Precancer and cancer-associated depression and anxiety among older adults with blood cancers in the United States

Abstract

For patients with blood cancers, comorbid mental health disorders at diagnosis likely affect the entire disease trajectory, as they can interfere with disease information processing, lead to poor coping, and even cause delays in care. We aimed to characterize the prevalence of depression and anxiety in patients with blood cancers. Using the Surveillance, Epidemiology, and End Results-Medicare database, we identified patients 67 years and older diagnosed with lymphoma, myeloma, leukemia, or myelodysplastic syndromes between 2000 and 2015. We determined the prevalence of pre-cancer and cancer-associated (CA) depression and anxiety using claims data. We identified factors associated with CA-depression and CA-anxiety in multivariate analyses. Among 75,691 patients, 18.6% had at least one diagnosis of depression or anxiety. Of the total cohort, 13.7% had pre-cancer depression and/or pre-cancer anxiety, while 4.9% had CA-depression or CA-anxiety. Compared to patients without pre-cancer anxiety, those with pre-cancer anxiety were more likely to have subsequent claims for CA-depression (OR 2.98; 95% CI 2.61-3.41). Other factors associated with higher risk of CA-depression included female sex, non-married status, higher comorbidity, and myeloma diagnosis. Patients with pre-cancer depression were significantly more likely to have subsequent claims for CA-anxiety compared to patients without pre-cancer depression (OR 3.01; 95% CI 2.63-3.44). Female sex and myeloma diagnosis were also associated with CA-anxiety. In this large cohort of older patients with newly diagnosed blood cancers, almost one in five suffered from depression or anxiety, highlighting a critical need for systematic mental health screening and management for this population.

Short Sleep Duration as a Risk Factor for Depression, Anxiety and Fatigue in Patients with Leukemia

“…Previous study suggested that a blood cancer diagnosis itself may contribute to the development of underlying mental health disorders. 48 In our study, we found a significant proportion of leukemia patients had symptoms of depression or anxiety. However, the proportion of leukemia patients with mental health problems may vary.…”

“…Our results confirmed the conclusions of a previous study that mental health screening and systematic implementation of psychosocial interventions for patients with blood cancers are essential to achieve high-quality cancer care. 48 Interestingly, Castelli et al highlighted the sleep problems in hematological cancer patients. 50 Our study confirmed this result.…”

Psychological adverse effects of anxiety and stress in treating patients with cancer

“…Comorbidity of cancer with psychological factors may also interfere with oncological treatment. There is strong evidence that oncological patients, who delay their treatment, or get poor appraisal, encounter difficulty in coping with cancer [12]. In particular, chemotherapy compared to other treatments have shown higher anxiety levels [13].…”

L’atteinte psychologique des patients marocains suivis pour hémopathie maligne et son impact sur leur qualité de vie

“…Parmi les causes de cette association, on a trouvé que le sexe féminin est lié significativement aux symptômes anxieux et a une moins bonne qualité de vie mentale (MCS). Etant donné que le caractère féminin est souvent associé à la vulnérabilité mentale [20,21]. de même, une étude cas-émoin sur 110 patients atteints de lymphome trouve un niveau élevé de dépression et d'anxiété chez les femmes plus que chez les hommes [22,23].…”