCC), Research Center-LAB2, Porto, Portugal
- ICBAS, Abel Salazar Institute for the Biomedical Sciences, University of Porto, Porto, Portugal
- Biomedical Research Center (CEBIMED), Faculty of Health Sciences, Fernando Pessoa University (UFP), Porto, Portugal
- Research Department, LPCC- Portuguese League Against Cancer (NRNorte), Porto, Portugal
| | - Marina P. Guerra
- Faculty of Psychology and Education Sciences, University of Porto, Porto, Portugal
- Center for Psychology at University of Porto (CPUP), Porto, Portugal
| | - Carmine M. Pariante
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College of London, London, United Kingdom
| | - Lia Fernandes
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
- Psychiatry Service, Centro Hospitalar Universitário São João (CHUSJ), Porto, Portugal
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21
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Depression Is Associated with an Increased Risk of Subsequent Cancer Diagnosis: A Retrospective Cohort Study with 235,404 Patients. Brain Sci 2023; 13:brainsci13020302. [PMID: 36831845 PMCID: PMC9954234 DOI: 10.3390/brainsci13020302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/31/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
Background: Depression and cancer share common risk factors and mechanisms of disease. The current literature has not explored the effect of depression on cancer risk. We assessed the difference in cancer risk in patients with and without depression in a large cohort in Germany. Methods: We compared cancer risk and incidence in patients with and without depression aged 18 or above diagnosed between 2015 and 2018 documented in the Disease Analyzer Database. Patients from a comparator group were matched 1:1 to patients with depression based on propensity scores. Patients with previous bipolar disorder (F31), mania (F30) or schizophrenia (F20-29) and cancer diagnosis 3 years prior to index date were excluded. Analyses were stratified by cancer type, age group, and gender. Results: A total of 117,702 patients with depression were included and matched 1:1, resulting in a cohort overall of 235,404. 4.9% of patients with depression compared to 4.1% without depression received at least one cancer diagnosis over 3.9 years median follow-up. The depression group showed an 18% increase in risk for a cancer diagnosis overall, with largest increased risk in lung cancer (HR: 1.39 [1.21-1.60], p < 0.0001), cancers of the gastro-intestinal-tract (HR: 1.30 [1.15-1.46], p < 0.0001), breast (HR: 1.23 [1.12-1.35], p < 0.0001) and urinary (HR: 1.23 [1.06-1.43], p < 0.01). Similarly, the incidence of cancer diagnosis overall increased by 22% for depressed patients. IRs showed no difference across cancer types. Conclusions: Depression increased the risk for cancer diagnosis consistently independent of the comparison method used. The potential mediating factors or shared mechanisms of the disease require further investigation.
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22
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Moradinazar M, Mirzaei P, Moradivafa S, Saeedi M, Basiri M, Shakiba M. Epidemiological status of depressive disorders in the Middle East and North Africa from 1990 to 2019. Health Promot Perspect 2022; 12:301-309. [PMID: 36686044 PMCID: PMC9808901 DOI: 10.34172/hpp.2022.39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 10/16/2022] [Indexed: 01/15/2023] Open
Abstract
Background: Depressive disorders are one of the most common mental health diseases, which are associated with adverse life events such as increased risk of self-injury. This study was aimed to measure the epidemiological status and the burden of depressive disorders in the Middle East and North Africa (MENA) countries. Methods: The study population included 21 countries in the MENA region, covering a population of about 600 million. The Global Burden of Disease (GBD) 2019 database was used. The disability-adjusted life years (DALYs) were estimated by the years lived with disability (YLDs) component. The prevalence, incidence, and the DALYs rates per 100000 people by age-standardized rate (ASR) were measured. Results: In 2019, the highest prevalence 6198.95 (95% uncertainty interval [UI], 5402.41- 7108.39), incidence 7864.2 (95% UI, 6719.71-9216.83), and DALYs 1168.68 (95% UI, 802.95- 1624.31) per 100,000 were in Palestine by ASR. Between 1990 and 2019, the depressive disorders-related prevalence, incidence, and DALYs rates in the MENA region increased by 0.004%, 0.006%, and 0.005%. The highest increment of the prevalence, incidence, and DALYs rates was related to Saudi Arabia by 0.05%, 0.064%, and 0.055%. The highest percentage of major depressive disorder (MDD)-related DALYs attributed to intimate partner violence was related to Iran (101.1). Also, the highest percentage of MDD-related DALYs attributed to childhood sexual abuse (34.26) and bullying victimization (49.81) was related to Palestine. Conclusion: Given the increasing trend of depressive disorders in MENA region, mental health programs should be prioritized across the MENA countries, with significant contributions and involvement of the governments.
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Affiliation(s)
- Mehdi Moradinazar
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Parmida Mirzaei
- Department of Psychology, Faculty of Psychology, Kermanshah branch Islamic Azad University, Kermanshah, Iran
| | - Saied Moradivafa
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mahdieh Saeedi
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mona Basiri
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mohammad Shakiba
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran,Corresponding Author: Mohammad Shakiba,
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23
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Advanced Adrenocortical Carcinoma: From Symptoms Control to Palliative Care. Cancers (Basel) 2022; 14:cancers14235901. [PMID: 36497381 PMCID: PMC9739560 DOI: 10.3390/cancers14235901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 11/27/2022] [Accepted: 11/27/2022] [Indexed: 12/02/2022] Open
Abstract
The prognosis of patients with advanced adrenocortical carcinoma (ACC) is often poor: in the case of metastatic disease, five-year survival is reduced. Advanced disease is not a non-curable disease and, in referral centers, the multidisciplinary approach is the standard of care: if a shared decision regarding several treatments is available, including the correct timing for the performance of each one, overall survival is increased. However, many patients with advanced ACC experience severe psychological and physical symptoms secondary to the disease and the cancer treatments. These symptoms, combined with existential issues, debase the quality of the remaining life. Recent strong evidence from cancer research supports the early integration of palliative care principles and skills into the advanced cancer patient's trajectory, even when asymptomatic. A patient with ACC risks quickly suffering from symptoms/effects alongside the disease; therefore, early palliative care, in some cases concurrent with oncological treatment (simultaneous care), is suggested. The aims of this paper are to review current, advanced ACC approaches, highlight appropriate forms of ACC symptom management and suggest when and how palliative care can be incorporated into the ACC standard of care.
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Su K, Din ZU, Cui B, Peng F, Zhou Y, Wang C, Zhang X, Lu J, Luo H, He B, Kelley KW, Liu Q. A broken circadian clock: The emerging neuro-immune link connecting depression to cancer. Brain Behav Immun Health 2022; 26:100533. [PMID: 36281466 PMCID: PMC9587523 DOI: 10.1016/j.bbih.2022.100533] [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: 05/05/2022] [Revised: 09/26/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022] Open
Abstract
Circadian clocks orchestrate daily rhythms in many organisms and are essential for optimal health. Circadian rhythm disrupting events, such as jet-lag, shift-work, night-light exposure and clock gene alterations, give rise to pathologic conditions that include cancer and clinical depression. This review systemically describes the fundamental mechanisms of circadian clocks and the interacting relationships among a broken circadian clock, cancer and depression. We propose that this broken clock is an emerging link that connects depression and cancer development. Importantly, broken circadian clocks, cancer and depression form a vicious feedback loop that threatens systemic fitness. Arresting this harmful loop by restoring normal circadian rhythms is a potential therapeutic strategy for treating both cancer and depression.
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Affiliation(s)
- Keyu Su
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Zaheer Ud Din
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Bai Cui
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China,State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, 651 Dongfeng East Road, Guangzhou, Guangdong Province, 510060, China,Corresponding author. Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China.
| | - Fei Peng
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Yuzhao Zhou
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Cenxin Wang
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Xiaoyu Zhang
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Jinxin Lu
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Huandong Luo
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Bin He
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Keith W. Kelley
- Department of Animal Sciences, College of ACES, University of Illinois at Urbana-Champaign, 212 Edward R. Madigan Laboratory, 1201 West Gregory Drive, Urbana, Il, 61801, USA
| | - Quentin Liu
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China,State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, 651 Dongfeng East Road, Guangzhou, Guangdong Province, 510060, China,Corresponding author. Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China.
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Rababa’h SY, Alzoubi KH, Alquraan L, Karasneh R, Al-azzam SI, Alrabadi N. Depression Among the Caregivers of Breast Cancer Patients and its Association with the Quality of Life. Clin Pract Epidemiol Ment Health 2022; 18:e174501792208221. [PMID: 37274847 PMCID: PMC10156030 DOI: 10.2174/17450179-v18-e2208221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/25/2022] [Accepted: 07/01/2022] [Indexed: 06/07/2023]
Abstract
Introduction This study investigated the prevalence of depression among the Jordanian caregivers of patients with breast cancer and its effect on their health-related quality of life (QOL). Methods This was a cross-sectional study with a sample that consisted of 122 caregivers recruited from 2 hospitals in Jordan over 5 months. A validated questionnaire was used to assess the prevalence of depression symptoms and the aspects of QOL among the participants using Beck's Depression Inventory-II score and the 36-Item Survey Form (SF-36) score. Results and Discussion Depression symptoms were revealed in 27.9% of caregivers. Regarding the QOL, the mental health (MH) subscale was considerably associated with caregivers' age (P=0.007). The marital status of caregivers was significantly associated with pain (Bodily Pain BP) (P=0.015), Beck's Depression Inventory (BDI; P=0.009), and social functioning (SF) (P=0.008). The number of caregivers' siblings was considerably associated with MH (P=0.040) subscale. The monthly income of caregivers was associated with BP (P=0.042). The residency of caregivers was considerably connected with role limitations because of emotional problems (RE) (P=0.027) and role limitations due to physical health (RF) (P=0.013) subscales. There was a significant correlation between the existing family history of depression with RF (P=0.009), RE (P=0.005), SF (P=0.003), and energy/fatigue (Vitality VT) (P=0.001) subscales. Furthermore, the physical activity of caregivers was connected with the RF (P=0.030), general health (GH) (P=0.018), RE (P=0.015), and MH (P=0.003) subscales. Conclusion Around a third of the caregivers revealed depression symptoms. The QOL subscales for these caregivers were connected with various health and social factors, such as age, number of siblings, marital status, monthly income, residency, family history of depression, and physical activity. The evaluation of the mental and physical well-being of caregivers should always be considered and managed to help them to cope with their QOL.
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Affiliation(s)
- Suzie Y. Rababa’h
- Department of Medical Science, Irbid Faculty, Al-Balqa Applied University (BAU), Irbid, Jordan
| | - Karem H. Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, UAE
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Reema Karasneh
- Department of Basic Medical Sciences, Yarmouk University, Irbid, Jordan
| | - Sayer I Al-azzam
- Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Nasr Alrabadi
- Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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26
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Boccia ML. Social relationships and relational pain in brain tumor patients and their partners. FRONTIERS IN PAIN RESEARCH (LAUSANNE, SWITZERLAND) 2022; 3:979758. [PMID: 36277126 PMCID: PMC9581146 DOI: 10.3389/fpain.2022.979758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/16/2022] [Indexed: 11/25/2022]
Abstract
Partners play an important role in both the general well-being and the care needs of patients. The dynamic between brain tumor treatment and patients' families is a complex bidirectional relationship. Cancer diagnosis and treatments which leave patients compromised impact the nature and quality of their relationships, and these in turn impact the ability of their partners to care for them. This paper will review the nature of the impact of diagnosis and treatment on relationships and how couples and families respond to the disruption of cancer treatments. The impact of how emotional and social pain effect their relationships and their ability to engage in care will be addressed.
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27
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Fahed M, McManus K, Vahia IV, Offodile AC. Digital Phenotyping of Behavioral Symptoms as the Next Frontier for Personalized and Proactive Cancer Care. JCO Clin Cancer Inform 2022; 6:e2200095. [DOI: 10.1200/cci.22.00095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Mario Fahed
- Department of Psychiatry, University of Connecticut, Farmington, CT
- Department of Psychiatry, Yale University, New Haven, CT
| | - Kaitlin McManus
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA
| | - Ipsit V. Vahia
- Division of Geriatric Psychiatry, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Anaeze C. Offodile
- Department of Plastic Surgery, UT MD Anderson Cancer Center, Houston, TX
- Department of Health Services Research, UT MD Anderson Cancer Center, Houston, TX
- Baker Institute for Public Policy, Rice University, Houston, TX
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28
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McFarland DC, Fernbach M, Breitbart WS, Nelson C. Prognosis in metastatic lung cancer: vitamin D deficiency and depression—a cross-sectional analysis. BMJ Support Palliat Care 2022; 12:339-346. [DOI: 10.1136/bmjspcare-2020-002457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/16/2020] [Accepted: 07/19/2020] [Indexed: 11/04/2022]
Abstract
BackgroundDepression and vitamin D deficiency are common in patients with lung cancer and have prognostic implications in cancer settings. However, their relationship and concomitant survival implications have not been evaluated in patients with metastatic lung cancer specifically. We hypothesised that vitamin D deficiency would be associated with depression and inferior cancer-related survival in patients receiving therapies for stage IV lung cancer.MethodsThis was a cross-sectional analysis of vitamin D, depression and lung cancer characteristics. Vitamin D levels were stratified by level (no deficiency ≥30 units, mild deficiency 20 to 29 units and moderate-to-severe <20 units). Depression was measured by the Hospital
Anxiety and Depression Scale-Depression (HADS-D). Survival estimations were made using Cox proportional hazard model and Kaplan-Meier analyses.ResultsVitamin D deficiency was evident in almost half of the sample (n=98) and was associated with significant depression (HADS-D ≥8) (χ2=4.35, p<0.001) even when controlling for age, sex and inflammation (β=-0.21, p=0.03). Vitamin D deficiency and depression were associated with worse survival and showed evidence of an interaction effect (HR 1.5, p=0.04).ConclusionVitamin D deficiency is associated with depression in patients with metastatic lung cancer. Depression modulates the survival implications of vitamin D deficiency in this population. The role of vitamin D deficiency in cancer-related depression warrants further investigation since both are amenable to treatment. Psychological and nutritional prognostic considerations may help inform treatment paradigms that enhance quality of life and survival.
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Xu J, Xu P, Han Q, Sun J, Chen B, Dong X. Socioeconomic status-based survival disparities and nomogram prediction for patients with multiple myeloma: Results from American and Chinese populations. Front Oncol 2022; 12:941714. [PMID: 36091116 PMCID: PMC9458969 DOI: 10.3389/fonc.2022.941714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/11/2022] [Indexed: 11/13/2022] Open
Abstract
Objective This study aimed to comprehensively investigate the relationship between the survival differences and socioeconomic status (SES) in patients with multiple myeloma (MM) and construct a predictive nomogram to assess clinical outcomes of MM patients. Methods The Surveillance, Epidemiology, and End Results (SEER) census tract-level SES database provides two specialized attributes: SES index and rurality. Using this database, 37,819 patients diagnosed with MM between January 2007 and December 2016 were enrolled. We evaluated the effects of SES index on overall survival (OS) and myeloma-specific survival (MSS) using Kaplan-Meier curves and Cox regression analyses. Thereafter, we included 126 patients with MM from two independent medical centers in China and divided them into training (Center 1) and validation (Center 2) cohorts. Univariate and multivariate Cox analyses were used in the training cohort to construct a nomogram for predicting clinical outcomes. Nomogram performance was assessed using the area under the curve (AUC) and calibration curves. Results In the SEER cohort, lower SES was significantly associated with worse OS rates and MSS rates (both P < 0.001). Multivariate analysis confirmed SES as an independent predictor of survival. Subgroup analysis indicated an increasing linear trend in survival benefits in non-Hispanic White, married, insured, and urban populations with increasing SES (all P < 0.001). In the training cohort, albumin, creatinine, rurality, and SES were confirmed as independent prognostic indicators. A nomogram for OS prediction was developed using these four factors, and it showed satisfactory discrimination and calibration. The 18- and 36-month AUC values of the nomogram were 0.79 and 0.82, respectively. Based on the total nomogram points, patients were categorized into two risk levels with good separation. Conclusion SES strongly influences survival disparities in patients with MM. Our nomogram consisting of clinical and sociodemographic characteristics can potentially predict survival outcomes.
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Affiliation(s)
- Jiaxuan Xu
- Department of Hematology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Peipei Xu
- Department of Hematology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Qiaoyan Han
- Department of Hematology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
- Department of Hematology, Jingjiang People’s Hospital, Jingjiang, China
| | - Jingjing Sun
- Department of Hematology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Bing Chen
- Department of Hematology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Xiaoqing Dong
- Department of Hematology, the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
- *Correspondence: Xiaoqing Dong,
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Wu E, Ni JT, Xie T, Tao L. Noncausal effects of genetic predicted depression and colorectal cancer risk: A Mendelian randomization study. Medicine (Baltimore) 2022; 101:e30177. [PMID: 36042675 PMCID: PMC9410676 DOI: 10.1097/md.0000000000030177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Depression has been associated with colorectal cancer (CRC) in observational studies. However, the causality of depression on CRC risk remained unknown. This study aimed to evaluate the potential causal association between genetic variants related to depression and the risk of CRC using Mendelian randomization (MR). Two-sample MR analysis using summary data was performed to examine whether depression was causally associated with CRC risk. We used 2 sets of instrumental variables (IV) from the genome-wide association study results for analysis. A set of IV related to major depressive disorder contain 44 single-nucleotide polymorphisms. Another set of IV was related to major depression, including 53 single-nucleotide polymorphisms. Summary data of CRC was from the FinnGen consortium. Based on the results of MR using inverse-variance weighted method, we found that genetically determined major depressive disorder (odds ratio = 1.06, 95% confidence interval = 0.77-1.45) or major depression (odds ratio = 0.77, 95% confidence interval = 0.57-1.04) did not causally increase CRC risk. The results of MR-Egger and the weighted median method are consistent with the inverse-variance weighted method. The two-sample MR analysis showed that depression is not causally associated with CRC risk. Further research is needed to investigate the association between depression and CRC.
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Affiliation(s)
- E. Wu
- School of Pharmacy, Hangzhou Normal University, Hangzhou, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
| | - Jun-Tao Ni
- Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Tian Xie
- School of Pharmacy, Hangzhou Normal University, Hangzhou, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
| | - Lin Tao
- School of Pharmacy, Hangzhou Normal University, Hangzhou, China
- Key Laboratory of Elemene Class Anti-Cancer Chinese Medicines, Engineering Laboratory of Development and Application of Traditional Chinese Medicines, Collaborative Innovation Center of Traditional Chinese Medicines of Zhejiang Province, Hangzhou Normal University, Hangzhou, China
- *Correspondence: Lin Tao, School of Pharmacy, Hangzhou Normal University, Hangzhou, Zhejiang 311121, China (e-mail: ; )
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The Combination of Sleep Disorders and Depression Significantly Increases Cancer Risk: A Nationwide Large-Scale Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159266. [PMID: 35954622 PMCID: PMC9368707 DOI: 10.3390/ijerph19159266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 07/23/2022] [Accepted: 07/24/2022] [Indexed: 12/10/2022]
Abstract
Introduction: Sleep disorders, depression, and cancer have become increasingly prevalent worldwide. However, it is unknown whether coexistence of sleep disorders and depression influences the risk of cancer development. Therefore, we conducted a nationwide population-based study to examine this association among patients in Taiwan. Materials and Methods: A total of 105,071 individuals diagnosed with cancer and 420,284 age- and sex-matched patients without a diagnosis of cancer between 2000 and 2015 were identified from Taiwan’s National Health Insurance Research Database. The underlying chronic diseases of patients that may developed cancer were gathered and studied as the predictor. A multivariate Cox proportional odds model was used to estimate the crude and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) to estimate the interaction effect between sleep disorders and depression on the risk of cancer. Results: After adjusting for age, sex, comorbidities, and other covariates, the cancer group was associated with increased exposure to sleep disorders than the non-cancer group (aOR = 1.440, 95% CI = 1.392−1.489, p < 0.001). In addition, patients with both sleep disorders and depression were at an even higher risk for cancer than the general population (aOR = 6.857, p < 0.001). Conclusions: This retrospective cohort study shows that patients with both sleep disorders and depression are at a higher risk of cancer. Clinically, a meticulous cancer risk evaluation is recommended for patients with both sleep disorders and depression.
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Gene Expression Profile Associated with Asmt Knockout-Induced Depression-Like Behaviors and Exercise Effects in Mouse Hypothalamus. Biosci Rep 2022; 42:231525. [PMID: 35771226 PMCID: PMC9284346 DOI: 10.1042/bsr20220800] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 06/16/2022] [Accepted: 06/29/2022] [Indexed: 11/17/2022] Open
Abstract
Sleep disorder caused by abnormal circadian rhythm is one of the main symptoms and risk factors of depression. As a known hormone regulating circadian rhythms, melatonin (MT) is also namely N-acetyl-5-methoxytryptamine. N-acetylserotonin methyltransferase (Asmt) is the key rate-limiting enzyme of MT synthesis and has been reportedly associated with depression. Although 50–90% of patients with depression have sleep disorders, there are no effective treatment ways in the clinic. Exercise can regulate circadian rhythm and play an important role in depression treatment. In the present study, we showed that Asmt knockout induced depression-like behaviors, which were ameliorated by swimming exercise. Moreover, swimming exercise increased serum levels of MT and 5-hydroxytryptamine (5-HT) in Asmt knockout mice. In addition, the microarray data identified 10 differentially expressed genes (DEGs) in KO mice compared with WT mice and 29 DEGs in KO mice after swimming exercise. Among the DEGs, the direction and magnitude of change in epidermal growth factor receptor pathway substrate 8-like 1 (Eps8l1) and phospholipase C-β 2 (Plcb2) were confirmed by qRT-PCR partly. Subsequent bioinformatic analysis showed that these DEGs were enriched significantly in the p53 signaling pathway, long-term depression and estrogen signaling pathway. In the protein–protein interaction (PPI) networks, membrane palmitoylated protein 1 (Mpp1) and p53-induced death domain protein 1 (Pidd1) were hub genes to participate in the pathological mechanisms of depression and exercise intervention. These findings may provide new targets for the treatment of depression.
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Belete AM, Alemagegn A, Mulu AT, Yazie TS, Bewket B, Asefa A, Shiferaw WS. Prevalence of depression and associated factors among adult cancer patients receiving chemotherapy during the era of COVID-19 in Ethiopia. Hospital-based cross-sectional study. PLoS One 2022; 17:e0270293. [PMID: 35749489 PMCID: PMC9232136 DOI: 10.1371/journal.pone.0270293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/08/2022] [Indexed: 01/12/2023] Open
Abstract
Background Depression is a major public health problem among cancer patients undergoing chemotherapy. It compromises patient outcomes, resulting in higher rates of mortality. Currently, there are little data on the prevalence of depression in Sub-Sharan countries. Therefore, the current study was done to assess the prevalence of depression among adult cancer patients and its associated factors in Ethiopia. Method An institutional based cross-sectional study was conducted among 420 adult cancer patients from 1st March to April 30, 2021. Systematic random sampling technique was used to recruit participants. Depression was assessed using the Patient Health Questionnaire-9. The collected data were coded and entered into Epi-data version 4.2 and exported to SPSS version 25 for analysis. Bivariate binary logistic regression was performed to select factors that will be included in multivariate analysis, and variables with a p-value < 0.05 were included in multivariate analysis. In multivariate analysis, odds ratios and their 95% confidence intervals were computed and variables with p-value < 0.05 were considered to declare a significant association. Results In this study, the prevalence of depression was 33.1% (95% CI = 0.2858, 0.3761). Minimal symptoms of depression, minor depression, moderate depression, moderate severe depression, and severe depression were found to be 272 (64.8%), 9 (2.1%), 104 (24.8%), 28 (6.7%), and 7 (1.7%), respectively. Those cancer patients who had unemployed status, sacked from jobs, and had stage IV cancer were most likely to develop depression, whereas patients who completed primary education, colon, prostate and cervical cancer were less likely to have depression. Conclusion Depression is found to be a major public health concern for adult cancer patients in Ethiopia. To reduce the occurrence of depression among cancer patients, special attention is needed.
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Affiliation(s)
- Abebe Muche Belete
- Department of Biomedical Science, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
- * E-mail:
| | - Anmut Alemagegn
- Oncology Clinic, Tikur Anbesa Specialized Hospital, Addis Ababa University, Addis Ababa, Ethiopia
| | - Anemut Tilahun Mulu
- Department of Biomedical Science, College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Taklo Simeneh Yazie
- Pharmacology and Toxicology Unit, Department of Pharmacy, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Bekalu Bewket
- Department of Nursing, College of Health Science, Injibara University, Injibara, Ethiopia
| | - Adisu Asefa
- Department of Biomedical Science, College of Health Science, Debre Berhan University, Debre Berhan, Ethiopia
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Turossi-Amorim ED, Camargo B, do Nascimento DZ, Schuelter-Trevisol F. Potential Drug Interactions Between Psychotropics and Intravenous Chemotherapeutics Used by Patients With Cancer. J Pharm Technol 2022; 38:159-168. [PMID: 35600279 PMCID: PMC9116124 DOI: 10.1177/87551225211073942] [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: 11/15/2022] Open
Abstract
Introduction: Patients undergoing cancer treatment usually have comorbidities, and psychiatric disorders are commonly seen in these patients. For the treatment of these psychiatric disorders, the use of psychotropic drugs is common, turning these patients susceptible to untoward drug interactions. Therefore, the aim of this study was to estimate the prevalence of clinically relevant drug-drug interactions (DDI) between chemotherapeutic and psychotropic agents in patients with cancer treated at an oncology service in southern Brazil. Methods: An observational epidemiological study with a cross-sectional census-type design was carried out between October and December 2020. The drug-drug interactions were identified through consultation and analysis of the Medscape Drug Interaction Check and Micromedex databases. The interactions were classified as major, when the interaction can be fatal and/or require medical intervention to avoid or minimize serious adverse effects and moderate, when the interaction can exacerbate the patient's condition and/or requires changes in therapy. Results: A total of 74 patients was included in the study among the 194 patients seen in the oncology service during the period studied. A total of 24 (32.4%) DDIs were found, 21 (87.5%) of which were classified as being of major risk and 3 (12.5%) as moderate risk. According to the mechanism of action, 19 (79.1%) were classified as pharmacodynamic interactions and 5 (20.9%) as pharmacokinetic interactions. Conclusion: It was shown that a considerable percentage of patients undergoing intravenous chemotherapy are at risk of pharmacological interaction with psychotropic drugs. Thus, it is essential that the oncologist considers all psychotropic drugs and other drugs used by patients in order to avoid drug-drug interactions.
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Affiliation(s)
- Eric Diego Turossi-Amorim
- State University of Londrina, Tubarao,
Brazil,Eric Diego Turossi Amorim, PhD in
Physiological Sciences, University of Southern Santa Catarina, Avenida José
Acácio Moreira, 787, Tubarao 121 88704-900, Brazil.
| | - Bruna Camargo
- University of Southern Santa Catarina,
Tubarao, Brazil
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Lobefaro R, Rota S, Porcu L, Brunelli C, Alfieri S, Zito E, Taglialatela I, Ambrosini M, Spagnoletti A, Zimatore M, Fatuzzo G, Lavecchia F, Borreani C, Apolone G, De Braud F, Platania M. Cancer-related fatigue and depression: a monocentric, prospective, cross-sectional study in advanced solid tumors. ESMO Open 2022; 7:100457. [PMID: 35366489 PMCID: PMC9058920 DOI: 10.1016/j.esmoop.2022.100457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/14/2022] [Accepted: 02/28/2022] [Indexed: 12/28/2022] Open
Abstract
Background Cancer-related fatigue (CRF) is common in patients with advanced solid tumors and several risk factors are described. The possible role of depression is reported by clinicians despite the association with CRF being unclear. Material and methods In this monocentric, cross-sectional, prospective study we recruited patients with advanced solid tumors who were hospitalized at Fondazione IRCCS Istituto Nazionale dei Tumori of Milan. The primary objective was to assess the correlation between CRF and depression. Secondary objectives were the estimation of CRF and depression prevalence and the identification of associated clinical risk factors. CRF and depression were evaluated through the Functional Assessment of Cancer Therapy-Fatigue subscale and the Zung Self Depression Scale (ZSDS) questionnaires. The Cochran-Armitage trend test was used to demonstrate the primary hypothesis. Univariate and multivariate logistic regression models were used to investigate the impact of clinical variables. Results A total of 136 patients were enrolled. The primary analysis found a linear correlation (P < 0.0001) between CRF and depression. The prevalence of CRF and of moderate to severe depressive symptoms was 43.5% and 29.2%, respectively. In univariate analysis, patients with poor Eastern Cooperative Oncology Group performance status (ECOG PS), anemia, distress, pain, and receiving oncological treatment were at a significantly higher risk for CRF, whereas poor ECOG PS, pain, and distress were risk factors for depression. In multivariate analysis, high levels of ZSDS were confirmed to be correlated to CRF: odds ratio of 3.86 [95% confidence interval (CI) 0.98-15.20) and 11.20 (95% CI 2.35-53.36) for ZSDS of 50-59 and 60-100, respectively (P value for trend 0.002). Moreover, the ECOG PS score was confirmed to be significantly associated with CRF (OR 7.20; 95% CI 1.73-29.96; P = 0.007). Conclusions Our data suggest a strong correlation between CRF and depression in patients with advanced solid tumors. Further investigations are needed to better understand this relationship and if depressive disorder therapeutic strategies could also impact on CRF. Validated patient-reported outcome measures were used for screening CRF and depression in advanced cancer patients. A direct strong correlation between CRF and depression was found in these patients, often unconsidered by clinicians. Other different clinical risk factors for the onset and worsening of CRF were identified. A comprehensive evaluation of cancer patients, that should also consider mood disorders, could improve CRF management.
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Affiliation(s)
- R Lobefaro
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
| | - S Rota
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - L Porcu
- Methodology for Clinical Research Laboratory, Oncology Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - C Brunelli
- Palliative Care, Pain Therapy and Rehabilitation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - S Alfieri
- Clinical Psychology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - E Zito
- Information and Communication Technology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - I Taglialatela
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Ambrosini
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A Spagnoletti
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - M Zimatore
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Fatuzzo
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F Lavecchia
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - C Borreani
- Clinical Psychology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - G Apolone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - F De Braud
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy; Department of Oncology and Hematology, University of Milan, Milan, Italy
| | - M Platania
- Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
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Bai R, Dong W, Peng Q, Bai Z. Trends in depression incidence in China, 1990-2019. J Affect Disord 2022; 296:291-297. [PMID: 34606800 DOI: 10.1016/j.jad.2021.09.084] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 08/28/2021] [Accepted: 09/26/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Depression is one of the most widespread health burdens for the general population in China. This study aims to assess the long-term trends of depression incidence in China between 1990 and 2019. METHODS The incidence data were drawn from the Global Burden of Disease Study 2019, and an age-period-cohort model was used in the analysis. RESULTS The net drift was -0.66% (95% CI: -0.79% to -0.53%) per year for both genders. For males, the local drift was lower than 0 (P<0.05) in those aged 10-54 years, and higher than 0 (P<0.05) in those aged 60-69 years. For females, the local drift was lower than 0 (P<0.05) in those aged 10-49 years and higher than 0 (P<0.05) in those aged 55-84 years. Females had a higher risk of depression incidence than males. Compared with the 1990-1994 period, the relative risk (RR) of depression incidence in 2015-2019 decreased by 12.2% in males and 12.3% in females, and compared to the 1903-1907 birth cohort, the cohort RRs in the 2008-2012 birth cohort decreased by 42.1% in males and 34.5% in females. Period and cohort RRs all showed an increased tendency in recent periods and birth cohorts. LIMITATIONS These data are macrolevel estimates at the national level, may have ecological fallacies. CONCLUSIONS Although the age-standard incidence of depression has declined in China as a whole in the last three decades, the incidence of depression among older individuals has increased. More efforts are needed to promote the mental health of elderly individuals in China.
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Affiliation(s)
- Ruhai Bai
- Evidence-Based Research Center of Social Science & Health, Public Affair School of Nanjing University of Science & Technology, Nanjing 210000, China
| | - Wanyue Dong
- School of Health Economics and Management, Nanjing Chinese Medicine University, Nanjing 210000, China
| | - Qiao Peng
- Health Science Center, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zhenggang Bai
- Evidence-Based Research Center of Social Science & Health, Public Affair School of Nanjing University of Science & Technology, Nanjing 210000, China.
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Liu M, Li Y, Liu X. Serum tumor necrosis factor-α, interleukin-1β, interleukin-6, and interleukin-17 relate to anxiety and depression risks to some extent in non-small cell lung cancer survivor. CLINICAL RESPIRATORY JOURNAL 2021; 16:105-115. [PMID: 34697903 PMCID: PMC9060128 DOI: 10.1111/crj.13457] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/07/2021] [Accepted: 10/19/2021] [Indexed: 12/25/2022]
Abstract
Introduction Inflammatory cytokines are proposed as modulators for the pathogenesis of anxiety and depression (anxiety/depression), and anxiety/depression are frequently existed in non‐small cell lung cancer (NSCLC) survivors. However, no published study has explored the association of inflammation cytokines with anxiety/depression in NSCLC survivors. Objectives We aimed to evaluate serum tumor necrosis factor‐α (TNF‐α), interleukin‐1 beta (IL‐1β), interleukin‐6 (IL‐6), interleukin‐17 (IL‐17) levels, and their correlations with anxiety/depression in NSCLC survivors. Methods Totally, 217 NSCLC survivors and 200 controls were recruited. Then, inflammatory cytokines in serum samples were detected by enzyme‐linked immunosorbent assay (ELISA). Besides, their anxiety/depression status was assessed by Hospital Anxiety and Depression Scale (HADS). Results HADS‐anxiety score, anxiety rate, anxiety severity, HADS‐depression score, depression rate, and depression severity were all increased in NSCLC survivors compared with controls (all P < 0.001). Regarding inflammatory cytokines, TNF‐α, IL‐1β, and IL‐17 levels were higher (all P < 0.01), while IL‐6 (P = 0.105) level was of no difference in NSCLC survivors compared with controls. Furthermore, TNF‐α, IL‐1β, IL‐6, and IL‐17 were all positively associated with HADS‐A score (all P < 0.05), anxiety occurrence (all P < 0.05), HADS‐D score (all P < 0.05), and depression occurrence (all P < 0.05) in NSCLC survivors, while the correlation‐coefficients were weak. Additionally, multivariate logistic regression analyses disclosed that TNF‐α (both P < 0.05) and IL‐1β (both P < 0.001) were independently correlated with increased anxiety and depression risks in NSCLC survivors. Conclusion Serum TNF‐α, IL‐1β, IL‐6, and IL‐17 are related to increased anxiety and depression risks to some extent in NSCLC survivors.
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Affiliation(s)
- Meifang Liu
- Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yao Li
- Department of Hematology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Xuesong Liu
- Ministry of Nursing, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
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Yang X, Yang Q, Tang Y, Ma J, Ye H. Impact of the Extent of Thyroidectomy on Quality of Life in Differentiated Thyroid Cancer Survivors: A Propensity Score Matched Analysis. Cancer Manag Res 2021; 13:6953-6967. [PMID: 34522138 PMCID: PMC8434861 DOI: 10.2147/cmar.s321988] [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: 06/08/2021] [Accepted: 08/16/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose As most thyroid cancer patients survive for more than ten years, it has become increasingly important to understand whether the different surgery types have any effect on the quality of life (QoL) of patients. Patients and Methods Using observational data from head and neck surgery at the Sichuan Cancer Hospital in China, three scoring methods – sum scoring, domain-based scoring and IRT-based scoring, were employed to measure the QoL in differentiated thyroid cancer (DTC) patients and a propensity score matched analysis performed to explore the impact of surgery type on QoL as measured by the Treatment of Cancer Quality of Life core Questionnaire version 3.0 (EORTC QLQ-C30) and a disease-specific health-related quality of life questionnaire (THYCA-QoL). Results No statistically significant patient QoL differences were found between the two surgery types regardless of which questionnaire was used and which scoring method was used (\documentclass[12pt]{minimal}
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$${\rm{ATE}} = - 0.4491$$
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$$p = 0.807$$
\end{document} using the EORTC QLQ-C30 and the domain-based scoring; and \documentclass[12pt]{minimal}
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$${\rm{ATE}} = - 0.442$$
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$$p = 0.114$$
\end{document} using the EORTC QLQ-C30 and the IRT-based scoring; \documentclass[12pt]{minimal}
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$${\rm{ATE}} = - 0.827$$
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$$p = 0.586$$
\end{document} using the THYCA-QoL and the sum scoring; \documentclass[12pt]{minimal}
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$${\rm{ATE}} = - 1.692$$
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$$p = 0.406$$
\end{document} using the THYCA-QoL and the domain-based scoring; and \documentclass[12pt]{minimal}
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$${\rm{ATE}} = - 0.032$$
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$$p = 0.908$$
\end{document} using the THYCA-QoL and the IRT-based scoring). Conclusion This study confirmed that the surgery type (hemithyroidectomy or total thyroidectomy) for DTC patients did not appear to influence their general QoL.
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Affiliation(s)
- Xiongtao Yang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, People's Republic of China
| | - Qing Yang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, People's Republic of China
| | - Yuan Tang
- Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610041, People's Republic of China
| | - Jing Ma
- Business School, Sichuan University, Chengdu, 610064, People's Republic of China
| | - Huamei Ye
- People's Hospital of Dujiangyan City, Chengdu, 611830, People's Republic of China
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39
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Van der Elst S, Bardash Y, Wotman M, Kraus D, Tham T. The prognostic impact of depression or depressive symptoms on patients with head and neck cancer: A systematic review and meta-analysis. Head Neck 2021; 43:3608-3617. [PMID: 34525238 DOI: 10.1002/hed.26868] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 07/18/2021] [Accepted: 08/31/2021] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND This systematic review and meta-analysis sought to assess the extent to which pretreatment depression or depressive symptoms are related to prognosis in patients with head and neck cancer (HNC). METHODS Medline, EMbase, Scopus, and The Cochrane Library databases were searched. A meta-analysis was done to generate a forest plot and pooled hazard ratio (HR) with 95% CI for overall survival (OS). RevMan 5.3 and Meta Essentials were used for statistical analysis. RESULTS Based on seven studies involving 1743 patients, the results showed that HNC patients with pretreatment depression or depressive symptoms had worse OS than patients without depression or depressive symptoms, with an HR of 1.33, 95% CI 1.16-1.52, p = <0.0001. There is heterogeneity in the pooled summary effect (I2 = 80%, p < 0.0001). CONCLUSIONS Pretreatment depression or depressive symptoms may indicate worse OS in patients with HNC. The pooled analysis demonstrated a statistically significant effect. These results were limited by mild heterogeneity.
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Affiliation(s)
- Sarah Van der Elst
- Department of Otolaryngology-Head and Neck Surgery, Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Yonatan Bardash
- Department of Otolaryngology-Head and Neck Surgery, Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Michael Wotman
- Department of Otolaryngology-Head and Neck Surgery, Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Dennis Kraus
- Department of Otolaryngology-Head and Neck Surgery, Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Tristan Tham
- Department of Otolaryngology-Head and Neck Surgery, Donald & Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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40
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Chen VCH, Kao CJ, Tsai YH, Cheok MT, McIntyre RS, Weng JC. Assessment of Disrupted Brain Structural Connectome in Depressive Patients With Suicidal Ideation Using Generalized Q-Sampling MRI. Front Hum Neurosci 2021; 15:711731. [PMID: 34512298 PMCID: PMC8430248 DOI: 10.3389/fnhum.2021.711731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 07/30/2021] [Indexed: 11/13/2022] Open
Abstract
Suicide is one of the leading causes of mortality worldwide. Various factors could lead to suicidal ideation (SI), while depression is the predominant cause among all mental disorders. Studies have shown that alterations in brain structures and networks may be highly associated with suicidality. This study investigated both neurological structural variations and network alterations in depressed patients with suicidal ideation by using generalized q-sampling imaging (GQI) and Graph Theoretical Analysis (GTA). This study recruited 155 participants and divided them into three groups: 44 depressed patients with suicidal ideation (SI+; 20 males and 24 females with mean age = 42, SD = 12), 56 depressed patients without suicidal ideation (Depressed; 24 males and 32 females with mean age = 45, SD = 11) and 55 healthy controls (HC; nine males and 46 females with mean age = 39, SD = 11). Both the generalized fractional anisotropy (GFA) and normalized quantitative anisotropy (NQA) values were evaluated in a voxel-based statistical analysis by GQI. We analyzed different topological parameters in the graph theoretical analysis and the subnetwork interconnections in the Network-based Statistical (NBS) analysis. In the voxel-based statistical analysis, both the GFA and NQA values in the SI+ group were generally lower than those in the Depressed and HC groups in the corpus callosum and cingulate gyrus. Furthermore, we found that the SI+ group demonstrated higher global integration and lower local segregation among the three groups of participants. In the network-based statistical analysis, we discovered that the SI+ group had stronger connections of subnetworks in the frontal lobe than the HC group. We found significant structural differences in depressed patients with suicidal ideation compared to depressed patients without suicidal ideation and healthy controls and we also found several network alterations among these groups of participants, which indicated that white matter integrity and network alterations are associated with patients with depression as well as suicidal ideation.
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Affiliation(s)
- Vincent Chin-Hung Chen
- School of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Chun-Ju Kao
- Department of Medical Imaging and Radiological Sciences, Bachelor Program in Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan
| | - Yuan-Hsiung Tsai
- School of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Man Teng Cheok
- Department of Medical Imaging and Radiological Sciences, Bachelor Program in Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan.,Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Roger S McIntyre
- Mood Disorder Psychopharmacology Unit, University Health Network, Department of Psychiatry, University of Toronto, Toronto, ON, Canada.,Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Departments of Psychiatry and Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Jun-Cheng Weng
- Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan.,Department of Medical Imaging and Radiological Sciences, Bachelor Program in Artificial Intelligence, Chang Gung University, Taoyuan, Taiwan.,Medical Imaging Research Center, Institute for Radiological Research, Chang Gung University and Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
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41
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McFarland DC, Applebaum AJ, Bengtsen E, Alici Y, Breitbart W, Miller AH, Nelson C. Potential use of albumin and neutrophil-to-lymphocyte ratio to guide the evaluation and treatment of cancer-related depression and anxiety. Psychooncology 2021; 31:306-315. [PMID: 34480784 DOI: 10.1002/pon.5811] [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: 12/19/2020] [Revised: 08/16/2021] [Accepted: 08/24/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Depression and anxiety are common and associated with inflammation in patients with cancer. Inflammatory indices such as albumin and neutrophil-to-lymphocyte ratio (NLR) obtained from metabolic panels and complete blood counts should be available for mental health professionals treating anxiety and depression at cancer centers. We hypothesized that albumin and NLR extrapolated from non-mental health oncology appointments would be associated with anxiety and depression and drawn close enough to psychiatry visits to be useful for the psycho-oncologist. MATERIALS & METHODS: Depression and anxiety were evaluated in patients (n = 97) referred to a cancer center psychiatric service for depression using the Patient Health Questionnaire-9 and General Anxiety Disorder-7. Albumin concentration and NLR were assessed for timing and correlation strength with anxiety and depression by setting (localized/metastatic cancer). RESULTS Most patients (96%) had albumin or NLR available at any time point of which 45% were drawn within one week of the psychiatric appointment. No significant correlations were noted when evaluating localized cancer or NLR exclusively. For patients with metastatic cancer, anxiety and depression were correlated with albumin at any time point (r = -0.28, p < 0.05; r = -0.40, p < 0.01, respectively) and within a week of psychiatry appointment (r = -0.40, p < 0.05; r = -0.68, p < 0.001, respectively). Albumin evaluated within a week predicted 32% of depression score variance (β = -0.63, p = 0.002). Hypoalbuminemia (<3.8 g/ul) was associated with anxiety (χ2 = 4.43, p = 0.04) and depression (χ2 = 11.06, p = 0.001). CONCLUSION Hypoalbuminemia in patients with metastatic cancer may help establish the presence or persistence of anxiety, depression, treatment refractoriness, and the use of inflammation in cancer-related psychological symptom management.
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Affiliation(s)
- Daniel C McFarland
- Department of Medicine, Northwell Health, Lenox Hill Hospital, New York, New York, USA
| | - Allison J Applebaum
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Erik Bengtsen
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Yesne Alici
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Andrew H Miller
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
| | - Christian Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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42
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Sass D, Saligan L, Fitzgerald W, Berger AM, Torres I, Barb JJ, Kupzyk K, Margolis L. Extracellular vesicle associated and soluble immune marker profiles of psychoneurological symptom clusters in men with prostate cancer: an exploratory study. Transl Psychiatry 2021; 11:440. [PMID: 34429399 PMCID: PMC8385103 DOI: 10.1038/s41398-021-01554-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/27/2021] [Accepted: 08/10/2021] [Indexed: 02/07/2023] Open
Abstract
Psychoneurological symptom clusters are co-occurring and interrelated physiological symptoms that may include cancer-related fatigue, pain, depressive symptoms, cognitive disturbances, and sleep disturbances. These symptoms are hypothesized to share a common systemic proinflammatory etiology. Thus, an investigation of systemic immune biomarkers is an important approach to test this hypothesis. Here, we investigated the associations between extracellular vesicle (EV)-associated and soluble cytokines with immune markers and symptom clusters in men with non-metastatic prostate cancer. This observational study included 40 men with non-metastatic prostate cancer at the start (T1) of external beam radiation therapy (EBRT) and 3 months post treatment (T2), as well as 20 men with non-metastatic prostate cancer on active surveillance (AS) seen at one time point. Collected questionnaires assessed patient-reported fatigue, sleep disturbances, depressive symptoms, and cognitive fatigue. In total, 45 soluble and EV-associated biomarkers in plasma were determined by multiplex assays. Principal component analysis (PCA) was used to identify psychoneurological symptom clusters for each study group and their time points. Bivariate correlation analysis was run for each identified PCA cluster with the concentrations of EV-associated and soluble cytokines and immune markers. Both EV-associated and soluble forms of RANTES significantly correlated with the symptom cluster for EBRT at T1, whereas, at T2, soluble IFNα2, IL-9, and IL-17 correlated with the corresponding symptom cluster. For the AS group, soluble survivin correlated with psychoneurological symptoms. Linking specific inflammatory cytokines with psychoneurological symptom clusters in men receiving prostate cancer treatment can enhance understanding of the underlying mechanisms of this phenomenon and aid in developing targeted interventions.
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Affiliation(s)
- Dilorom Sass
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
- University of Nebraska Medical Center, Omaha, 68105, NE, USA
| | - Leorey Saligan
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA.
| | - Wendy Fitzgerald
- Section on Intercellular Interactions, Eunice Kennedy-Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Ann M Berger
- University of Nebraska Medical Center, Omaha, 68105, NE, USA
| | - Isaias Torres
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD, USA
| | - Jennifer J Barb
- Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Kevin Kupzyk
- University of Nebraska Medical Center, Omaha, 68105, NE, USA
| | - Leonid Margolis
- Section on Intercellular Interactions, Eunice Kennedy-Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
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43
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Cuomo A, Paudice F, D'Angelo G, Perrotta G, Carannante A, Attanasio U, Iengo M, Fiore F, Tocchetti CG, Mercurio V, Pirozzi F. New-Onset Cancer in the HF Population: Epidemiology, Pathophysiology, and Clinical Management. Curr Heart Fail Rep 2021; 18:191-199. [PMID: 34181210 PMCID: PMC8342372 DOI: 10.1007/s11897-021-00517-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/19/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW Oncological treatments are known to induce cardiac toxicity, but the impact of new-onset cancer in patients with pre-existing HF remains unknown. This review focuses on the epidemiology, pathophysiological mechanisms, and clinical implications of HF patients who develop malignancies. RECENT FINDINGS Novel findings suggest that HF and cancer, beside common risk factors, are deeply linked by shared pathophysiological mechanisms. In particular, HF itself may enhance carcinogenesis by producing pro-inflammatory cytokines, and it has been suggested that neurohormonal activation, commonly associated with the failing heart, might play a pivotal role in promoting neoplastic transformation. The risk of malignancies seems to be higher in HF patients compared to the general population, probably due to shared risk factors and common pathophysiological pathways. Additionally, management of these patients represents a challenge for clinicians, considering that the co-existence of these diseases significantly worsens patients' prognosis and negatively affects therapeutic options for both diseases.
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Affiliation(s)
- Alessandra Cuomo
- Department of Translational Medical Sciences, Federico II University, Naples, Italy.
| | - Francesca Paudice
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Giovanni D'Angelo
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Giovanni Perrotta
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Antonio Carannante
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Umberto Attanasio
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Martina Iengo
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Francesco Fiore
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Carlo Gabriele Tocchetti
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
- Interdepartmental Center of Clinical and Translational Sciences (CIRCET), Federico II University, Naples, Italy
- Interdepartmental Hypertension Research Center (CIRIAPA), Federico II University, Naples, Italy
| | - Valentina Mercurio
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Flora Pirozzi
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
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Marcotte LM, Reddy A, Zhou L, Razliff A, Unützer J, Chang D, Liao JM. Provision of Collaborative Care Model and General Behavioral Health Integration Services in Medicare. Psychiatr Serv 2021; 72:822-825. [PMID: 33853381 DOI: 10.1176/appi.ps.202000265] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors sought to describe the early use of collaborative care model (CoCM) and general behavioral health integration (BHI) billing codes among clinicians. METHODS Counts and payments were calculated for accepted and denied claims for CoCM and general BHI services delivered to Medicare beneficiaries nationwide in 2017-2018. Payment and utilization data were stratified by clinical specialty and site of service. RESULTS Overall, 10,294 CoCM and general BHI services were delivered in 2017, totaling $626,292 in payments, and 81,433 CoCM and general BHI services were delivered in 2018, totaling $7,442,985 in payments. Medicare denied 5% of services in 2017 and 32% in 2018. Most CoCM and general BHI services were delivered by primary care physicians in office-based settings. CONCLUSIONS This study of codes designed to promote BHI revealed an eightfold increase in CoCM and general BHI use between 2017 and 2018. However, denied services represent a barrier, and use among eligible beneficiaries remains low.
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Affiliation(s)
- Leah M Marcotte
- Department of Medicine (Marcotte, Reddy, Zhou, Liao) and Department of Psychiatry and Behavioral Science (Razliff, Unützer, Chang), School of Medicine, University of Washington, Seattle; Value and Systems Science Lab, Seattle (Marcotte, Reddy, Zhou, Liao)
| | - Ashok Reddy
- Department of Medicine (Marcotte, Reddy, Zhou, Liao) and Department of Psychiatry and Behavioral Science (Razliff, Unützer, Chang), School of Medicine, University of Washington, Seattle; Value and Systems Science Lab, Seattle (Marcotte, Reddy, Zhou, Liao)
| | - Lingmei Zhou
- Department of Medicine (Marcotte, Reddy, Zhou, Liao) and Department of Psychiatry and Behavioral Science (Razliff, Unützer, Chang), School of Medicine, University of Washington, Seattle; Value and Systems Science Lab, Seattle (Marcotte, Reddy, Zhou, Liao)
| | - Anna Razliff
- Department of Medicine (Marcotte, Reddy, Zhou, Liao) and Department of Psychiatry and Behavioral Science (Razliff, Unützer, Chang), School of Medicine, University of Washington, Seattle; Value and Systems Science Lab, Seattle (Marcotte, Reddy, Zhou, Liao)
| | - Jürgen Unützer
- Department of Medicine (Marcotte, Reddy, Zhou, Liao) and Department of Psychiatry and Behavioral Science (Razliff, Unützer, Chang), School of Medicine, University of Washington, Seattle; Value and Systems Science Lab, Seattle (Marcotte, Reddy, Zhou, Liao)
| | - Denise Chang
- Department of Medicine (Marcotte, Reddy, Zhou, Liao) and Department of Psychiatry and Behavioral Science (Razliff, Unützer, Chang), School of Medicine, University of Washington, Seattle; Value and Systems Science Lab, Seattle (Marcotte, Reddy, Zhou, Liao)
| | - Joshua M Liao
- Department of Medicine (Marcotte, Reddy, Zhou, Liao) and Department of Psychiatry and Behavioral Science (Razliff, Unützer, Chang), School of Medicine, University of Washington, Seattle; Value and Systems Science Lab, Seattle (Marcotte, Reddy, Zhou, Liao)
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Castro-Figueroa EM, Acevedo KI, Peña-Vargas CI, Torres-Blasco N, Flores I, Colón-Echevarria CB, Maldonado L, Rodríguez Z, Aquino-Acevedo AN, Jim H, Lazaro MI, Armaiz-Peña GN. Depression, Anxiety, and Social Environmental Adversity as Potential Modulators of the Immune Tumor Microenvironment in Breast Cancer Patients. Med Sci (Basel) 2021; 9:46. [PMID: 34205709 PMCID: PMC8293308 DOI: 10.3390/medsci9020046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/10/2021] [Accepted: 06/11/2021] [Indexed: 12/24/2022] Open
Abstract
Background: Mounting data suggest that exposure to chronic stress is associated with worse breast cancer outcomes. This study aimed to explore the impact of social environmental adversity (SEA, e.g., child abuse, crime, sexual, and physical violence), depressive symptomatology, and anxiety on immune cell infiltration into the breast tumor microenvironment. Methods: Participants (n = 33) completed a series of surveys assessing depression and anxiety symptoms, adverse childhood events (ACE), and trauma history. Tumor-associated macrophages (CD68+), B cells (CD19+), and T cells (CD3+) were identified by immunohistochemical analyses of formalin-fixed paraffin-embedded tumor samples and quantified. Spearman rank tests were used to explore the relationships between the variables studied. Results: Exposure to SEA was high (ACE = 72%, exposure to crime = 47%, and exposure to physical/sexual assault = 73%) among participants. Moreover, 30% reported a comorbid history of depression and ACE; 39% reported one or more traumatic events, and clinically significant depression symptomatology, while 21% reported trauma history and significant anxiety symptomatology. Increased tumor-infiltrating B cells were significantly correlated with exposure to crime, anxiety symptoms, and exposure to an ACE. The ACE plus anxiety group presented the highest infiltration of B cells, T cells, and macrophages. Conclusion: These findings support a role for SEA, anxiety symptoms, and depression as potential modulators of the immune tumor microenvironment in breast cancer.
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Affiliation(s)
- Eida M. Castro-Figueroa
- Clinical Psychology Program, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR 00716, USA; (K.I.A.); (C.I.P.-V.); (N.T.-B.); (M.I.L.)
- Division of Mental Health, Ponce Research Institute, Ponce, PR 00716, USA
| | - Karina I. Acevedo
- Clinical Psychology Program, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR 00716, USA; (K.I.A.); (C.I.P.-V.); (N.T.-B.); (M.I.L.)
| | - Cristina I. Peña-Vargas
- Clinical Psychology Program, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR 00716, USA; (K.I.A.); (C.I.P.-V.); (N.T.-B.); (M.I.L.)
- Division of Mental Health, Ponce Research Institute, Ponce, PR 00716, USA
| | - Normarie Torres-Blasco
- Clinical Psychology Program, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR 00716, USA; (K.I.A.); (C.I.P.-V.); (N.T.-B.); (M.I.L.)
- Division of Mental Health, Ponce Research Institute, Ponce, PR 00716, USA
| | - Idhaliz Flores
- Division of Women’s Health, Ponce Research Institute, Ponce, PR 00716, USA; (I.F.); (G.N.A.-P.)
- Division of Microbiology, Department of Basic Sciences, School of Medicine, Ponce Health Sciences University, Ponce, PR 00716, USA
| | - Claudia B. Colón-Echevarria
- Division of Pharmacology, Department of Basic Sciences, School of Medicine, Ponce Health Sciences University, Ponce, PR 00716, USA; (C.B.C.-E.); (A.N.A.-A.)
| | - Lizette Maldonado
- Division of Cancer Biology, Ponce Research Institute, Ponce, PR 00716, USA; (L.M.); (Z.R.)
| | - Zindie Rodríguez
- Division of Cancer Biology, Ponce Research Institute, Ponce, PR 00716, USA; (L.M.); (Z.R.)
| | - Alexandra N. Aquino-Acevedo
- Division of Pharmacology, Department of Basic Sciences, School of Medicine, Ponce Health Sciences University, Ponce, PR 00716, USA; (C.B.C.-E.); (A.N.A.-A.)
| | - Heather Jim
- Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA;
| | - María I. Lazaro
- Clinical Psychology Program, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR 00716, USA; (K.I.A.); (C.I.P.-V.); (N.T.-B.); (M.I.L.)
| | - Guillermo N. Armaiz-Peña
- Division of Women’s Health, Ponce Research Institute, Ponce, PR 00716, USA; (I.F.); (G.N.A.-P.)
- Division of Pharmacology, Department of Basic Sciences, School of Medicine, Ponce Health Sciences University, Ponce, PR 00716, USA; (C.B.C.-E.); (A.N.A.-A.)
- Division of Cancer Biology, Ponce Research Institute, Ponce, PR 00716, USA; (L.M.); (Z.R.)
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McFarland DC, Jutagir DR, Miller AH, Breitbart W, Nelson C, Rosenfeld B. Tumor Mutation Burden and Depression in Lung Cancer: Association With Inflammation. J Natl Compr Canc Netw 2021; 18:434-442. [PMID: 32259781 DOI: 10.6004/jnccn.2019.7374] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/28/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Patients with lung cancer with greater systemic inflammation have higher rates of depression. Tumor mutation burden (TMB) predicts immunotherapy response in patients with lung cancer and is associated with intratumoral inflammation, which may contribute to systemic inflammation and depression. This study evaluated whether higher TMB was associated with increased depression and systemic inflammation in patients with lung cancer. PATIENTS AND METHODS Patients with metastatic lung cancers were evaluated for depression severity using the Hospital Anxiety and Depression Scale. TMB was measured using the Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets. Inflammation was evaluated using C-reactive protein (CRP) level and neutrophil-to-lymphocyte ratio (NLR). RESULTS A total of 96 patients with adequate TMB testing were evaluated. The average number of mutations (TMB) was 10.8 (SD, 10.9). A total of 19% of patients endorsed clinically significant depression symptoms. TMB was significantly correlated with depression severity (r = 0.34; P=.001) and NLR (r = 0.37; P=.002) but not CRP level (r = 0.19; P=.07). TMB was also higher in patients receiving chemotherapy (mean, 12.0) and immunotherapy (mean, 14.4) versus targeted therapy (mean, 4.8). A multivariate model found that TMB (β = 0.30; P=.01) and CRP level (β = 0.31; P=.01) were independently associated with depression; there was no significant interaction effect of TMB × CRP and depression. A similar multivariate model showed no independent effect for NLR and depression (β = 0.16; P=.17) after accounting for TMB. CONCLUSIONS These data provide evidence for biologic depression risk in patients with lung cancer who have high levels of TMB. The underlying mechanism of the association is not clearly related to inflammation but warrants further analysis to broadly elucidate the mechanism of biologically derived depression in cancer.
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Affiliation(s)
- Daniel C McFarland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Devika R Jutagir
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Andrew H Miller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia; and
| | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Christian Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Barry Rosenfeld
- Department of Psychology, Fordham University, Bronx, New York
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Parikh RB, Gallo JJ, Wong YN, Robinson KW, Cashy JP, Narayan V, Jayadevappa R, Chhatre S. Long-term depression incidence and associated mortality among African American and White prostate cancer survivors. Cancer 2021; 127:3476-3485. [PMID: 34061986 DOI: 10.1002/cncr.33656] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/13/2021] [Accepted: 04/08/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Depression is common after a diagnosis of prostate cancer and may contribute to poor outcomes, particularly among African Americans. The authors assessed the incidence and management of depression and its impact on overall mortality among African American and White veterans with localized prostate cancer. METHODS The authors used the Veterans Health Administration Corporate Data Warehouse to identify 40,412 African American and non-Hispanic White men diagnosed with localized prostate cancer from 2001 to 2013. Patients were followed through 2019. Multivariable logistic regression was used to measure associations between race and incident depression, which were ascertained from administrative and depression screening data. Cox proportional hazards models were used to measure associations between incident depression and all-cause mortality, with race-by-depression interactions used to assess disparities. RESULTS Overall, 10,013 veterans (24.5%) were diagnosed with depression after a diagnosis of prostate cancer. Incident depression was associated with higher all-cause mortality (adjusted hazard ratio [aHR], 1.27; 95% confidence interval [CI], 1.23-1.32). African American veterans were more likely than White veterans to be diagnosed with depression (29.3% vs 23.2%; adjusted odds ratio [aOR], 1.15; 95% CI, 1.09-1.21). Among those with depression, African Americans were less likely to be prescribed an antidepressant (30.4% vs 31.7%; aOR, 0.85; 95% CI, 0.77-0.93). The hazard of all-cause mortality associated with depression was greater for African American veterans than White veterans (aHR, 1.32 [95% CI, 1.26-1.38] vs 1.15 [95% CI, 1.07-1.24]; race-by-depression interaction P < .001). CONCLUSIONS Incident depression is common among prostate cancer survivors and is associated with higher mortality, particularly among African American men. Patient-centered strategies to manage incident depression may be critical to reducing disparities in prostate cancer outcomes.
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Affiliation(s)
- Ravi B Parikh
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania.,VA Center for Health Equity Research and Promotion, Philadelphia, Pennsylvania.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Joseph J Gallo
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland
| | - Yu-Ning Wong
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kyle W Robinson
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - John P Cashy
- VA Center for Health Equity Research and Promotion, Philadelphia, Pennsylvania
| | - Vivek Narayan
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ravishankar Jayadevappa
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania.,VA Center for Health Equity Research and Promotion, Philadelphia, Pennsylvania.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.,Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania.,Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Sumedha Chhatre
- Corporal Michael J. Crescenz VA Medical Center, Philadelphia, Pennsylvania.,VA Center for Health Equity Research and Promotion, Philadelphia, Pennsylvania.,Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
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McFarland DC, Walsh LE, Saracino R, Nelson CJ, Breitbart W, Rosenfeld B. The Sickness Behavior Inventory-Revised: Sickness behavior and its associations with depression and inflammation in patients with metastatic lung cancer. Palliat Support Care 2021; 19:312-321. [PMID: 33222717 PMCID: PMC8311665 DOI: 10.1017/s1478951520001169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Inflammation may contribute to the high prevalence of depressive symptoms seen in lung cancer. "Sickness behavior" is a cluster of symptoms induced by inflammation that are similar but distinct from depressive symptoms. The Sickness Behavior Inventory-Revised (SBI-R) was developed to measure sickness behavior. We hypothesized that the SBI-R would demonstrate adequate psychometric properties in association with inflammation. METHOD Participants with stage IV lung cancer (n = 92) were evaluated for sickness behavior using the SBI-R. Concomitant assessments were made of depression (Patient Hospital Questionniare-9, Hospital Anxiety and Depression Scale) and inflammation [C-reactive protein (CRP)]. Classical test theory (CTT) was applied and multivariate models were created to explain SBI-R associations with depression and inflammation. Factor Analysis was also used to identify the underlying factor structure of the hypothesized construct of sickness behavior. A longitudinal analysis was conducted for a subset of participants. RESULTS The sample mean for the 12-item SBI-R was 8.3 (6.7) with a range from 0 to 33. The SBI-R demonstrated adequate internal consistency with a Cronbach's coefficient of 0.85, which did not increase by more than 0.01 with any single-item removal. This analysis examined factor loadings onto a single factor extracted using the principle components method. Eleven items had factor loadings that exceeded 0.40. SBI-R total scores were significantly correlated with depressive symptoms (r = 0.78, p < 0.001) and CRP (r = 0.47, p < 0.001). Multivariate analyses revealed that inflammation and depressive symptoms explained 67% of SBI-R variance. SIGNIFICANCE OF RESULTS The SBI-R demonstrated adequate reliability and construct validity in this patient population with metastatic lung cancer. The observed findings suggest that the SBI-R can meaningfully capture the presence of sickness behavior and may facilitate a greater understanding of inflammatory depression.
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Affiliation(s)
- Daniel C. McFarland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Leah E. Walsh
- Department of Psychology, Fordham University, Bronx, NY
| | - Rebecca Saracino
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Christian J. Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
| | - William Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY
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Zheng J, Cai W, Lu X, He W, Li D, Zhong H, Yang L, Li S, Li H, Rafee S, Zhao Z, Wang Q, Pan H. Chronic stress accelerates the process of gastric precancerous lesions in rats. J Cancer 2021; 12:4121-4133. [PMID: 34093815 PMCID: PMC8176425 DOI: 10.7150/jca.52658] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 04/23/2021] [Indexed: 02/06/2023] Open
Abstract
Background: Gastrointestinal cancers account for 20% of all deaths worldwide. Gastric cancer (GC) patients are susceptible to psychological change, especially depression which is commonly induced by chronic stress. Gastric precancerous lesions (GPL) is an important prodromal stage in the occurrence of gastric cancer. Chronic stress influences the prognosis of GC and may influence the process of GPL as well. Methods: Sixty SD rats were randomly divided into a control group, GPL group, and GPL+CUMS group. In the GPL group, 200μg/mL N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) free drinking method combined with intermittent fasting was applied to establish the GPL animal model. Based on this, we combined the GPL rats with chronic unpredicted mild stress (CUMS) to establish a comprehensive model. We then evaluated their behavior by open field tests and sucrose preference tests. We tested the IL-6, IL-10, TNF-α, Ghrelin, Leptin and Somatostatin (SS) levels in serum and observed the expression of Ghrelin and Gastrokine 2(GKN2) in the gastric mucosa of rats with tumors by immunofluorescence. Results: Our results showed that GPL and GPL+CUMS rats all displayed a significantly decreased total distance and mean velocity traveled in the open field test. The percentages of sucrose preference were significantly decreased in the GPL+CUMS group compared to the control group. In addition, IL-6 and TNF-α were significantly increased in both the GPL and GPL+CUMS groups. Furthermore, the GPL+CUMS group showed significantly increased TNF-α levels in serum compared to the GPL rats. Our results showed that the expression of NF-κB, p53, and BCL-2 were significantly increased while BAX was reduced in the GPL and GPL+CUMS groups. Moreover, Ghrelin and Leptin levels in serum were significantly decreased in the GPL and GPL+CUMS groups. SS levels in serum were significantly increased in the GPL+CUMS group. Additionally, we found that the GPL+CUMS rats with tumors not only had strong expression of GKN2 on the luminal side and the lamina propria of the gastric mucosa and tumor, but also had expression of Ghrelin on the luminal side of the gastric mucosa. The areas that showed strong expression of GKN2 and Ghrelin, are all located around the blood vessels in the tumor. Conclusions: GPL rats under chronic stress would aggravate the conditions of GPL, shorten the process of GPL, and increase the risk of tumorigenesis. In addition, the close monitoring of the mental health of cancer survivors and precancerous lesion patients is suggested to be of great significance in the prevention and treatment of cancer.
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Affiliation(s)
- Jiayi Zheng
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.,Institute of Gastroenterology, Guangzhou University of Chinese Medicine, China
| | - Weiwu Cai
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.,Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xuen Lu
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.,Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wei He
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.,Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ding Li
- The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haoyu Zhong
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.,Clinical Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Liangjun Yang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.,Institute of Gastroenterology, Guangzhou University of Chinese Medicine, China
| | - Siyi Li
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.,Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haishan Li
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.,Second Clinical Medical College of Guangzhou university of Chinese Medicine
| | - Sereen Rafee
- Rutgers University Graduate School of Biomedical Sciences, Newark, NJ, USA
| | - Ziming Zhao
- Guangdong Province Engineering Technology Research Institute of Traditional Chinese Medicine, Guangzhou, China
| | - Qi Wang
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.,Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Huafeng Pan
- Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China.,Institute of Gastroenterology, Guangzhou University of Chinese Medicine, China.,Institute of Clinical Pharmacology, Guangzhou University of Chinese Medicine, Guangzhou, China
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50
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Kraav SL, Lehto SM, Kauhanen J, Hantunen S, Tolmunen T. Loneliness and social isolation increase cancer incidence in a cohort of Finnish middle-aged men. A longitudinal study. Psychiatry Res 2021; 299:113868. [PMID: 33774371 DOI: 10.1016/j.psychres.2021.113868] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 03/11/2021] [Indexed: 10/21/2022]
Abstract
Globally, cancer is the second leading cause of death. Loneliness has been suggested as a risk factor for cancer mortality. However, connections between loneliness, social isolation, and cancer are poorly understood. In our longitudinal study (mean follow-up: 20.44 years) of 2570 middle-aged men, loneliness, social isolation, and health-related factors were measured at baseline. Cox proportional hazards analysis was used to examine the association between cancer incidence, loneliness, and social isolation. The effect of relationship status on cancer mortality among cancer patients was tested with the Kaplan-Meier method. Loneliness was associated with total cancer incidence after adjustments for tested lifestyle and health-related covariates. Social Isolation was associated with total cancer incidence, except when adjusted for lifestyle, diet, or Human Population Laboratory (HPL) Depression Scale scores. Loneliness was associated with lung cancer incidence, except when adjusted for HPL Depression Scale scores. There was no significant association between social isolation and lung cancer. Neither loneliness nor social isolation were connected with prostate or colorectal cancer. Being single at baseline was associated with worse survival outcomes for cancer patients. Our findings suggest that regardless of the social network size, loneliness among middle-aged men is associated with an increased likelihood of cancer.
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Affiliation(s)
- Siiri-Liisi Kraav
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland; Department of Social Sciences, University of Eastern Finland, Kuopio, Finland.
| | - Soili M Lehto
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; R&D department, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway; Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Sari Hantunen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Tommi Tolmunen
- Institute of Clinical Medicine/Psychiatry, University of Eastern Finland, Kuopio, Finland; Department of Adolescent Psychiatry, Kuopio University Hospital, Kuopio, Finland
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