1
|
Kuang Q, Zhou S, She S, Zheng Y. A Case Report of Sinus Bradycardia after the Addition of Lurasidone in a Patient with Bipolar Disorder. Clin Psychopharmacol Neurosci 2023; 21:395-399. [PMID: 37119233 PMCID: PMC10157016 DOI: 10.9758/cpn.2023.21.2.395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/19/2022] [Accepted: 08/24/2022] [Indexed: 05/01/2023]
Abstract
To date, tachycardia and orthostatic hypotension have been reported as one of the negative cardiovascular complications of antipsychotics. The aim of this study was to report a case of sinus bradycardia caused by the addition of lurasidone. The patient, a 46-year-old bipolar disorder female, was admitted to the Affiliated Brain Hospital of Guangzhou Medical University with 28 years of alternating euphoric and dysphoria. On the basis of lithium carbonate 1,200 mg/day and sodium valproate 1,500 mg/day, the patient was given lurasidone 80 mg/day. After 5 days of medication, her heart rate (HR) became 48 beats per minute (beats/min). As a result, lurasidone treatment was held. On 5th day after discontinuing lurasidone, the HR reached 80 beats/min. This case report notifies that although the cardiovascular effects of lurasidone are not significant, it is also important to monitor HR status after the first administration of lurasidone.
Collapse
Affiliation(s)
- Qijie Kuang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| | - Sumiao Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| | - Shenglin She
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| | - Yingjun Zheng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, China
| |
Collapse
|
2
|
Kuang Q, Zhou S, Huang R, Zheng Y, She S. Restless arms syndrome with oral olanzapine: case based review. Heliyon 2022; 8:e12258. [PMID: 36619467 PMCID: PMC9816658 DOI: 10.1016/j.heliyon.2022.e12258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 10/21/2022] [Accepted: 12/02/2022] [Indexed: 12/23/2022] Open
Abstract
Background Restless arms syndrome (RAS) is a specific variant of restless legs syndrome (RLS). RAS is characterised by an uncomfortable, painful, burning or uneasy sensation confined to the arm. Case presentation We report a case of RAS with oral olanzapine, which improved with medication reduction. In addition, all reported cases of RAS were reviewed to explore the underlying mechanisms, diagnosis and treatment for psychiatric drug-induced RAS. The literature review and new case suggest that iron deficiency may be a predisposing factor for RAS. Psychiatric medications are closely associated with RAS, especially olanzapine, quetiapine, and mirtazapine. Discontinuation is the recommended treatment for psychotropic drug-induced RAS, while α2δ calcium channel ligand drugs and benzodiazepines may be considered. Conclusion In conclusion, psychiatrists should be alert to the possibility of RAS when administering psychiatric medications for the first time to psychiatric patients with iron deficiency.
Collapse
|
3
|
Zhou S, Huang Y, Kuang Q, Yan S, Feng Y, Li H, Wu K, Wu F, Huang X. Gender differences in associations of cognitive impairments with homocysteine in schizophrenia. Asian J Psychiatr 2022; 75:103214. [PMID: 35870313 DOI: 10.1016/j.ajp.2022.103214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/08/2022] [Accepted: 07/15/2022] [Indexed: 11/02/2022]
Affiliation(s)
- Sumiao Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuanyuan Huang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qijie Kuang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Su Yan
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yangdong Feng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hehua Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Kai Wu
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Fengchun Wu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China; Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.
| | - Xingbing Huang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
| |
Collapse
|
4
|
Zhou S, Huang Y, Kuang Q, Yan S, Li H, Wu K, Wu F, Huang X. Kynurenine pathway metabolites are associated with gray matter volume in subjects with schizophrenia. Front Psychiatry 2022; 13:941479. [PMID: 36016974 PMCID: PMC9395706 DOI: 10.3389/fpsyt.2022.941479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There has been growing evidence of the existence of abnormalities in the kynurenine pathway (KP) and structural gray matter volume (GMV) in schizophrenia (SCZ). Numerous studies have suggested that abnormal kynurenine metabolism (KM) in the brain is clearly associated with the pathogenesis of schizophrenia and may be one of the pathological mechanisms of SCZ. In this pilot study, we investigated whether there was a correlation between KP and GMV in schizophrenia patients. METHODS The plasma levels of KM were measured in 41 patients who met the Structured Clinical Interview of the Diagnostic IV criteria for schizophrenia and 60 healthy controls by using liquid chromatography-tandem mass spectrometry, and cortical thickness (as measured via magnetic resonance imaging) was obtained. RESULTS Our study showed no statistically significant differences in the concentrations of kynurenine (KYN), tryptophan (TRP), and KYNA/TRP (all p > 0.05), but kynurenic acid (KYNA) and the KYNA/KYN ratio were significantly higher in the schizophrenia subjects than in the healthy controls (F = 4.750, p = 0.032; F = 6.153, p = 0.015, respectively) after controlling for age and sex. Spearman's tests showed that KYN concentrations in SCZ patients were negatively correlated with GMV in the left front cingulate belt (r = -0.325, p = 0.046) and that KYN/TRP was negatively correlated with GMV in the left island (r = -0.396, p = 0.014) and right island (r = -0.385, p = 0.017). CONCLUSION Our findings appear to provide new insights into the predisposition of an imbalance in the relative metabolism of KYN/TRP and KYN to GMV in schizophrenia.
Collapse
Affiliation(s)
- Sumiao Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yuanyuan Huang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qijie Kuang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Su Yan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Hehua Li
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Kai Wu
- School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Fengchun Wu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.,School of Biomedical Sciences and Engineering, South China University of Technology, Guangzhou, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Xingbing Huang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
5
|
Liu Y, Bi T, Zhang B, Kuang Q, Li H, Zong K, Zhao J, Ning Y, She S, Zheng Y. Face and object visual working memory deficits in first-episode schizophrenia correlate with multiple neurocognitive performances. Gen Psychiatr 2021; 34:e100338. [PMID: 33728399 PMCID: PMC7896562 DOI: 10.1136/gpsych-2020-100338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/19/2020] [Accepted: 12/15/2020] [Indexed: 12/17/2022] Open
Abstract
Background Working memory (WM) deficit is considered a core feature and cognitive biomarker in patients with schizophrenia. Several studies have reported prominent object WM deficits in patients with schizophrenia, suggesting that visual WM in these patients extends to non-spatial domains. However, whether non-spatial WM is similarly affected remains unclear. Aim This study primarily aimed to identify the processing of visual object WM in patients with first-episode schizophrenia. Methods The study included 36 patients with first-episode schizophrenia and 35 healthy controls. Visual object WM capacity, including face and house WM capacity, was assessed by means of delayed matching-to-sample visual WM tasks, in which participants must distribute memory so that they can discriminate a target sample. We specifically examined their anhedonia experience by the Temporal Experience of Pleasure Scale and the Snaith-Hamilton Pleasure Scale. Cognitive performance was measured by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Results Both face and house WM capacity was significantly impaired in patients with schizophrenia. For both tasks, the performance of all the subjects was worse under the high-load condition than under the low-load condition. We found that WM capacity was highly positively correlated with the performance on RBANS total scores (r=−0.528, p=0.005), RBANS delayed memory scores (r=−0.470, p=0.013), RBANS attention scores (r=−0.584, p=0.001), RBANS language scores (r=−0.448, p=0.019), Trail-Making Test: Part A raw scores (r=0.465, p=0.015) and simple IQ total scores (r=−0.538, p=0.005), and correlated with scores of the vocabulary test (r=−0.490, p=0.011) and scores of the Block Diagram Test (r=−0.426, p=0.027) in schizophrenia. No significant correlations were observed between WM capacity and Positive and Negative Syndrome Scale symptoms. Conclusions Our research found that visual object WM capacity is dramatically impaired in patients with schizophrenia and is strongly correlated with other measures of cognition, suggesting a mechanism that is critical in explaining a portion of the broad cognitive deficits observed in schizophrenia.
Collapse
Affiliation(s)
- Yi Liu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Taiyong Bi
- Centre for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, Guizhou, China
| | - Bei Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.,Department of Psychology, General and Experimental Psychology, LMU Munich, Germany
| | - Qijie Kuang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Haijing Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Kunlun Zong
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Jingping Zhao
- Mental Health Institute of the Second Xiangya Hospital, Central South University; Chinese National Clinical Research Center on Mental Disorders; Chinese National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, China
| | - Yuping Ning
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shenglin She
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yingjun Zheng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| |
Collapse
|
6
|
Liu Y, Bi T, Kuang Q, Zhang B, Wu H, Li H, Zhang B, Zhao J, Ning Y, She S, Zheng Y. Cortical Pathways or Mechanism in the Face Inversion Effect in Patients with First-Episode Schizophrenia. Neuropsychiatr Dis Treat 2021; 17:1893-1906. [PMID: 34140773 PMCID: PMC8203188 DOI: 10.2147/ndt.s302584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/26/2021] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE Impaired face perception is considered as a hallmark of social disability in schizophrenia. It is widely believed that inverted faces and upright faces are processed by distinct mechanisms. Previous studies have identified that individuals with schizophrenia display poorer face processing than controls. However, the mechanisms underlying the face inversion effect (FIE) in patients with first-episode schizophrenia (FSZ) remain unclear. METHODS We designed an fMRI task to investigate the FIE mechanism in patients with schizophrenia. Thirty-four patients with FSZ and thirty-five healthy controls (CON) underwent task-related fMRI scanning, clinical assessment, anhedonia experience examination, and social function and cognitive function evaluation. RESULTS The patients with FSZ exhibited distinct functional activity regarding upright and inverted face processing within the cortical face and non-face network. These results suggest that the differences in quantitative processing might mediate the FIE in schizophrenia. Compared with controls, affected patients showed impairments in processing both upright and inverted faces; and for these patients with FSZ, upright face processing was associated with more severe and broader impairment than inverted face processing. Reduced response in the left middle occipital gyrus for upright face processing was related to poorer performance of social function outcomes evaluated using the Personal and Social Performance Scale. CONCLUSION Our data suggested that patients with FSZ exhibited similar performance in processing inverted faces and upright faces, but were less efficient than controls; and for these patients, inverted faces are processed less efficiently than upright faces. We also provided a clue that the mechanism under abnormal FIE might be related to an aberrant activation of non-face-selective areas instead of abnormal activation of face-specific areas in patients with schizophrenia. Finally, our study indicated that the neural pathway for upright recognition might be relevant in determining the functional outcomes of this devastating disorder.
Collapse
Affiliation(s)
- Yi Liu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, 510370, People's Republic of China
| | - Taiyong Bi
- Centre for Mental Health Research in School of Management, Zunyi Medical University, Zunyi, Guizhou, 563000, People's Republic of China
| | - Qijie Kuang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, 510370, People's Republic of China
| | - Bei Zhang
- General and Experimental Psychology, Department of Psychology, LMU, Munich, Germany
| | - Huawang Wu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, 510370, People's Republic of China
| | - Haijing Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, 510370, People's Republic of China
| | - Bin Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, 510370, People's Republic of China
| | - Jingping Zhao
- Mental Health Institute of the Second Xiangya Hospital, Central South University; Chinese National Clinical Research Center on Mental Disorders; Chinese National Technology Institute on Mental Disorders; Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, Hunan, 410011, People's Republic of China
| | - Yuping Ning
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, 510370, People's Republic of China
| | - Shenglin She
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, 510370, People's Republic of China
| | - Yingjun Zheng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, Guangdong, 510370, People's Republic of China
| |
Collapse
|
7
|
She S, Zhang B, Mi L, Li H, Kuang Q, Bi T, Zheng Y. Stimuli may have little impact on the deficit of visual working memory accuracy in first-episode schizophrenia. Neuropsychiatr Dis Treat 2019; 15:481-489. [PMID: 30858705 PMCID: PMC6387591 DOI: 10.2147/ndt.s188645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Working memory (WM) deficits have been observed in people with schizophrenia (SZ) and are considered a core cognitive dysfunction in these patients. However, little is known about how stimuli and memory load influence visual WM deficits. PATIENTS AND METHODS In the present study, we adopted a match-to-sample task to examine the visual WM in 18 first-episode patients with SZ and 18 healthy controls (HCs). Faces and houses were used as the stimuli, and there were two levels of memory load - one item and two items; the average accuracy (ACC) and reaction time were calculated for each condition. The Positive and Negative Syndrome Scale and the Personal and Social Performance scale were used to assess the psychiatric symptoms and social function, respectively. RESULTS The results showed equivalent levels of WM deficit when using face and house stimuli. Moreover, the WM deficits were not related to the duration of illness, medication, or SZ symptoms. CONCLUSION These results demonstrate that stimuli may have little impact on ACC in WM tasks in people with SZ. In addition, the memory load may have little impact on WM ACC when the load is relatively low.
Collapse
Affiliation(s)
- Shenglin She
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China,
| | - Bei Zhang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China,
| | - Lin Mi
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China,
| | - Haijing Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China,
| | - Qijie Kuang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China,
| | - Taiyong Bi
- School of Management, Zunyi Medical University, Guizhou 563000, China,
| | - Yingjun Zheng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China,
| |
Collapse
|
8
|
She S, Kuang Q, Zheng Y. Aripiprazole-induced tardive dyskinesia in patients with schizophrenia: A case report of twins. Schizophr Res 2018; 197:564-565. [PMID: 29128325 DOI: 10.1016/j.schres.2017.10.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Revised: 10/28/2017] [Accepted: 10/28/2017] [Indexed: 11/15/2022]
Affiliation(s)
- Shenglin She
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), No.36 Mingxin Road, Liwan District, Guangzhou 510370, China.
| | - Qijie Kuang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), No.36 Mingxin Road, Liwan District, Guangzhou 510370, China.
| | - Yingjun Zheng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), No.36 Mingxin Road, Liwan District, Guangzhou 510370, China.
| |
Collapse
|
9
|
Chu KP, Habbous S, Kuang Q, Boyd K, Mirshams M, Liu FF, Espin-Garcia O, Xu W, Goldstein D, Waldron J, O'Sullivan B, Huang SH, Liu G. Socioeconomic status, human papillomavirus, and overall survival in head and neck squamous cell carcinomas in Toronto, Canada. Cancer Epidemiol 2015; 40:102-12. [PMID: 26706365 DOI: 10.1016/j.canep.2015.11.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 11/17/2015] [Accepted: 11/21/2015] [Indexed: 01/12/2023]
Abstract
BACKGROUND Despite universal healthcare in some countries, lower socioeconomic status (SES) has been associated with worse cancer survival. The influence of SES on head and neck cancer (HNC) survival is of immense interest, since SES is associated with the risk and prognostic factors associated with this disease. PATIENTS AND METHODS Newly diagnosed HNC patients from 2003 to 2010 (n=2124) were identified at Toronto's Princess Margaret Cancer Centre. Principal component analysis was used to calculate a composite score using neighbourhood-level SES variables obtained from the 2006 Canada Census. Associations of SES with overall survival were evaluated in HNC subsets and by p16 status (surrogate for human papillomavirus). RESULTS SES score was higher for oral cavity (n=423) and p16-positive oropharyngeal cancer (OPC, n=404) patients compared with other disease sites. Lower SES was associated with worse survival [HR 1.14 (1.06-1.22), p=0.0002], larger tumor staging (p<0.001), current smoking (p<0.0001), heavier alcohol consumption (p<0.0001), and greater comorbidity (p<0.0002), but not with treatment regimen (p>0.20). After adjusting for age, sex, and stage, the lowest SES quintile was associated with the worst survival only for OPC patients [HR 1.66 (1.09-2.53), n=832], primarily in the p16-negative subset [HR 1.63 (0.96-2.79)]. The predictive ability of the prognostic models improved when smoking/alcohol was added to the model (c-index 0.71 vs. 0.69), but addition of SES did not (c-index 0.69). CONCLUSION SES was associated with survival, but this effect was lost after accounting for other factors (age, sex, TNM stage, smoking/alcohol). Lower SES was associated with greater smoking, alcohol consumption, comorbidity, and stage.
Collapse
Affiliation(s)
- K P Chu
- Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Canada
| | - S Habbous
- Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Canada
| | - Q Kuang
- Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Canada
| | - K Boyd
- Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Canada
| | - M Mirshams
- Ontario Cancer Institute, Princess Margaret Hospital, Toronto, Canada
| | - F-F Liu
- Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - O Espin-Garcia
- Department of Biostatistics, Princess Margaret Hospital, Toronto, Canada
| | - W Xu
- Department of Biostatistics, Princess Margaret Hospital, Toronto, Canada
| | - D Goldstein
- Otolaryngology-Head and Neck Surgery, University of Toronto, Canada
| | - J Waldron
- Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - B O'Sullivan
- Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - S H Huang
- Department of Radiation Oncology, University of Toronto, Ontario, Canada
| | - G Liu
- Medicine and Epidemiology, Dalla Lana School of Public Health, University of Toronto, Canada.
| |
Collapse
|