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      Postoperative anxiety and depression in surgical gastric cancer patients: their longitudinal change, risk factors, and correlation with survival

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      Author(s): , MM a , , MB b , * ,
      Editor(s):
      Publication date (Electronic):
      Journal: Medicine
      Publisher: Lippincott Williams & Wilkins
      Keywords: postoperative anxiety, postoperative depression, risk factors, surgical gastric cancer, survival

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          Abstract

          Anxiety and depression are important concerns negatively affecting life quality and prognosis in cancer patients. Then, this prospective cohort study aimed to explore the longitudinal change and potential risk factors for postoperative anxiety and depression in surgical gastric cancer patients.

          A total of 226 surgical gastric cancer patients were consecutively enrolled. The Hospital Anxiety and Depression Scale (HADS) was used to assess the anxiety and depression status at baseline (M0), 12 th month (M12), 24 th month (M24), and 36 th month (M36) after hospital discharge, then the HADS for anxiety (HADS-A) score and HADS for depression (HADS-D) score were calculated. Diseasefree survival (DFS) and overall survival (OS) were evaluated.

          HADS-A and HADS-D scores were gradually increased from M0 to M36, and their occurrences and grades were also worsened piece by piece. Additionally, older age, female, unemployed before surgery, single/divorced/widowed marry status, poor education duration, diabetes, hyperlipidemia, large tumor size, high TNM stage, and adjuvant chemotherapy were independent risk factors for postoperative anxiety or depression. Regarding survival, DFS and OS appeared to be shorter in anxiety patients compared to nonanxiety patients at M0 but showed no statistical significance. However, DFS and OS were worse in depression patients compared to non-depression patients at M0.

          In conclusion, postoperative anxiety and depression are gradually worsened, relating to poor prognosis, and their main risk factors include female, single/divorced/widowed marry status, diabetes, hyperlipidemia, large tumor size, and high TNM stage in gastric cancer patients.

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          Most cited references21

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          Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries

          Ahmedin Jemal, Lindsey A Torre, Rebecca Siegel … (2018)
          This article provides a status report on the global burden of cancer worldwide using the GLOBOCAN 2018 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer, with a focus on geographic variability across 20 world regions. There will be an estimated 18.1 million new cancer cases (17.0 million excluding nonmelanoma skin cancer) and 9.6 million cancer deaths (9.5 million excluding nonmelanoma skin cancer) in 2018. In both sexes combined, lung cancer is the most commonly diagnosed cancer (11.6% of the total cases) and the leading cause of cancer death (18.4% of the total cancer deaths), closely followed by female breast cancer (11.6%), prostate cancer (7.1%), and colorectal cancer (6.1%) for incidence and colorectal cancer (9.2%), stomach cancer (8.2%), and liver cancer (8.2%) for mortality. Lung cancer is the most frequent cancer and the leading cause of cancer death among males, followed by prostate and colorectal cancer (for incidence) and liver and stomach cancer (for mortality). Among females, breast cancer is the most commonly diagnosed cancer and the leading cause of cancer death, followed by colorectal and lung cancer (for incidence), and vice versa (for mortality); cervical cancer ranks fourth for both incidence and mortality. The most frequently diagnosed cancer and the leading cause of cancer death, however, substantially vary across countries and within each country depending on the degree of economic development and associated social and life style factors. It is noteworthy that high-quality cancer registry data, the basis for planning and implementing evidence-based cancer control programs, are not available in most low- and middle-income countries. The Global Initiative for Cancer Registry Development is an international partnership that supports better estimation, as well as the collection and use of local data, to prioritize and evaluate national cancer control efforts. CA: A Cancer Journal for Clinicians 2018;0:1-31. © 2018 American Cancer Society.
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            The hospital anxiety and depression scale.

            A Zigmond, R P Snaith (1983)
            A self-assessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. It is suggested that the introduction of the scales into general hospital practice would facilitate the large task of detection and management of emotional disorder in patients under investigation and treatment in medical and surgical departments.
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              Depression and anxiety in women with early breast cancer: five year observational cohort study.

              Caroline Burgess, Victoria A Cornelius, Sharon Love … (2005)
              To examine the prevalence of, and risk factors for, depression and anxiety in women with early breast cancer in the five years after diagnosis. Observational cohort study. NHS breast clinic, London. 222 women with early breast cancer: 170 (77%) provided complete interview data up to either five years after diagnosis or recurrence. Prevalence of clinically important depression and anxiety (structured psychiatric interview with standardised diagnostic criteria) and clinical and patient risk factors, including stressful life experiences (Bedford College life events and difficulties schedule). Nearly 50% of the women with early breast cancer had depression, anxiety, or both in the year after diagnosis, 25% in the second, third, and fourth years, and 15% in the fifth year. Point prevalence was 33% at diagnosis, falling to 15% after one year. 45% of those with recurrence experienced depression, anxiety, or both within three months of the diagnosis. Previous psychological treatment predicted depression, anxiety, or both in the period around diagnosis (one month before diagnosis to four months after diagnosis). Longer term depression and anxiety, were associated with previous psychological treatment, lack of an intimate confiding relationship, younger age, and severely stressful non-cancer life experiences. Clinical factors were not associated with depression and anxiety, at any time. Lack of intimate confiding support also predicted more protracted episodes of depression and anxiety. Increased levels of depression, anxiety, or both in the first year after a diagnosis of early breast cancer highlight the need for dedicated service provision during this time. Psychological interventions for women with breast cancer who remain disease free should take account of the broader social context in which the cancer occurs, with a focus on improving social support.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Medicine (Baltimore)
                Journal ID (iso-abbrev): Medicine (Baltimore)
                Journal ID (publisher-id): MEDI
                Title: Medicine
                Publisher: Lippincott Williams & Wilkins (Hagerstown, MD )
                ISSN (Print): 0025-7974
                ISSN (Electronic): 1536-5964
                Publication date Collection: 18 March 2022
                Publication date (Electronic): 18 March 2022
                Volume: 101
                Issue: 11
                Electronic Location Identifier: e28765
                Affiliations
                Author notes
                [*] * Correspondence: Zhe Wang, Nursing Department, Heilongjiang Provincial Hospital, No. 82 Zhongshan Road, Xiangfang District, Harbin 150036, China (e-mail: 13945187766@ 123456163.com ).
                Author information
                https://orcid.org/0000-0002-9148-7453
                Article
                Publisher ID: MD-D-21-01756 Accession ID: 28765
                DOI: 10.1097/MD.0000000000028765
                PMC ID: 10684124
                PubMed ID: 35356898
                SO-VID: 2d53ef54-136f-444c-8868-3a46e6571cfc
                Copyright © Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal.

                History
                Date received : 02 March 2021
                Date received : 27 July 2021
                Date accepted : 14 January 2022
                Categories
                Subject: Observational Study
                Custom metadata
                OPEN-ACCESS TRUE

                Keywords: postoperative anxiety,postoperative depression,risk factors,surgical gastric cancer,survival
                Data availability:
                Keywords: postoperative anxiety, postoperative depression, risk factors, surgical gastric cancer, survival

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