Global prevalence of depression and anxiety in patients with hepatocellular carcinoma: Systematic review and meta-analysis

Abstract

Background:Depression and anxiety are associated with poorer outcomes in patients with hepatocellular carcinoma (HCC). However, the prevalence of depression and anxiety in HCC are unclear. We aimed to establish the prevalence of depression and anxiety in patients with HCC. Methods:MEDLINE and Embase were searched and original articles reporting prevalence of anxiety or depression in patients with HCC were included. A generalized linear mixed model with Clopper-Pearson intervals was used to obtain the pooled prevalence of depression and anxiety in patients with HCC. Risk factors were analyzed via a fractional-logistic regression model. Results:17 articles involving 64,247 patients with HCC were included. The pooled prevalence of depression and anxiety in patients with HCC was 24.04% (CI 13.99-38.11%) and 22.20% (CI 10.07-42.09) respectively. Subgroup analysis determined that the prevalence of depression was lowest in studies where depression was diagnosed via clinician-administered scales (16.07%, CI 4.42-44.20%) and highest in self-reported scales (30.03%, CI 17.19-47.01%). Depression in patients with HCC was lowest in the Americas (16.44%, CI 6.37-36.27%) and highest in South-East Asia (66.67%, CI 56.68-75.35%). Alcohol consumption, cirrhosis, and college education significantly increased risk of depression in patients with HCC. The prevalence of anxiety in HCC was 22.20% (CI 10.07-42.09). Conclusion:One in four patients with HCC have depression, while one in five have anxiety. Further studies are required to validate these findings, as seen from the wide confidence intervals in certain subgroup analyses. Screening strategies for depression and anxiety should also be developed for patients with HCC.

Barriers to palliative care in hepatocellular carcinoma: A review of the literature

“…18,19 A recent and extensive meta-analysis by Tan et al found that in 64 247 patients with HCC, one in four suffered from depression, while one in five suffered from anxiety. 20 In line with this, individuals with HCC suffer the third highest reported levels of psychological stress among people with the 14 leading cancers. 21 Despite this, the severe physical and psychosocial burden of liver disease is not addressed for patients with liver disease until late in the treatment course, near the terminal stage.…”

“…When combined with HCC and its long and protracted treatment journey, patients with this typical dual presentation are subject to severe physical and psychological burden 18,19 . A recent and extensive meta‐analysis by Tan et al found that in 64 247 patients with HCC, one in four suffered from depression, while one in five suffered from anxiety 20 . In line with this, individuals with HCC suffer the third highest reported levels of psychological stress among people with the 14 leading cancers 21 .…”

Combined Administration of Escitalopram Oxalate and Nivolumab Exhibits Synergistic Growth-Inhibitory Effects on Liver Cancer Cells through Inducing Apoptosis

“…Notably, depression and anxiety are common in liver cancer patients, with a frequency about 25% and 20%, respectively [ 43 , 44 ]. These psychological illnesses and related symptoms have been reported to be associated with worse survival outcomes and quality of life for liver cancer patients and their family [ 45 , 46 ].…”

Correspondence on Letter 1 regarding “Assessing the performance of ChatGPT in answering questions regarding cirrhosis and hepatocellular carcinoma”

“…2 The nature of the disease requires patients to adhere to specific lifestyle changes and treatment protocols. Regular monitoring and timely intervention are essential in managing cirrhosis and HCC, as well as providing emotional support, 3 which often requires a comprehensive understanding of the disease by patients. In light of this, an artificial intelligence (AI) model like GPT-4 can play a pivotal role in patient education, rendering detailed and accurate information on basic knowl-edge and disease management.…”

“…The nature of the disease requires patients to adhere to specific lifestyle changes and treatment protocols. Regular monitoring and timely intervention are essential in managing cirrhosis and HCC, as well as providing emotional support [ 3 ]. which often requires a comprehensive understanding of the disease by patients.…”