Racial disparities in the burden of depression and anxiety in patients with pancreatic cancer.

Abstract

e16283 Background: The prevalence of depression ranges from 33% to 45% in pancreatic cancer, the highest among gastrointestinal malignancies. Psychiatric illnesses impact the quality of life and compliance with treatment and regular physician visits. Therefore, we sought to examine ethnic differences in the prevalence of depression and anxiety in pancreatic cancer. Methods: We investigated the National Inpatient Sample 2019 employing International Classification of Diseases-10 (ICD-10) codes to include adult patients with pancreatic cancer. Multivariate linear or logistic regression was used (for continuous and categorical variables, respectively). The confounders adjusted for in the regression models were: history of MI and stroke, coronary artery disease, sleep disorders, chronic pain disorders, smoking, alcohol, obesity, PTSD, sexual abuse, arthritis, and physical disability, in addition to patient and hospital-level variables. We used Stata, version 14.2, to perform analyses considering 2 sided P < 0.05 as statistically significant. Results: A total of 116,055 patients with pancreatic cancer were included. 13,825 (11.91%) had depression and 16,845 (14.51%) had anxiety. The prevalence of depression in various ethnic categories was: 13.63% in Whites, 7.59% in Blacks, 8.47% in Hispanics, and 5.63% in Asians ( P< 0.001). Anxiety prevalence was: 16.25% in Whites, 9.92% in Blacks, 11.65% in Hispanics, and 7.29% in Asians ( P< 0.001). On multivariate analysis, compared to Whites, all ethnic groups had lower odds of depression (Blacks; adjusted odds ratio (aOR): 0.45, 95% confidence interval (CI): 0.38–0.52, P< 0.001, Hispanics; aOR: 0.60, 95% CI: 0.49–0.73, P< 0.001, Asians; aOR: 0.43, 95% CI: 0.31–0.59, P< 0.001). Similar results were seen for anxiety when ethnic groups were compared to Whites (Blacks; aOR: 0.49, 95% CI: 0.43–0.56, P< 0.001, Hispanics; aOR: 0.67, 95% CI: 0.55–0.82, P< 0.001, Asians; aOR: 0.44, 95% CI: 0.33–0.59, P< 0.001). Conclusions: Whites had the highest burden of depression and anxiety in pancreatic cancer. However, Hispanics represented the ethnic minority with a greater prevalence of psychiatric disorders. Further research needs to establish the factors responsible for these ethnic differences.[Table: see text]

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“…Our study revealed a worrying fact that among 425 participants, the incidence of anxiety was 22.2% ( N = 94) and depression was 20.2% ( N = 86), which were higher than previous surveys on the anxiety and depression status of pancreatic cancer patients in the United States and Australia ( 53 , 54 ), suggesting that pancreatic cancer patients in China are currently facing a higher burden of anxiety and depression and need urgent attention. Moreover, the results of mental health differences under demographic variables indicated that the anxiety and depression conditions of pancreatic cancer patients were closely related to gender, age, education, income, marital status, and cancer staging, and that men of older age with lower education, lower income, and divorced or widowed marital status may face a more severe burden of anxiety and depression, a finding similar to previous studies ( 55 , 56 ).…”