Risk for depression and anxiety in long-term survivors of hematologic cancer.

Abstract

Objective: An increasing number of hematologic cancer patients outlive 10 years past diagnosis. Nevertheless, few studies investigated psychological strain in this patient group beyond 5 years after diagnosis. We conducted a registry-based investigation of risk for depression and anxiety among long-term hematologic cancer survivors up to 26 years after diagnosis compared to the general population. Methods: In this cross-sectional postal survey, cancer survivors were recruited through 2 regional cancer registries in Germany. Depression (Patient Health Questionnaire-9) and anxiety (Generalized Anxiety Disorder-7) were assessed. Survivor data were compared to age- and gender-matched comparison groups (CG) randomly drawn from large representative samples (N > 5,000). Results: Out of 2,001 eligible patients, 46% participated (n = 922). Survivors were significantly more likely than the CG to report elevated depressive (relative risk [RR] = 3.1; 95% confidence interval [CI]: 2.2–4.3) and anxious symptomatology (RR = 1.7; 95% CI: 1.2–2.3). Depression scores remained high even in the survivor Group 12—26 years after diagnosis. RR for anxiety decreased to values comparable to the CG. Younger and middle-aged survivors (≤65 years) were at highest relative and absolute risk to be psychologically impaired. Conclusion: This study shows that depression rather than anxiety is a prominent problem in long-term survivors of hematologic cancer. The results stress the importance of monitoring patients even years after diagnosing and supplying psychosocial support to patients in need.

Psychosocial impact of prognostic genetic testing in uveal melanoma patients: a controlled prospective clinical observational study

“…We further found fear of progression and younger age to be predictive for future anxiety. The latter is congruous with a study suggesting that younger (hematologic) cancer patients have the highest risk to experience both depression and anxiety [50]. However, it has to be taken into account that the mean score of both depression and anxiety did not exceed the cut-off for a pathological condition at any point in our study.…”

Risk and associated factors of depression and anxiety in men with prostate cancer: Results from a German multicenter study

“…To assess the risk of depression and anxiety in different subgroups, we stratified the total sample by variables that were chosen according to research gaps 5 and clinical relevance in other oncological studies 23 . In detail, we split the sample by (a) a binary variable which combined all TNM‐information into a clinically relevant outcome ( localized vs non‐localized ; algorithm see Figure S1), (b) occurrence of distant metastases ( yes vs no ), (c) completed/ongoing treatment with surgery, radiation, chemotherapy or androgen deprivation therapy ( yes vs no ), (d) under active treatment (yes vs not), (e) age ( below vs above the median of 67 years ) and (f) time since diagnosis ( below vs above the median of 3 months ).…”

“…To assess the risk of depression and anxiety in different subgroups, we stratified the total sample by variables that were chosen according to research gaps 5 and clinical relevance in other oncological studies. 23 In detail, we split the sample by The absolute risk (AR) of depression/anxiety was calculated as the prevalence of patients exceeding the respective cut-off (sum score ≥ 7).…”

Long‐term Follow‐up of Hematopoietic Stem Cell Transplant Survivors: A Focus on Screening, Monitoring, and Therapeutics

“…Similarly, risk factors for the development of depression in HCT recipients include younger age, lower socioeconomic status, chronic pain, and the presence of GVHD. 21,22 The incidence of depression is slightly lower than that of anxiety in long-term survivors after HCT, at 11%, and varies greatly depending on the time interval after HCT with as many as 12-15% of patients with depressive symptoms immediately before HCT. 15,17,23 Studies evaluating the rates of depression in post-HCT patients have been mixed.…”