Major Depression and Survival in People With Cancer.
Journal
Psychosomatic medicine
ISSN: 1534-7796
Titre abrégé: Psychosom Med
Pays: United States
ID NLM: 0376505
Informations de publication
Date de publication:
01 06 2021
01 06 2021
Historique:
pubmed:
4
5
2021
medline:
21
10
2021
entrez:
3
5
2021
Statut:
ppublish
Résumé
The question of whether depression is associated with worse survival in people with cancer remains unanswered because of methodological criticism of the published research on the topic. We aimed to study the association in a large methodologically robust study. We analyzed data on 20,582 patients with breast, colorectal, gynecological, lung, and prostate cancers who had attended cancer outpatient clinics in Scotland, United Kingdom. Patients had completed two-stage screening for major depression as part of their cancer care. These data on depression status were linked to demographic, cancer, and subsequent mortality data from national databases. We estimated the association of major depression with survival for each cancer using Cox regression. We adjusted for potential confounders and interactions between potentially time-varying confounders and the interval between cancer diagnosis and depression screening, and used multiple imputation for missing depression and confounder data. We pooled the cancer-specific results using fixed-effects meta-analysis. Major depression was associated with worse survival for all cancers, with similar adjusted hazard ratios (HRs): breast cancer (HR = 1.42, 95% confidence interval [CI] = 1.15-1.75), colorectal cancer (HR = 1.47, 95% CI = 1.11-1.94), gynecological cancer (HR = 1.36, 95% CI = 1.08-1.71), lung cancer (HR = 1.39, 95% CI = 1.24-1.56), and prostate cancer (HR = 1.76, 95% CI = 1.08-2.85). The pooled HR was 1.41 (95% CI = 1.29-1.54, p < .001, I2 = 0%). These findings were not materially different when we only considered the deaths (90%) that were attributed to cancer. Major depression is associated with worse survival in patients with common cancers. The mechanisms of this association and the clinical implications require further study.
Identifiants
pubmed: 33938501
doi: 10.1097/PSY.0000000000000942
pii: 00006842-202106000-00003
pmc: PMC7614901
mid: EMS181443
doi:
Types de publication
Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
410-416Subventions
Organisme : Medical Research Council
ID : MC_UU_00004/07
Pays : United Kingdom
Organisme : Cancer Research UK
ID : C5547/A7375
Pays : United Kingdom
Informations de copyright
Copyright © 2021 by the American Psychosomatic Society.
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