Depressive Symptoms in Danish Patients With Glioma and a Cancer-Free Comparison Group

Abstract

Background: It is well established that patients with glioma may experience adverse general (eg, headache) or focal symptoms (eg, personality changes) and neurocognitive deficits (eg, planning), but they may also experience severe emotional distress. We investigated the prevalence of depressive symptoms in patients with newly diagnosed glioma and in matched cancer-free persons. Methods: For this study, we recruited patients with glioma diagnosed within 12 months at all 4 neurosurgical clinics in Denmark. The cancer-free comparison group was identified through the Danish Central Person Register and matched on sex and age. Participants’ depressive symptoms were evaluated using the Center for Epidemiologic Studies Depression Scale (CES-D; score range, 0–60), with a cutoff score ≥16 indicating moderate-to-severe depressive symptoms. Results: In this study, 363 of 554 patients with glioma and 481 of 1,304 cancer-free persons participated. Mean age of all patients was 55 years and 60% of the population was male. Mean scores for depressive symptoms were statistically significantly higher among patients with glioma, with a mean CES-D score of 10.9 (95% CI, 10.1–11.8) compared with 5.3 (95% CI, 4.7–5.8) among cancer-free persons (P<.0001). Overall, 92 patients with glioma (25%) and 30 cancer-free persons (6%) had moderate-to-severe depressive symptoms. After adjustment for marital status, education level, and comorbidity, the prevalence of depressive symptoms was 5 times higher among patients with glioma compared with cancer-free persons. Conclusions: A substantially higher prevalence of moderate-to-severe depressive symptoms was identified in patients with glioma compared with cancer-free persons. This indicates the importance of programs to systematically identify and manage depressive symptoms in patients with glioma.

Depression and Quality of Life in Patients with Gliomas: A Narrative Review

“…In a study by Hao et al [ 22 ] evaluating depression in 190 consecutive patients with gliomas, HADS revealed that education < 12 years, female sex, marital status (single/divorced/widowed/married), and chronic kidney disease were independent risk factors for depression, while the Zung self-rating depression scale revealed that female sex, marital status (single/divorced/widowed/married), and hyperlipidemia were independent risk factors for depression [ 22 ]. In a study involving 363 patients with gliomas (response rate, 66%) and 481 cancer-free patients (response rate, 37%) diagnosed within 12 months at neurosurgery clinics in Denmark, the prevalence of depression did not differ significantly by sex, age, tumor grade, marital status, or education level, inconsistent with previous findings [ 49 ]. The study was limited in that antidepressant use in the follow-up period was not investigated, possibly underestimating the prevalence of moderate-to-severe depression, and patients with significant cognitive impairment were excluded, possibly deceasing the generalizability of the results to the entire population with depression [ 49 ].…”

“…In a study involving 363 patients with gliomas (response rate, 66%) and 481 cancer-free patients (response rate, 37%) diagnosed within 12 months at neurosurgery clinics in Denmark, the prevalence of depression did not differ significantly by sex, age, tumor grade, marital status, or education level, inconsistent with previous findings [ 49 ]. The study was limited in that antidepressant use in the follow-up period was not investigated, possibly underestimating the prevalence of moderate-to-severe depression, and patients with significant cognitive impairment were excluded, possibly deceasing the generalizability of the results to the entire population with depression [ 49 ].…”

Associations Between Outcome Resilience and Sociodemographic Factors, Childhood Trauma, Personality Dimensions and Self-Rated Health in Middle-Aged Adults

“…For chronic mental disorders, it has already been reported that major depressive disorder [ 50 ], anorexia [ 77 ], Parkinson’s disease [ 78 ], anxiety disease [ 79 ], and addiction disease [ 80 ] are associated with poorer mental health and more mental health problems. Likewise, it was already reported that somatic disease events intensified mental health problems (myocardial infarction [ 81 ], stroke [ 82 ], cancer [ 83 ], and thrombosis [ 84 ]). In terms of practical implications, the present results indicated that the onset of chronic mental disorder led to an increase of 2.1 CES-D points, while the experience of a somatic disease event led to an increase of 1.46 CES-D points.…”

Association of antidepressant drug use with outcome of patients with glioblastoma

“…In contrast, antidepressants were used in 8.4%, 9.9% and 13.6% of patients, respectively. Published studies reported a prevalence of depression among patients with glioma ranging from 15% to 93% 27‐30 . There is a significant difference between self‐reported and physician‐reported prevalence of depression in glioma patients as shown in a systematic review of observational studies 31 …”