Association between anxiety, depression, and comorbid chronic diseases among cancer survivors

Yan, Rui; Xia, Juan; Yang, Renren; Lv, Binghui; Wu, Peng; Chen, Wan-Li; Zhang, Yaxuan; Lu, Xinyuan; Che, Beibei; Wang, Jiwei; Yu, Jinming

doi:10.1002/pon.5078

Cited by 44 publications

(32 citation statements)

References 42 publications

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“…A 2019 paper authored by Yan et al performed a similar analysis, but investigated depression and multimorbidity in survivors of all cancer types as opposed to a specific focus on people with breast cancer [ 26 ]. They found that cancer survivors with 1–2 chronic comorbidities had greater risk of depression and there was also an additional association between comorbidities and anxiety, with patients with 3 or more comorbidities having 3.39 times the odds of anxiety compared to those without any comorbidity [ 26 ]. This study was limited to the population of Shanghai, China.…”

Section: Discussionmentioning

confidence: 99%

Associations between multimorbidity and depression among breast cancer survivors within the UK Biobank cohort: a cross-sectional study

Foster

2021

BMC Cancer

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Background Advances in the early detection of cancer and its treatment have resulted in an increasing number of people living with and beyond breast cancer. Multimorbidity is also becoming more common in this population as more people live longer with breast cancer and experience late effects of cancer treatment. Breast cancer survivors have heightened risk of depression, but to what extent multimorbidity affects the mental health of this population is less clear. This study aims to investigate the association between multimorbidity and depression among women living with and beyond breast cancer in the UK Biobank cohort. Methods Data from UK Biobank (recruitment during 2006 to 2010, aged 40–70 years) were used to identify 8438 women with a previous diagnosis of breast cancer via linked cancer registries in England, Scotland and Wales. The lifetime number of chronic conditions was self-reported and multimorbidity defined as 0, 1, 2, 3, 4 or 5+. The Patient Health Questionnaire (PHQ-2) was used to define participants that were likely to have depression based on their symptom reporting at baseline. Logistic regression models were used to analyse the associations between multimorbidity and depression, accounting for a number of potential sociodemographic confounding variables (including age, ethnicity, socioeconomic deprivation, education level and marital status) and characteristics related to the cancer (number of years since diagnosis and recurrence/secondary cancer). Results Multimorbidity was common among breast cancer survivors, with 32.9% of women experiencing one and 30.1% experiencing two or more chronic health conditions. Hypertension (25.8%), painful conditions (18.3%), and asthma (11.6%) were the three most common co-morbid conditions. 5.3% of participants had current depression. A strong, dose-response relationship was found between multimorbidity and the likelihood of depression (OR = 2.09, 95% CI: 1.56–2.79 for two conditions and OR = 6.06, 95% CI: 3.63–10.14 for five or more conditions). Conclusions Multimorbidity and depression were strongly associated among female UK Biobank participants with a previous breast cancer diagnosis. This association became increasingly pronounced as the number of chronic comorbid conditions increased. As more people survive cancer for longer, increasing recognition and support for multimorbidity and its impact on mental health is needed.

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Section: Discussionmentioning

confidence: 99%

Associations between multimorbidity and depression among breast cancer survivors within the UK Biobank cohort: a cross-sectional study

Foster

2021

BMC Cancer

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“…Six of thirteen selected features were comorbid chronic diseases. Our previous study had shown that comorbid chronic diseases was associated with greater probability of anxiety and depression (26), which indicating that physical problem might had great in uence on CSs' psychological health, and effectively monitoring and management of CCDs should be provided for CSs to address the psychological and psychical problems. Social support was another important predictor of CAD.…”

Section: Discussionmentioning

confidence: 98%

Prediction of comorbid anxiety and depression using machine learning models in cancer survivors

Yan

Wang

Yang

et al. 2020

Preprint

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Background We aimed to investigate the prevalence and associated factors of comorbid anxiety and depression (CAD) in Chinese cancer survivors (CS), and develop novel prediction model using traditional logistic regression and machine-learning algorithms to predict CS’ CAD, which would be helpful to accurately distinguish individuals with high risk of psychological problems. Methods A cross-sectional study of 1546 CSs were conducted in Shanghai China. Self-reported structured questionnaire was used to collect information about basic socio-demographic factors, socioeconomic status, life behavior, health conditions, fatigue, social support, anxiety (Zung self-rating anxiety scale) and depression (Zung self - rating depression scale). Stepwise logistic regression and three machine learning algorithms (support vector machine, decision tree, and random forest) were used to construct the prediction model of CS’ CAD. Results 18.24% CSs reported CAD. The AUC of models to predict the high-risk CAD in the training set was best in that of RF (0.839), followed by LR (0.811), SVM (0.808), and DT (0.794). Social support and several comorbid chronic diseases were important top ranking contributing factors of CAD in all the predictive models. Conclusion CAD was a common psychological problems in cancer survivors (CSs).The machine leaning techniques and logistic regression showed similar performance to classify Chinese CSs at risk of CAD using questionnaire-based survey. Effective treatment to control the coexisting disease, more social support should be provided to CSs to improve psychological health. Psychological care was recommend to be incorporated into regular health care and management of cancer survivors.

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“…Having a chronic condition, such as diabetes, requires extensive self‐management, similar to cancer. It is possible that as the number of chronic conditions increases, patients’ risk for depression increases due to the stressors associated with disease management 48,56 . Moreover, those with multiple conditions exhibit a significant decline in physical functioning, limiting interpersonal and social activities 57 .…”

Section: Discussionmentioning

confidence: 99%

Patient–provider discussion about emotional and social needs, mental health outcomes, and benefit finding among U.S. Adults living with cancer

et al. 2021

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Background A discussion about patient's nonmedical needs during treatment is considered a crucial component of high‐quality patient–provider communication. We examined whether having a patient–provider discussion about cancer patients’ emotional and social needs is associated with their psychological well‐being. Methods Using the 2016–2017 Medical Expenditure Panel Survey‐Experiences with Cancer Survivorship Supplement (MEPS–ECSS) data, we identified the cancer survivors in the United States (US) who reported having a detailed discussion about emotional and social needs during cancer care. We used multivariable logistic regression to assess the association between having a patient–provider discussion and the patients’ psychological well‐being outcomes (depressive symptoms, severe psychological distress, and worrying about cancer recurrence/worsening condition) and benefit finding experience after a cancer diagnosis. Results Among 1433 respondents (equivalent to 13.8 million cancer survivors in the US), only 33.6% reported having a detailed patient–provider discussion about their emotional and social needs. Having a discussion was associated with 55% lower odds (odds ratio [OR], 0.45; 95% confidence interval [CI], 0.26–0.77) of having depressive symptoms and 97% higher odds (OR, 1.97; 95% CI, 1.46–2.66) of having benefit finding experience. There was no statistically significant association between patient–provider discussion and psychological distress or worrying about cancer recurrence/worsening. Conclusion Detailed patient–provider discussion about the cancer patients’ emotional and social needs was associated with a lower likelihood of depressive symptoms and a higher likelihood of experiencing benefit finding. These findings stress the importance of improving the patient–provider discussion about psychosocial needs in cancer survivorship.

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Association between anxiety, depression, and comorbid chronic diseases among cancer survivors

Cited by 44 publications

References 42 publications

Associations between multimorbidity and depression among breast cancer survivors within the UK Biobank cohort: a cross-sectional study

Associations between multimorbidity and depression among breast cancer survivors within the UK Biobank cohort: a cross-sectional study

Prediction of comorbid anxiety and depression using machine learning models in cancer survivors

Patient–provider discussion about emotional and social needs, mental health outcomes, and benefit finding among U.S. Adults living with cancer

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