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Two-scale assessment of anxiety and depression in postoperative non-small cell lung cancer patients: their prevalence, risk factors, and prognostic potency

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Abstract

Objective

Anxiety and depression commonly occur and correlate with poor prognosis in patients with cancer. The study aimed to assess the anxiety and depression in patients with postsurgical non-small cell lung cancer (NSCLC) using both Hospital Anxiety and Depression Scale (HADS) and Self-Rating Anxiety/Depression Scale (SAS/SDS) and to investigate their risk factors and linkage with prognosis.

Methods

HADS and SAS/SDS were assessed in 350 patients with NSCLC at 3 months after surgical resection and 100 healthy controls (HCs). Patients with NSCLC were followed up for a median period of 27.0 (range: 6.0–52.0) months for prognostic evaluation.

Results

HADS-identified anxiety rate (39.7% vs. 10.0%, P < 0.001), SAS-identified anxiety rate (34.9% vs. 9.0%, P < 0.001), HADS-identified depression rate (29.7% vs. 5.0%, P < 0.001), and SDS-identified depression rate (27.1% vs. 6.0%, P < 0.001) were all elevated in patients with NSCLC vs. HCs. Multivariate logistic regression analysis uncovered that diabetes, adjuvant therapy, postoperative complications, and poor differentiation were independently linked with increased HADS- or SAS-identified anxiety risk (all P < 0.05); meanwhile, female gender, hypertension, diabetes, poor differentiation, adjuvant therapy, postoperative complications, and TNM stage were independently linked with increased HADS- or SDS-identified depression risk (all P < 0.05). Furthermore, HADS-identified anxiety, SAS-identified anxiety, HADS-identified depression, and SDS-identified depression independently predicted shorter disease-free survival and overall survival (all P < 0.05).

Conclusion

Anxiety and depression are prevalent and linked with poor survival in patients with postsurgical NSCLC. Meanwhile, gender, comorbidities, advanced tumor features, adjuvant therapy, and postoperative complications relate to the prevalence of anxiety and depression.

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Data availability

The datasets generated and/or analyzed during the current study are available from the corresponding author upon reasonable request.

References

  1. Siegel RL, Miller KD, Jemal A (2020) Cancer statistics. CA Cancer J Clin 70(1):7–30. https://doi.org/10.3322/caac.21590

    Article  PubMed  Google Scholar 

  2. Nasim F, Sabath BF, Eapen GA (2019) Lung cancer. Med Clin North Am 103(3):463–473. https://doi.org/10.1016/j.mcna.2018.12.006

    Article  PubMed  Google Scholar 

  3. Zhang Z, Yang S, Ma Y et al (2021) Consistency of recommendations for the diagnosis and treatment of non-small cell lung cancer: a systematic review. Transl Lung Cancer Res 10(6):2715–2732. https://doi.org/10.21037/tlcr-21-423

  4. Bassanelli M, Ramella S, Zeuli M, Ceribelli A (2022) Radiotherapy and immunotherapy: the power of the teamwork for the treatment of NSCLC. Anticancer Res 42(5):2241–2247. https://doi.org/10.21873/anticanres.15704

  5. Yang Q, Luo LC, Li FM et al (2022) Survival outcomes of radiofrequency ablation compared with surgery in patients with early-stage primary non-small-cell lung cancer: a meta-analysis. Respir Investig 60(3):337–344. https://doi.org/10.1016/j.resinv.2022.01.002

    Article  PubMed  Google Scholar 

  6. Choi SH, Yoo SS, Lee SY, Park JY (2022) Anti-angiogenesis revisited: reshaping the treatment landscape of advanced non-small cell lung cancer. Arch Pharm Res 45(4):263–279. https://doi.org/10.1007/s12272-022-01382-6

    Article  CAS  PubMed  Google Scholar 

  7. Siwik CJ, Phillips K, Zimmaro L et al (2022) Depressive symptoms among patients with lung cancer: elucidating the roles of shame, guilt, and self-compassion. J Health Psychol 27(5):1039–1047. https://doi.org/10.1177/1359105320988331

    Article  PubMed  Google Scholar 

  8. Arrieta O, Angulo LP, Nunez-Valencia C et al (2013) Association of depression and anxiety on quality of life, treatment adherence, and prognosis in patients with advanced non-small cell lung cancer. Ann Surg Oncol 20(6):1941–1948. https://doi.org/10.1245/s10434-012-2793-5

    Article  PubMed  Google Scholar 

  9. Jung JY, Lee JM, Kim MS et al (2018) Comparison of fatigue, depression, and anxiety as factors affecting posttreatment health-related quality of life in lung cancer survivors. Psychooncology 27(2):465–470. https://doi.org/10.1002/pon.4513

    Article  PubMed  Google Scholar 

  10. Polanski J, Chabowski M, Chudiak A et al (2018) Intensity of anxiety and depression in patients with lung cancer in relation to quality of life. Adv Exp Med Biol 1023:29–36. https://doi.org/10.1007/5584_2017_50

    Article  CAS  PubMed  Google Scholar 

  11. Yan X, Chen X, Li M, Zhang P (2019) Prevalence and risk factors of anxiety and depression in Chinese patients with lung cancera cross-sectional study. Cancer Manag Res 11:4347–4356. https://doi.org/10.2147/CMAR.S202119

    Article  PubMed  PubMed Central  Google Scholar 

  12. Vodermaier A, Lucas S, Linden W, Olson R (2017) Anxiety after diagnosis predicts lung cancer-specific and overall survival in patients with stage III non-small cell lung cancer: a population-based cohort study. J Pain Symptom Manage 53(6):1057–1065. https://doi.org/10.1016/j.jpainsymman.2016.12.338

    Article  PubMed  Google Scholar 

  13. Huang X, Zhang TZ, Li GH et al (2020) Prevalence and correlation of anxiety and depression on the prognosis of postoperative non-small-cell lung cancer patients in North China. Medicine (Baltimore) 99(11):e19087. https://doi.org/10.1097/MD.0000000000019087

  14. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

    Article  CAS  PubMed  Google Scholar 

  15. Gainotti G, Cianchetti C, Taramelli M, Tiacci C (1972) The guided self-rating anxiety-depression scale for use in clinical psychopharmacology. Act Nerv Super (Praha) 14(1):49–51

    CAS  PubMed  Google Scholar 

  16. Zung WW, Gianturco JA (1971) Personality dimension and the self-rating depression scale. J Clin Psychol 27(2):247–248. https://doi.org/10.1002/1097-4679(197104)27:2%3c247::aid-jclp2270270230%3e3.0.co;2-6

    Article  CAS  PubMed  Google Scholar 

  17. Guo C, Huang X (2021) Hospital anxiety and depression scale exhibits good consistency but shorter assessment time than Zung self-rating anxiety/depression scale for evaluating anxiety/depression in non-small cell lung cancer. Medicine (Baltimore) 100(8):e24428. https://doi.org/10.1097/MD.0000000000024428

  18. Chirico A, Vizza D, Valente M et al (2022) Assessing the fear of recurrence using the Cancer Worry Scale in a sample of Italian breast cancer survivors. Support Care Cancer 30(3):2829–2837. https://doi.org/10.1007/s00520-021-06718-4

    Article  PubMed  Google Scholar 

  19. Lobefaro R, Rota S, Porcu L et al (2022) Cancer-related fatigue and depression: a monocentric, prospective, cross-sectional study in advanced solid tumors. ESMO Open 7(2):100457. https://doi.org/10.1016/j.esmoop.2022.100457

  20. Yue T, Li Q, Wang R et al (2020) Comparison of hospital anxiety and depression scale (HADS) and Zung self-rating anxiety/depression scale (SAS/SDS) in evaluating anxiety and depression in patients with psoriatic arthritis. Dermatology 236(2):170–178. https://doi.org/10.1159/000498848

    Article  PubMed  Google Scholar 

  21. Park S, Kang CH, Hwang Y et al (2016) Risk factors for postoperative anxiety and depression after surgical treatment for lung cancerdagger. Eur J Cardiothorac Surg 49(1):e16-21. https://doi.org/10.1093/ejcts/ezv336

    Article  PubMed  Google Scholar 

  22. Zsido RG, Villringer A, Sacher J (2017) Using positron emission tomography to investigate hormone-mediated neurochemical changes across the female lifespan: implications for depression. Int Rev Psychiatry 29(6):580–596. https://doi.org/10.1080/09540261.2017.1397607

    Article  PubMed  Google Scholar 

  23. Depression (PDQ(R)): health professional version (2002). In: PDQ Cancer Information Summaries. Bethesda (MD)

  24. Lemij AA, de Glas NA, Derks MGM et al (2022) Discontinuation of adjuvant endocrine therapy and impact on quality of life and functional status in older patients with breast cancer. Breast Cancer Res Treat 193(3):567–577. https://doi.org/10.1007/s10549-022-06583-7

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Zhu P, Chen C, Liu X et al (2022) Factors associated with benefit finding and mental health of patients with cancer: a systematic review. Support Care Cancer. https://doi.org/10.1007/s00520-022-07032-3

    Article  PubMed  PubMed Central  Google Scholar 

  26. Bach L, Kalder M, Kostev K (2021) Depression and sleep disorders are associated with early mortality in women with breast cancer in the United Kingdom. J Psychiatr Res 143:481–484. https://doi.org/10.1016/j.jpsychires.2020.11.036

    Article  PubMed  Google Scholar 

  27. Liu P, Wang Z (2022) Postoperative anxiety and depression in surgical gastric cancer patients: their longitudinal change, risk factors, and correlation with survival. Medicine (Baltimore) 101(11). https://doi.org/10.1097/MD.0000000000028765

  28. Drevets WC, Wittenberg GM, Bullmore ET, Manji HK (2022) Immune targets for therapeutic development in depression: towards precision medicine. Nat Rev Drug Discov 21(3):224–244. https://doi.org/10.1038/s41573-021-00368-1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Spiegel D, Giese-Davis J (2003) Depression and cancer: mechanisms and disease progression. Biol Psychiatry 54(3):269–282. https://doi.org/10.1016/s0006-3223(03)00566-3

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Thoracic Surgery, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China

    Liping Deng & Bei Chen

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  2. Bei Chen
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Correspondence to Bei Chen.

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This study was permitted by the Ethics Committee of Shanghai Pulmonary Hospital.

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Deng, L., Chen, B. Two-scale assessment of anxiety and depression in postoperative non-small cell lung cancer patients: their prevalence, risk factors, and prognostic potency. Ir J Med Sci 192, 2613–2619 (2023). https://doi.org/10.1007/s11845-023-03321-w

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