Depressive reactions to lung cancer are common and often followed by a poor outcome

Abstract

In diverse human malignancies, including lung cancer, quality of life (QOL) affects the clinical outcome of patients. Many QOL dimensions, however, are influenced by physical status. The current study was undertaken to delineate the role of depression, a state of mind not necessarily influenced by somatic factors. All patients, seen for a newly diagnosed carcinoma of the lung, received a copy of the Self-rating Depression Scale (SDS) proposed by W.W.K. Zung. One hundred and thirty three patients were able and willing to complete the questionnaire. A depression index was calculated, as originally described. Nineteen other prognostically important variables were recorded and available for evaluation. Among the 95 patients who completed all 20 items included in the questionnaire, 53 had an SDS index < or = 50 (no depression), while 42 were moderately or severely depressed (SDS index >50). The survival of depressed patients was significantly lower (p=0.048). Diverse SDS subscales were associated with survival, in either univariate or multivariate analysis. SDS item 19, "I feel that others would be better off if I were dead", emerged as the most significant one. A multivariate model of survival, constructed using only SDS data, had a global Chi-squared value of 29.78, and a p-value of 0.00023. Based on this evidence, it appears that a relationship does exist between patients' depression and prognosis, at least in lung cancer. Further studies are needed to clarify the prognostic effect of depression in more specific (and homogeneous) subgroups of patients.

The lung cancer patient, the pneumologist and palliative care: a developing alliance

“…While in the study by AKECHI et al [78] in 122 consecutive advanced NSCLC patients no significant correlations between psychological distress variables and survival were seen, ARRIETA et al [79] proved in a prospective design that depression is a negative predictor of treatment adherence (in 82 NSCLC stage IIIB/IV patients; p=0.004). In the study by ARRIETA et al [79], depression was also correlated with poorer survival, which was in concordance with two other trials [80,81]. Conversely, an active coping style seemed to positively influence survival in a study with 103 lung cancer patients [82].…”

Suppression of negative affect in cancer patients. Trauma and defensiveness of self-esteem as predictors of depression and anxiety

“…This "bodymind" discrepancy is probably due to the denial of the negative affect, as too difficult to adapt to (or accept). The physiological indications are consistent with therapists' observation of excessive, difficult to control responses of cancer sufferers to fearful events, as well as with data showing that 30-40% of patients suffering from cancer simultaneously suffer depression and anxiety disorders (Bucceri, 1998;Jehn et al, 2006;Stommel, Given, & Given, 2002). The concept of "cancer proneness," "cancerous personality" or "personality susceptible to immunosuppression" assumes the tendency to repress emotional reactions to difficult life events (Dattore et al, 1980;Eysenc, 1985;Watson, Pettingale, & Greer, 1984).…”

Depression and survival in patients with non‐small cell lung cancer after curative resection: a preliminary study

“…(22)(23)(24) The majority of these studies had some methodological limitations, including the failure to control sufficiently for potential confounding variables such as comorbidity, respiratory function, smoking status and social support; (15,(22)(23)(24) the use of a selfreported questionnaire on depression and the absence of a structured clinical interview in some of these studies were further limitations. (15,22,24) To further examine the association between depression and survival in patients with lung cancer, we conducted a prospective cohort study in Japan. This study assessed depression using both a structured clinical interview and a selfreported questionnaire at 3 months after complete resection, and focused on patients with NSCLC.…”