Prodromal depression and anxiety are associated with worse treatment compliance and survival among patients with pancreatic cancer

Abstract

Objective To determine the frequency of depression or anxiety preceding a diagnosis of pancreatic cancer (PC). Further, to examine the association of PC‐associated depression or anxiety with treatment compliance and survival. Methods 856 patients with PC from a single institution were identified using International Classification of Diseases (ICD) codes. For each case, two non‐cancer age‐ and sex‐matched controls were included. Dates of depression or anxiety diagnosis identified using ICD codes were compared to the date of PC diagnosis. The medical record was queried to further explore psychiatric symptoms. Multivariable analyses were performed to examine if prediagnosis depression or anxiety was associated with receipt of treatment or survival. Results A greater proportion of patients with PC experienced depression or anxiety in the year preceding diagnosis than the overall frequency in controls (4.6% vs. 2.6%, p = 0.005) based on ICD codes. Patients with PC exhibited signs of prodromal depression or anxiety based on ICD codes, clinical documentation of psychiatric symptoms, or initiation of new psychiatric medications more often than controls (20.7% vs. 6.7%, p < 0.001). Prediagnosis depression or anxiety was associated with a reduced likelihood of receiving chemotherapy (OR = 0.58, p = 0.04). There was an associated decrease in overall survival among patients with metastatic disease who experienced depression or anxiety before PC diagnosis (HR = 1.32, p = 0.04). Conclusions The frequency of depression or anxiety among patients with PC was higher than the general population. Prediagnosis psychiatric symptoms were associated with reduced chemotherapy utilization and worse overall survival. Thus, timely identification and treatment of these symptoms may improve outcomes.

A long waiting time from diagnosis to treatment decreases the survival of non-small cell lung cancer patients with stage IA1: A retrospective study

“…Besides, the psychological burden negatively The survival curves based on waiting time within one month for overall survival (A) and cancer-specific survival (B), or waiting time within two months for overall survival (C) and cancer-specific survival (D). influenced survival quality and prognosis in patients with malignant tumors (27,28). Our findings showed that the waiting time ≥3 months had a significant negative effect on CSS and OS for stage IA1 NSCLC patients after adjusting for other confounders, and the waiting time ≥2 months only influenced OS rates.…”

“…Previous studies confirmed that greater psychological distress was associated with slower time to treatment in oncological patients ( 25 , 26 ). Besides, the psychological burden negatively influenced survival quality and prognosis in patients with malignant tumors ( 27 , 28 ). Our findings showed that the waiting time ≥3 months had a significant negative effect on CSS and OS for stage IA1 NSCLC patients after adjusting for other confounders, and the waiting time ≥2 months only influenced OS rates.…”

Profile of the Postoperative Care Provided for Patients With Pancreatic and Periampullary Cancers by Family and Unpaid Caregivers

“…9,31 The prevalence of patient depression and anxiety was associated with nonreceipt of chemotherapy treatment and poorer overall survival. 32 It is likely that patients' caregivers also experience similar impairment to their well-being in the preoperative setting. Future studies should include caregiver assessment at the time of preoperative evaluation as another important time to provide initial support.…”

Health‐related quality of life and survival outcomes for patients with major depressive disorder and anxiety: A longitudinal study in pancreatic ductal adenocarcinoma

“…A PHQ-9 total score ≥5 indicated MDD, while a GAD-7 total score ≥5 indicated anxiety. The severity of MDD was graded as Grade I (5-9), Grade II (10)(11)(12)(13)(14), Grade III (15)(16)(17)(18)(19), and Grade IV (20)(21)(22)(23)(24)(25)(26)(27). Anxiety severity was graded as Grade I (5-9), Grade II (10)(11)(12)(13)(14), and Grade III (15)(16)(17)(18)(19)(20)(21).…”