Mental health among patients with non‐Hodgkin lymphoma: A Danish nationwide study of psychotropic drug use in 8750 patients and 43 750 matched comparators

Abstract

Psychological distress following cancer diagnosis may lead to mental health complications including depression and anxiety. Non-Hodgkin lymphomas (NHLs) include indolent and aggressive subtypes for which treatment and prognosis differ widely.Incident use of psychotropic drugs (PDs-antidepressants, antipsychotics, and anxiolytics) and its correlation to lymphoma types can give insights into the psychological distress these patients endure. In this prospective matched cohort study, we used nationwide population-based registries to investigate the cumulative risk of PD use in NHL patients compared to a sex-and age-matched cohort from the Danish

Factors of emotional distress in lymphoma: A systematic review

“…anxiolytics and antidepressants) prescriptions over 5 years compared to younger HL patients 35 . This difference was also observed for NHL patients >70 years 41 . While the previous findings may point to younger age being a significant risk factor for distress, it is possible that age may have differential effects depending on the type of distress examined.…”

“…Twelve of sixteen studies suggest that age may be a significant factor, 25,27,31,32,34–41 although this association was not found to be significant in some studies 26,42–44 . For example, a cross‐sectional study by Smith and colleagues 32 found that younger age at study enrolment predicts worse mental health status, even when other sociodemographic/clinical characteristics and perceived impact of cancer were accounted for.…”

“…Four of eight studies suggest that education level may be significant. Prospective studies highlight that lower education at study baseline may be a risk factor for anxiety and depression 34 and use of psychotropic drugs 41 . There are mixed findings among large cross‐sectional studies.…”

“…Eight of eleven studies suggest that presenting symptoms may influence distress. Four out of five studies suggest that comorbidity may be a significant factor risk factor for anxiety and depression over time, 34 the use of psychotropic drugs over time, 41 worse mental health status 31 and greater PTSD symptoms 32 . However, one study found that patients with clinical levels of fear of cancer recurrence did not present mental/behavioural disorders more frequently nor have a higher Charlson Comorbidity Index compared to patients without clinical levels of fear of cancer recurrence 43 …”

“…During pre‐diagnosis, whether symptoms were acute or vague seemed to influence the type of emotional distress experienced—for patients who experienced sudden/acute symptoms, anxiety, fear and panic were prevalent; for patients who experienced long‐term/vague symptoms, a feeling of general unease better described their emotions 55 . A prospective study by Øvlisen and colleagues 41 found that an ECOG performance score of >1 and a higher International Prognostic Index (IPI) predicted greater risk for psychotropic prescriptions, which highlights that poor physical functioning and prognosis may contribute to distress. Indeed, a large cross‐sectional study found that among the domains outlined in NCCN's Problem List, physical symptoms were one of the significant predictors of clinically significant distress in Chinese patients 42 .…”