What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Cancer. Intervention: Depressive symptoms and major/minor depression. Primary outcome: Mortality (RR 1.25, 95% CI 1.12-1.40, p=<.001).

What question did this study set out to answer?

To determine whether depressive symptoms and major or minor depressive disorder predict cancer progression and mortality.

September 14, 2009Cancer

Depression as a predictor of disease progression and mortality in cancer patients

Q: What are the key findings of this study?

Depressive symptoms significantly predicted higher mortality in cancer patients (RR 1.25; 95% CI 1.12-1.40; P<.001), but did not significantly predict disease progression.

Q: What question did this study set out to answer?

To determine whether depressive symptoms and major or minor depressive disorder predict cancer progression and mortality.

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Key result

Depressive symptoms significantly predicted higher mortality in cancer patients (RR 1.25; 95% CI 1.12-1.40; P<.001), but did not significantly predict disease progression.

Why the study?

Does depression predict disease progression and mortality in cancer patients?

Key Points

To determine whether depressive symptoms and major or minor depressive disorder predict cancer progression and mortality.
Systematic search of prospective studies indexed in MEDLINE, PsycINFO, CINAHL, and EMBASE evaluating depression and cancer outcomes.
Dual independent extraction of effect sizes analyzed using a random effects model across progression and mortality endpoints.
Depressive symptoms did not significantly predict cancer progression across 3 studies (unadjusted RR = 1.23, 95% CI, 0.85–1.77; P = .28).
Mortality was significantly higher in patients with depressive symptoms across 25 studies (unadjusted RR = 1.25, 95% CI, 1.12–1.40; P < .001) and in those diagnosed with major or minor depression (unadjusted RR = 1.39, 95% CI, 1.10–1.89; P = .03).
Adjustment for known clinical prognostic factors did not diminish the observed association between depression and increased cancer mortality.

Study Design

Type

Meta-Analysis

Structured PICO

Does depression predict disease progression and mortality in cancer patients?

Population

Cancer patients (meta-analysis of 25 independent studies for mortality and 3 studies for progression)

Intervention

Depressive symptoms or major/minor depression

Comparator

Absence of depressive symptoms or depression

Outcome

Disease progression and mortalityhard clinical

Main Result

Effect estimate: RR 1.25 (95% CI 1.12-1.40)

p-value: p=<.001

Depression is a statistically significant predictor of mortality, but not disease progression, in cancer patients, even after adjusting for clinical prognosticators.

Discussion

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Implication

Supports incorporating depression assessment into cancer prognostication for mortality risk; leaves open whether treating symptoms alters progression.

Cite This Study

Satin et al. (2009) conducted a meta-analysis in Cancer. Depressive symptoms and major/minor depression was evaluated on Mortality (RR 1.25, 95% CI 1.12-1.40, p=<.001). Depressive symptoms significantly predicted higher mortality in cancer patients (RR 1.25; 95% CI 1.12-1.40; P<.001), but did not significantly predict disease progression.

synapsesocial.com/papers/6a139371c1194a2af5044be5 https://doi.org/10.1002/cncr.24561

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Implication

Supports incorporating depression assessment into cancer prognostication for mortality risk; leaves open whether treating symptoms alters progression.

Depression as a predictor of disease progression and mortality in cancer patients

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Depression as a predictor of disease progression and mortality in cancer patients

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Also Consider