Socioeconomic disparities of depressive symptoms and cytokines in hepatocellular carcinoma

Abstract

Objective To examine the associations among socioeconomic factors, depressive symptoms, and cytokines in patients diagnosed with hepatocellular carcinoma (HCC). Methods A total of 266 patients diagnosed with HCC were administered a battery of questionnaires including a sociodemographic questionnaire and the Center for Epidemiologic StudiesDepression (CES‐D) scale. Blood samples were collected to assess serum levels of cytokines using Luminex. Descriptive statistics, Mann‐Whitney U, Kruskal‐Wallis, linear regression, and Bonferroni corrections were performed to test the hypotheses. Results Of the 266 patients, 24% reported depressive symptoms in the clinical range (CES‐D ≥ 22). Females had higher CES‐D score than males (Mann‐Whitney U = 7135, P = .014, Padj = .028). Being unemployed/disabled (Kruskal‐Wallis = 14.732, P = .001, Padj = .005) was found to be associated with higher depressive symptoms in males but not in females. Serum level of IL‐2 (Kruskal‐Wallis = 17.261, P = .001, Padj = .005) were found to be negatively associated with education level. Gender (β = .177, P = .035), income (β = −.252, P = .004), whether the patient's income met their basic needs (β = .180, P = .035), and IL‐1β (β = −.165, P = .045) independently predicted depressive symptoms and together explained 19.4% of variance associated with depressive symptoms. Conclusions Sociodemographic and socioeconomic factors were predictive of inflammation and depressive symptoms. Recommendations include the development of gender‐targeted interventions for patients diagnosed with HCC who have low socioeconomic status (SES) and may suffer from depressive symptoms.

Psychological Burden and Psycho-Oncological Interventions for Patients With Hepatobiliary Cancers–A Systematic Review

“… Studies assessing the prevalence of depressiveness and anxiety in patients with hepatocellular carcinoma. Data for depressiveness ( n = 799 patients) are based on Mikoshiba et al (2013) , Cheng et al (2019) , Jia et al (2019) , and Wang et al (2019) , for anxiety ( n = 515 patients) on Liu et al (2017) , Jia et al (2019) , and Wang et al (2019) . …”

“…From the study data presented so far two things become apparent: Firstly, patients suffering from hepatobiliary cancers often experience a considerable amount of psychological distress. About a quarter of the patients suffer from depressive symptoms ( Mikoshiba et al, 2013 ; Cheng et al, 2019 ; Jia et al, 2019 ; Wang et al, 2019 ); For depression, risk factors were lower level of social status ( Cheng et al, 2019 ), less social support, low quality of sleep, more pain and higher degree of liver cirrhosis or an impairment of liver function ( Cheng et al, 2019 ). Furthermore, female sex, older age, the occurrence of metastases and hepatitis C were identified as risk factors ( Chang et al, 2015 ).…”

“…In two cases the psychometric tools used were the Center for Epidemiologic Studies Depression Scale (CES-D), once the Hamilton depression scale (HAMD 17) and once the Hospital Anxiety and Depression Scale (HADS). As shown in Figure 2, the average (median) prevalence of depressive symptoms in 799 patients with hepatocellular cancer examined was 27.8% (Mikoshiba et al, 2013;Cheng et al, 2019;Jia et al, 2019;Wang et al, 2019). Risk factors for the occurrence of depressive symptoms were lower level of income (Cheng et al, 2019), lower educational level, lower level of social support, low quality of sleep, more pain and higher degree of liver cirrhosis or the impairment of liver function (Jia et al, 2019).…”

Association between socioeconomic status and survival in patients with hepatocellular carcinoma

“…It is because there are some connections between different factors, which might impact the results of prognosis. Previous studies had reported that age, race, sex, marital status, insurance, income, residence, and education level might influence the prognosis of cancer patients 10,26–30 . Based on this, our study included two more factors, COLI and poverty.…”

“…Previous studies had reported that age, race, sex, marital status, insurance, income, residence, and education level might influence the prognosis of cancer patients. 10 , 26 , 27 , 28 , 29 , 30 Based on this, our study included two more factors, COLI and poverty. As the smallest geographic unit in policy legislations, it is reasonable to assess individual indirectly based on the county‐level variables and previous studies adopted both individual variables and county‐level variables to construct the nomograms.…”