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June 13, 2005Archives of Internal Medicine261 citations

Long-term Risk for Depressive Symptoms After a Medical Diagnosis

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DPDaniel PolskyJohns Hopkins UniversityJDJalpa A. DoshiUniversity of PennsylvaniaSMSteven C. MarcusCalifornia University of Pennsylvania

Key Result

A new diagnosis of cancer, chronic lung disease, or heart disease increased the risk of depressive symptoms within 2 years (HR 3.55 [CI 2.79-4.52], HR 2.21, and HR 1.45, respectively).

Key Points

  • To evaluate the risk and timing of developing significant depressive symptoms following a new diagnosis of cancer, diabetes, hypertension, heart disease, arthritis, chronic lung disease, or stroke.
  • Analyzed 5 biennial waves (1992–2000) of the Health and Retirement Study tracking N=8,387 adults aged 51 to 61 years without baseline depressive symptoms.
  • Utilized time-dependent Cox proportional hazards regression models to estimate adjusted hazard ratios for depressive symptoms following each new medical diagnosis.
  • Within 2 years of initial diagnosis, the highest hazard of depressive symptoms occurred with cancer (HR, 3.55; 95% CI, 2.79–4.52), chronic lung disease (HR, 2.21; 95% CI, 1.64–2.79), and heart disease (HR, 1.45; 95% CI, 1.09–1.93).
  • Depression hazard declined over time for most conditions, but heart disease retained elevated risk at 2 to 4 years and 4 to 8 years post-diagnosis, while arthritis exhibited significantly increased risk at 2 to 4 years (HR, 1.46; 95% CI, 1.11–1.92).

Study Design

Type

Cohort (n=8,387)

Structured PICO

Does a new medical diagnosis increase the risk of developing significant depressive symptoms in middle-aged adults?

P
Population
8,387 adults aged 51 to 61 years without significant depressive symptoms at baseline (1992) from the Health and Retirement Study
I
Intervention
New diagnosis of cancer, diabetes, hypertension, heart disease, arthritis, chronic lung disease, or stroke
C
Comparator
Patients without the respective new medical diagnosis
O
Outcome
Episode of significant depressive symptomspatient reported

A new diagnosis of major medical conditions, particularly cancer, chronic lung disease, and heart disease, significantly increases the long-term risk of developing depressive symptoms in middle-aged adults.

Main Result

Effect estimate: HR 3.55 (95% CI 2.79-4.52)

Abstract

BACKGROUND: This study examines the risk of development of significant depressive symptoms after a new diagnosis of cancer, diabetes, hypertension, heart disease, arthritis, chronic lung disease, or stroke. METHODS: The study used 5 biennial waves (1992-2000) of the Health and Retirement Study to follow a sample of 8387 adults (aged 51 to 61 years and without significant depressive symptoms in 1992) from 1994 to 2000. Time-dependent Cox regression models estimated adjusted hazard ratios (HRs) for an episode of significant depressive symptoms after a new diagnosis for each of the 7 medical conditions. RESULTS: Within 2 years of initial diagnosis, subjects with cancer had the highest hazard of depressive symptoms (HR, 3.55; 95% confidence interval CI, 2.79-4.52), followed by subjects with chronic lung disease (HR, 2.21; 95% CI, 1.64-2.79) and heart disease (HR, 1.45; 95% CI, 1.09-1.93). The hazard for depressive symptoms for most of these diseases decreased over time; however, subjects with heart disease continued to have a higher risk for depressive symptoms even 2 to 4 years and 4 to 8 years after diagnosis, and a significantly higher hazard for depressive symptoms developed for persons with arthritis 2 to 4 years after diagnosis (HR, 1.46; 95% CI, 1.11-1.92). CONCLUSION: The findings identify several high-risk patient groups who might benefit from depression screening and monitoring to improve health outcomes in this vulnerable population facing new medical illnesses.

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Cite This Study

Polsky et al. (2005) conducted a cohort in New medical diagnosis (cancer, diabetes, hypertension, heart disease, arthritis, chronic lung disease, or stroke) (n=8,387). New medical diagnosis was evaluated on Episode of significant depressive symptoms (HR 3.55, 95% CI 2.79-4.52). A new diagnosis of cancer, chronic lung disease, or heart disease increased the risk of depressive symptoms within 2 years (HR 3.55 [CI 2.79-4.52], HR 2.21, and HR 1.45, respectively).

synapsesocial.com/papers/6a10d18d326831f8a264680dhttps://doi.org/10.1001/archinte.165.11.1260
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