Depression and anxiety in older adults with cancer: Systematic review and meta-summary of risk, protective and exacerbating factors

Lee, Ainsley Ryan Yan Bin; Leong, Ivan; Lau, Grace; Tan, Amanda Weiling; Ho, Roger; Ho, Cyrus S.H.; Chen, Matthew

doi:10.1016/j.genhosppsych.2023.01.008

Cited by 33 publications

(6 citation statements)

References 84 publications

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“…A healthy family environment was consistently found to be a strong and significant protective factor against depressive and anxiety symptoms. The importance of a positive environment and interactions following the period of trauma were similarly highlighted in previous studies to be significant contributors to post-traumatic growth and positive psychological prognosis [44,[49][50][51]. Psycho-oncological interventions may also seek to capitalise on modifiable exacerbating and protective factors, as highlighted in this review.…”

Section: Discussionmentioning

confidence: 52%

Severity and Longitudinal Course of Depression, Anxiety and Post-Traumatic Stress in Paediatric and Young Adult Cancer Patients: A Systematic Review and Meta-Analysis

Lee

Yau

Low

et al. 2023

JCM

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Background: A diagnosis of cancer and treatment may constitute a highly traumatic period for paediatric cancer patients (PYACPs). However, no review has comprehensively analysed how the mental health of PYACPs is acutely affected and the longitudinal course. Methods: This systematic review followed PRISMA guidelines. Comprehensive searches of databases were conducted to identify studies of depression, anxiety and post-traumatic stress symptoms in PYACPs. Random effects meta-analyses were used for the primary analysis. Results: From 4898 records, 13 studies were included. Acutely after diagnosis, depressive and anxiety symptoms were significantly elevated in PYACPs. Depressive symptoms only significantly decreased after 12 months (standardised mean difference, SMD = −0.88; 95% CI: −0.92, −0.84). This downward trajectory persisted to 18 months (SMD = −1.862; 95% CI: −1.29, −1.09). Anxiety symptoms similarly only decreased after 12 (SMD = −0.34; 95% CI: −0.42, −0.27) up to 18 months (SMD = −0.49; 95% CI: −0.60, −0.39) after the cancer diagnosis. Post-traumatic stress symptoms showed protracted elevations throughout follow-up. Overall, significant predictors of poorer psychological outcomes included unhealthy family functioning, concomitant depression or anxiety, poor cancer prognosis or experiencing cancer and treatment-related side effects. Conclusions: While depression and anxiety may improve over time with a favourable environment, post-traumatic stress may have a protracted course. Timely identification and psycho-oncological intervention are critical.

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Section: Discussionmentioning

confidence: 52%

Severity and Longitudinal Course of Depression, Anxiety and Post-Traumatic Stress in Paediatric and Young Adult Cancer Patients: A Systematic Review and Meta-Analysis

Lee

Yau

Low

et al. 2023

JCM

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“…The gap in the health care service experienced by patients living with cancer seems evident and could be attributed to the lack of social and mental health support. A recent systematic review of 33 studies has highlighted the lack of social support, among others, as an exacerbating factor within the social construct for developing depression and anxiety among older patients living with cancer [ 9 ]. Such mental health symptoms, particularly depression, are linked to increased risk of mortality among people living with cancer due to psychosocial reasons such as reduced adherence to therapy and appointments; thus, the accessibility to cancer control activities and mental health support can control cancer incidence, morbidity, and mortality rates [ 1 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Cancer survivors often report depression and anxiety symptoms, including the fear of the recurrence of cancer, low emotional support, social isolation, and feeling lonely or abandoned after the intensive support during the phase of the treatment [ 4 , 7 - 9 ]. Depression and anxiety symptoms negatively impact the health of cancer survivors and caregivers by eroding quality of life, decreasing treatment compliance, and increasing the risk of morbidity and mortality [ 4 , 8 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Cancer Care Supportive Text Messaging Program (Text4Hope) for People Living With Cancer and Their Caregivers During the COVID-19 Pandemic: Longitudinal Observational Study

Shalaby,

Vuong,

Agyapong

et al. 2024

JMIR Form Res

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Background Cancer is the leading cause of death in Canada, and living with cancer generates psychological demands, including depression and anxiety among cancer survivors and caregivers. Text4Hope-Cancer Care SMS text messaging–based service was provided to people with cancer and caregivers during the COVID-19 pandemic to support their mental health. Objective The aim of this study is to examine the clinical effectiveness of and satisfaction with Text4Hope-Cancer Care in addressing mental health conditions among people living with cancer and caregivers. Methods The study was conducted in Alberta, Canada. People who were diagnosed or receiving cancer treatment and caregivers self-subscribed to receive 3-months daily supportive cognitive behavioral therapy–based SMS text messages and a web-based survey was sent at designated time points to collect clinical and nonclinical data. The Hospital Anxiety and Depression scale (HADS) was used to examine changes in anxiety and depression symptoms after receiving the service. Satisfaction with the service was assessed using a survey with a Likert scale. Descriptive and inferential statistics were used, and test significance was considered with P≤.05. Results Overall, 107 individuals subscribed to the service, and 93 completed the program (completion rate 93/107, 86.9%). A significant improvement in the anxiety symptoms (HADS-Anxiety [HADS-A] subscale) was reported after 3 months of Text4Hope-Cancer Care (t11=2.62; P=.02), with medium effect size (Hedges g=0.7), but not depression symptoms (HADS-Depression [HADS-D] subscale). Subscribers expressed high satisfaction and agreed that the service has helped them to cope with mental health symptoms and improve their quality of life. Most subscribers read the SMS text messages more than once (30/30, 100%); took time to reflect or took a beneficial action after reading the messages (27/30, 90%); and highly agreed (27/30, >80%) with the value of the received supportive SMS text messages as being relevant, succinct, affirmative, and positive. All subscribers recommended SMS text messaging for stress, anxiety, and depression and for cancer care support (30/30, 100%). Conclusions Text4Hope-Cancer Care was well-perceived and effectively addressed anxiety symptoms among people living with cancer and caregivers during the peak of the COVID-19 pandemic. This study provides evidence-based support and insight for policy and stakeholders to implement similar convenient, economic, and accessible mental health services that support vulnerable populations during crises. International Registered Report Identifier (IRRID) RR2-10.2196/20240

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“…40,63 This review identified the associations between better mental health of CYACs and a positive social environment, strong social support, and higher levels of education and income, which was consistent with literature of older patients with cancer. 72,73 Crucial risk factors pertaining to specific populations particularly vulnerable to developing psychiatric comorbidity were identified. These findings may guide active and passive surveillance strategies for vulnerable subgroups of cancer survivors.…”

Section: Discussionmentioning

confidence: 99%

Lifetime Burden of Psychological Symptoms, Disorders, and Suicide Due to Cancer in Childhood, Adolescent, and Young Adult Years

et al. 2023

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ImportanceA cancer diagnosis and treatment may result in highly traumatic periods with lasting psychological consequences for children, adolescent, and young adult patients with cancer (CYACs). Early identification and management may prevent long-term psychological morbidity and suicide.ObjectiveTo analyze risk, severity, and risk factors for depression, anxiety, psychotic disorders, and suicide in CYACs and noncancer comparators.Data SourcesLiterature search of PubMed, MEDLINE, Embase, PsycINFO, CINAHL, and PubMed Central from January 1, 2000, to November 18, 2022.Study SelectionFull-length articles in peer-reviewed journals that measured and reported risk and/or severity of depression, anxiety, psychotic disorders, and suicide mortality in CYACs and a noncancer comparator group.Data Extraction and SynthesisPreferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines were followed with prospective PROSPERO registration.Main Outcomes and MeasuresRisk ratios (RRs) were used for dichotomous outcomes, and standardized mean differences (SMDs) were used for continuous outcomes. SMDs were defined as follows: 0.2, small; 0.5, medium; and 0.8, large. Sources of heterogeneity and risk factors were investigated using sensitivity, subgroup, and meta-regression analyses.ResultsFrom 7319 records, 52 studies were included. Meta-analyses revealed that CYACs were at increased lifetime risk of severe symptoms or a disorder of depression (RR, 1.57; 95% CI, 1.29-1.92), anxiety (RR, 1.29; 95% CI, 1.14-1.47), and psychotic disorders (RR, 1.56; 95% CI, 1.36-1.80) relative to both matched controls and their siblings. Overall suicide mortality was not significantly elevated (RR, 1.63; 95% CI, 0.78-3.40). The mean severity of depression was found to be elevated in CYACs receiving treatment (SMD, 0.44; 95% CI, 0.13-0.74) and long-term survivors (SMD, 0.18; 95% CI, 0.02-0.33). The mean severity of anxiety was found to be elevated only during treatment (SMD, 0.16; 95% CI, 0.03-0.20).Conclusions and RelevanceFindings of this systematic review and meta-analysis suggest that CYACs may experience lasting psychological burden long into survivorship. Timely identification, preventive efforts, and psycho-oncological intervention for psychological comorbidity are recommended.

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Depression and anxiety in older adults with cancer: Systematic review and meta-summary of risk, protective and exacerbating factors

Cited by 33 publications

References 84 publications

Severity and Longitudinal Course of Depression, Anxiety and Post-Traumatic Stress in Paediatric and Young Adult Cancer Patients: A Systematic Review and Meta-Analysis

Severity and Longitudinal Course of Depression, Anxiety and Post-Traumatic Stress in Paediatric and Young Adult Cancer Patients: A Systematic Review and Meta-Analysis

Cancer Care Supportive Text Messaging Program (Text4Hope) for People Living With Cancer and Their Caregivers During the COVID-19 Pandemic: Longitudinal Observational Study

Lifetime Burden of Psychological Symptoms, Disorders, and Suicide Due to Cancer in Childhood, Adolescent, and Young Adult Years

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