Document Detail

Depression as a predictor of disease progression and mortality in cancer patients: a meta-analysis.
MedLine Citation:
PMID:  19753617     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Cancer patients and oncologists believe that psychological variables influence the course of cancer, but the evidence remains inconclusive. This meta-analysis assessed the extent to which depressive symptoms and major depressive disorder predict disease progression and mortality in cancer patients. METHODS: Using the MEDLINE, PsycINFO, CINAHL, and EMBASE online databases, the authors identified prospective studies that examined the association between depressive symptoms or major/minor depression and risk of disease progression or mortality in cancer patients. Two raters independently extracted effect sizes using a random effects model. RESULTS: Based on 3 available studies, depressive symptoms were not shown to significantly predict cancer progression (risk ratio [RR] unadjusted = 1.23; 95% confidence interval [CI], 0.85-1.77; P = .28). Based on data from 25 independent studies, mortality rates were up to 25% higher in patients experiencing depressive symptoms (RR unadjusted = 1.25; 95% CI, 1.12-1.40; P < .001), and up to 39% higher in patients diagnosed with major or minor depression (RR unadjusted = 1.39; 95% CI, 1.10-1.89; P = .03). In support of a causal interpretation of results, there was no evidence that adjusting for known clinical prognostic factors diminished the effect of depression on mortality in cancer patients. CONCLUSIONS: This meta-analysis presented reasonable evidence that depression predicts mortality, but not progression, in cancer patients. The associated risk was statistically significant but relatively small. The effect of depression remains after adjustment for clinical prognosticators, suggesting that depression may play a causal role. Recommendations were made for future research to more clearly examine the effect of depression on cancer outcomes.
Jillian R Satin; Wolfgang Linden; Melanie J Phillips
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Cancer     Volume:  115     ISSN:  0008-543X     ISO Abbreviation:  Cancer     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-10     Completed Date:  2009-12-28     Revised Date:  2010-07-02    
Medline Journal Info:
Nlm Unique ID:  0374236     Medline TA:  Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  5349-61     Citation Subset:  AIM; IM    
Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada.
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MeSH Terms
Depression / complications*
Depressive Disorder / complications*
Disease Progression
Middle Aged
Neoplasms / complications*,  mortality*,  psychology
Grant Support
AQC83559//Canadian Institutes of Health Research
Comment In:
Cancer. 2010 Jul 1;116(13):3304; author reply 3304-5   [PMID:  20564636 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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