Major depressive disorder and associated factors in elderly patients with non-Hodgkin’s lymphoma

Abstract

Background: Data regarding elderly patients with cancer, more particularly with non-Hodgkin's lymphomas (NHL), are scarce, as is our knowledge concerning to comorbid depression in this population. The purpose of this work was to explore the frequency of major depressive disorder (MDD) and related factors in a group of elderly patients with these forms of cancer. Method: 42 elderly NHL patients aged 70 years and older were interviewed using the Mini International Neuropsychiatric Interview screening tool. Psychological variables such as coping strategies, cognitive status and quality of relationships, as well as clinical and socio-demographic data were collected. Results: Fourteen patients (33.3%) met criteria for current MDD of which five had melancholy features (35.7%). Elderly patients with comorbid NHL-MDD had a significantly poorer self-perceived global health and performance status than those without MDD, as well as more fatigue and history of depression. No other clinical, psychological or socio-demographic variable appeared associated with MDD in this sample. Conclusion: Further studies are needed in order to confirm these early results concerning a potential high frequency of MDD among elderly NHL patients. Depressive mood should be early recognized in order to provide appropriate treatments and avoid a detrimental effect of depression on cancer prognosis.

Towards a Better Understanding of the Factors Associated with Distress in Elderly Cancer Patients: A Systematic Review

“…The sample size of the different studies ranged between 42 [ 26 ] and 53,821 [ 27 ] (M = 3904; MD = 252.5; SD = 12,079) (see Table 1 ). This wide range in sample sizes among the different studies is due to the way in which the samples were obtained.…”

“…The type of cancer present in each sample was highly variable, with some studies selecting people with a specific diagnosis: hematological [ 28 ], gynecologic [ 30 ], non-Hodgkin´s lymphoma [ 26 ], colorectal [ 41 ], gastrointinal [ 45 ], and bladder [ 46 ]; and others including any type of cancer [ 27 , 29 , 32 , 33 , 34 , 37 , 38 , 39 , 40 , 42 , 43 , 44 ]. Despite this variability, breast/gynecological, gastrointestinal, and colorectal cancers were the most represented, with 20.9%, 17.7% and 16.4%, respectively.…”

“…Another variability present in the samples from different studies concerned the phase of the oncological disease in which participants were at the time of data collection. In most studies, participants were in the active phase of the disease and/or in treatment [ 26 , 27 , 29 , 32 , 33 , 34 , 35 , 39 , 40 , 43 , 44 , 45 ]. However, some studies included individuals who were diagnosed up to 5 years prior [ 28 ], while others included individuals diagnosed 5 years or more prior [ 36 , 38 ].…”

“…Regarding the measures used for depression, six studies used the geriatric depression scale (GDS) or a reduced version of it [ 32 , 34 , 37 , 43 , 44 , 45 ], three used the Veterans RAND 12-item Health Survey (VR-12) [ 30 , 41 , 46 ], three used the Hospital Anxiety and Depression Scale (HADS) [ 29 , 35 , 39 ] and two used the Center for Epidemiological Studies Depression Scale (CES-D) [ 36 , 38 ]. The Patient Health Questionnaire-9 (PHQ-9) [ 28 ], Mini International Neuropsychiatric Interview (MINI) [ 26 ] and Edmonton Symptom Assessment System Revised (ESAS-r) [ 42 ] were three other measures used to assess depression. In another study, the diagnosis of depression was identified through the codes of the International Statistical Classification of Diseases—Ninth Edition presents in the SEER database [ 27 ].…”

“…As for clinical variables related to health in general, limited/deficient mobility, limited activity, functional difficulties, deficiencies in Activities of Daily Living (ADL) and poor performance were different but closely related terms used by the authors [ 26 , 28 , 30 , 32 , 34 , 36 , 37 , 38 , 40 , 41 , 42 , 43 , 46 ]. Limited mobility and the need for care were associated in hematological cancer patients with depression [ 28 ].…”