The Difficult Task of Diagnosing Depression in Elderly People with Cancer: A Systematic Review.

Anticancer treatments Cancer Death risk Depression Elderly Quality of life Suicide

Journal

Clinical practice and epidemiology in mental health : CP & EMH
ISSN: 1745-0179
Titre abrégé: Clin Pract Epidemiol Ment Health
Pays: United Arab Emirates
ID NLM: 101245735

Informations de publication

Date de publication:
2021
Historique:
received: 18 02 2021
revised: 08 09 2021
accepted: 17 11 2021
entrez: 21 4 2022
pubmed: 22 4 2022
medline: 22 4 2022
Statut: epublish

Résumé

Depression is a common psychiatric problem in the elderly and oncology patients. In elderly people with cancer, depression has a peculiar phenomenology. It has a significant impact on the quality of life. Moreover, it is associated with poor adherence to treatments, increased risk of suicide, and mortality. Nevertheless, the topic of depression in elderly people with cancer remains unexplored. The main goal of this article is to review the literature from the past 20 years on the relationships between depression, cancer, and aging. The methods followed the Prisma model for eligibility of studies. The articles in which the keywords "depression", "cancer", " elderly, aging, or geriatric" were present, either in the text or in the abstract, were selected. 8.056 articles, by matching the keywords "depression and elderly and cancer," were identified. Only 532 papers met the eligibility criteria of search limits and selection process. Out of 532 papers, 467 were considered irrelevant, leaving 65 relevant studies. Out of 65 suitable studies, 39 (60.0%) met our quality criteria and were included. The risk factors associated with depression in elderly people with cancer can be divided into 4 groups: 1) tumor-related; 2) anticancer treatment-related; 3) patients-related; 4) number and type of comorbidity. The main obstacles in diagnosing depression in elderly patients with cancer are the overlap of the symptoms of cancer and side effects of treatment with the symptoms of depression but also the different ways of reporting depressive symptoms of elderly people and the different clinical types of depression. There is a lack of data regarding validated scales to assess depression in geriatric patients with cancer. Any mental illness, specifically co-occurring anxiety and depression, increases the risk of diagnosis delay and anticancer treatment adherence. Cancer and the diagnosis of mental disorders prior to cancer diagnosis correlate with an increased risk for suicide. A non-pharmacological therapeutic approach, pharmacological treatment and/or a combination of both can be used to treat elderly patients with cancer, but a detailed analysis of comorbidities and the assessment of polypharmacy is mandatory in order to avoid potential side-effects and interactions between antidepressants and the other drugs taken by the patients. Future research should be conducted with the aim of developing a modified and adapted assessment method for the diagnosis and treatment of depression in elderly people with cancer in order to improve their clinical outcomes and quality of life.

Sections du résumé

Background UNASSIGNED
Depression is a common psychiatric problem in the elderly and oncology patients. In elderly people with cancer, depression has a peculiar phenomenology. It has a significant impact on the quality of life. Moreover, it is associated with poor adherence to treatments, increased risk of suicide, and mortality. Nevertheless, the topic of depression in elderly people with cancer remains unexplored.
Objective UNASSIGNED
The main goal of this article is to review the literature from the past 20 years on the relationships between depression, cancer, and aging.
Methods UNASSIGNED
The methods followed the Prisma model for eligibility of studies. The articles in which the keywords "depression", "cancer", " elderly, aging, or geriatric" were present, either in the text or in the abstract, were selected. 8.056 articles, by matching the keywords "depression and elderly and cancer," were identified. Only 532 papers met the eligibility criteria of search limits and selection process. Out of 532 papers, 467 were considered irrelevant, leaving 65 relevant studies. Out of 65 suitable studies, 39 (60.0%) met our quality criteria and were included.
Results UNASSIGNED
The risk factors associated with depression in elderly people with cancer can be divided into 4 groups: 1) tumor-related; 2) anticancer treatment-related; 3) patients-related; 4) number and type of comorbidity. The main obstacles in diagnosing depression in elderly patients with cancer are the overlap of the symptoms of cancer and side effects of treatment with the symptoms of depression but also the different ways of reporting depressive symptoms of elderly people and the different clinical types of depression. There is a lack of data regarding validated scales to assess depression in geriatric patients with cancer. Any mental illness, specifically co-occurring anxiety and depression, increases the risk of diagnosis delay and anticancer treatment adherence. Cancer and the diagnosis of mental disorders prior to cancer diagnosis correlate with an increased risk for suicide. A non-pharmacological therapeutic approach, pharmacological treatment and/or a combination of both can be used to treat elderly patients with cancer, but a detailed analysis of comorbidities and the assessment of polypharmacy is mandatory in order to avoid potential side-effects and interactions between antidepressants and the other drugs taken by the patients.
Conclusion UNASSIGNED
Future research should be conducted with the aim of developing a modified and adapted assessment method for the diagnosis and treatment of depression in elderly people with cancer in order to improve their clinical outcomes and quality of life.

Identifiants

pubmed: 35444712
doi: 10.2174/1745017902117010295
pii: CPEMH-17-295
pmc: PMC8985471
doi:

Types de publication

Systematic Review

Langues

eng

Pagination

295-306

Informations de copyright

© 2021 Massa et al.

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Auteurs

Elena Massa (E)

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Clelia Donisi (C)

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Nicole Liscia (N)

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Clelia Madeddu (C)

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Valentino Impera (V)

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Stefano Mariani (S)

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Mario Scartozzi (M)

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Eleonora Lai (E)

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Classifications MeSH