Top

Journal of Cancer Survivorship

Published in:

01-10-2017

Impact of depression treatment on health-related quality of life among adults with cancer and depression: a population-level analysis

Authors: Ami Vyas, Zachary Babcock, Stephen Kogut

Published in: Journal of Cancer Survivorship | Issue 5/2017

Abstract

Purpose

Cancer diagnosis in adults is often accompanied by negative impacts, which increase the risk of depression thereby lowering health-related quality of life (HRQoL). We examined the association between depression treatment and HRQoL among US adults with cancer and depression.

Methods

Patients age 18 and above, with self-reported cancer and depression diagnoses were identified from Medical Expenditure Panel Survey database for 2006–2013. Baseline depression treatment was categorized as antidepressants only, psychotherapy with or without antidepressant use, and no reported use of antidepressants or psychotherapy. HRQoL was measured using SF-12 physical component summary (PCS) and mental component summary (MCS) scores. Adjusted ordinary least squares regressions estimated the association between type of depression treatment and HRQoL.

Results

Out of 450 (weighted per calendar year: 2.1 million) cancer adults included in the study, 51% received antidepressants only, while 16% received psychotherapy with or without antidepressants. In bivariate analyses, the mean MCS score was lowest among those who received psychotherapy with or without antidepressants compared to those receiving antidepressants only and those with no reported use of either modality, p < 0.05. In multivariate analyses, there was no significant difference in HRQoL by type of depression treatment.

Conclusion

Despite treatment for depression, HRQoL did not improve during the measurement timeframe. Quality of life is a priority health outcome in cancer treatment, yet our findings suggest that current clinical approaches to ameliorate depression in cancer patients appear to be suboptimal.

Implications for cancer survivors

Adults with cancer and comorbid depression should receive appropriate depression care in order to improve their HRQoL.

Available only for authorised users

American Cancer Society. Anxiety, Fear, and Depression. Available at https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/changes-in-mood-or-thinking/anxiety-and-fear.html Accessed on June 15, 2017.

Chochinov HM. Depression in cancer patients. Lancet Oncol. 2001;2:499–505.CrossRefPubMed

Honda K, Goodwin RD. Cancer and mental disorders in a national community sample: findings from the national comorbidity survey. Psychother Psychosom. 2004;73:235–42.CrossRefPubMed

Massie MJ. Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr. 2004;32:57–71.CrossRef

Pirl WF. Evidence report on the occurrence, assessment, and treatment of depression in cancer patients. J Natl Cancer Inst Monogr. 2004;32:32–9.CrossRef

Fann JR, Thomas-Rich AM, Katon WJ, Cowley D, Pepping M, McGregor BA, et al. Major depression after breast cancer: a review of epidemiology and treatment. Gen Hosp Psychiatry. 2008;30:112–26.CrossRefPubMed

Faller H, Brahler E, Harter M, Keller M, Schulz H, Wegscheider K, et al. Performance status and depressive symptoms as predictors of quality of life in cancer patients. A structural equation modeling analysis. Psychooncology. 2015;24(11):1456–62.CrossRefPubMed

Quinten C, Coens C, Mauer M, Comte S, Sprangers MA, Cleeland C, et al. EORTC Clinical Groups. Baseline quality of life as a prognostic indicator of survival: a meta-analysis of individual patient data from EORTC clinical trials. Lancet Oncol. 2009;10:865–71.CrossRefPubMed

Reyes-Gibby CC, Anderson KO, Morrow PK, Shete S, Hassan S. Depressive symptoms and health-related quality of life in breast caner survivors. J Women's Health. 2012;21(3):311–8.CrossRef

10.

National Comprehensive Cancer Network. Distress Management (Version 2.2016) 2016. https://www.nccn.org/professionals/physician_gls/pdf/distress.pdf Accessed June 15, 2017.

11.

Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006 Nov;163(11):1905–17.CrossRefPubMed

12.

Thase ME, Friedman SS, Biggs MM, Wisniewski SR, Trivedi MH, Luther JF, et al. Cognitive therapy versus medication in augmentation and switch strategies as second-step treatments: a STAR*D report. Am J Psychiatry. 2007 May;164(5):739–52.CrossRefPubMed

13.

Warden D, Rush AJ, Trivedi MH, Fava M, Wisniewski SR. The STAR*D project results: a comprehensive review of findings. Curr Psychiatry Rep. 2007;9(6):449–59.CrossRefPubMed

14.

Rodin G, Lloyd N, Katz M, Green E, Mackay JA, Wong RKS, et al. The treatment of depression in cancer patients: a systematic review. Support Care Cancer. 2007;15:123–36.CrossRefPubMed

15.

Fisch MJ, Loehrer PJ, Kristeller J, Passik S, Jung SH, Shen J, et al. Fluoxetine versus placebo in advanced cancer outpatients: a double-blinded trial of the Hoosier Oncology Group. J Clin Oncol. 2003;21(10):1937–43.CrossRefPubMed

16.

Razavi D, Allilaire JF, Smith M, Salimpour A, Verra M, Descalux B, et al. The effect of fluoxetine on anxiety and depression symptoms in cancer patients. Acta Psychiatr Scand. 1996;94(3):205–10.CrossRefPubMed

17.

Pezzella G, Moslinger-Gehmayr R, Contu A. Treatment of depression in patients with breast cancer: a comparison between paroxetine and amitriptyline. Breast Cancer Res Treat. 2001;70(1):1–10.CrossRefPubMed

18.

Laoutidis ZG, Mathiak K. Antidepressants in the treatment of depression/depressive symptoms in cancer patients: a systematic review and meta-nalaysis. BMC Psychiatry. 2013;13:140–60.CrossRefPubMedPubMedCentral

19.

Navari RM, Brenner MC, Wilson MN. Treatment of depressive symptoms in patients with early stage breast cancer undergoing adjuvant therapy. Breast Cancer Res Treat. 2008;112:197–201.CrossRefPubMed

20.

Osborn RL, Demoncada AC, Feuerstein M. Psychosocial interventions for depression, anxiety and quality of life in cancer survivors: meta-analyses. Int J Psychiatry Med. 2006;36(1):13–34.CrossRefPubMed

21.

Ell K, Xie B, Quon B, Quinn DI, Dwight-Johnson M, Lee PJ. Randomized controlled trial of collaborative care management of depression among low-income patients with cancer. J Clin Oncol. 2008;26(27):4488–96.CrossRefPubMedPubMedCentral

22.

Somerset W, Stout SC, Miller AH, Musselman D. Breast cancer and depression. Oncology (Williston Park). 2004;18(8):1021–34.

23.

Kissane DW, Grabsch B, Clarke DM, Smith GC, Love AW, Bloch S, et al. Supportive-expressive group therapy for women with metastatic breast cancer: survival and psychosocial outcome from a randomized controlled trial. Psychooncology. 2007;16(4):277–86.CrossRefPubMed

24.

Karimi M, Brazier J. Health, health-related quality of life, and quality of life: what is the difference? PharmacoEconomics. 2016;34:645–9.CrossRefPubMed

25.

Cohen JW, Monheit AC, Beauregard KM, Cohen SB, Lefkowitz DC, Potter DE, Sommers JP, Taylor AK, Arnett RH 3rd. The Medical Expenditure Panel Survey: a national health information resource. Inquiry. 1996–1997;33(4):373–389.

26.

Smith M, Davis MA, Stano M, Whedon JM. Aging baby boomers and the rising cost of chronic back pain: secular trend analysis of longitudinal Medical Expenditures Panel Survey data for years 2000 to 2007. J Manip Physiol Ther. 2013;36(1):2–11.CrossRef

27.

Machlin SR, Chevan J, Yu W, Zodet MW. Determinants of utilization and expenditures for episodes of ambulatory physical therapy among adults. Phys Ther. 2011;91(7):1018–29.CrossRefPubMed

28.

AHRQ MEPS Topics: Priority conditions-General. Available at http://meps.ahrq.gov/data_stats/MEPS_topics.jsp?topicid = 41Z-1 Accessed June 15, 2017.

29.

Medical Expenditure Panel Survey Clinical Classification Code to ICD-9-CM Code Crosswalk. http://meps.ahrq.gov/mepsweb/data_stats/download_data/pufs/h128/h128_icd9codes.shtml Accessed June 15, 2017.

30.

Soni A Trends in use and expenditures for depression among US adults age 18 and older, civilian noninstitutionalized population, 1999 and 2009. Statistical brief # 377. July 2012 Agency for Healthcare Research and Quality Rockville, MD Available at https://wwwmepsahrqgov/mepsweb/data_files/publications/st377/stat377pdf Accessed June 15, 2017.

31.

Wang S, Hsu SH, Gross CP, Sanft T, Davidoff AJ, Ma X, et al. Association between time since cancer diagnosis and health-related quality of life: a population-level analysis. Value Health. 2016;19:631–8.CrossRefPubMedPubMedCentral

32.

Ware J Jr, Kosinski M, Keller SD. A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34:220–33.CrossRefPubMed

33.

Ware J Jr, Kosinski M, Turner-Bowker DM, Gandek B. SF-12v2: how to score version 2 of the SF-12 health survey (with a supplement documenting version 1). Lincoln: QualityMetric Inc.

34.

Harman JS, Edlund MJ, Fortney JC, Kallas H. The influence of comorbid chronic medical conditions on the adequacy of depression care for older Americans. J Am Geriatr Soc. 2005;53(12):2178–83.CrossRefPubMed

35.

Pan X, Sambamoorthi U. Healthcare expenditures associated with depression in adults with cancer. J Community Support Oncol. 2015;13(7):240–7.CrossRefPubMedPubMedCentral

36.

Walker J, Hansen CH, Martin P, Symeonides S, Ramessur R, Murray G, et al. Prevalence, associations, and adequacy of treatment of major depression in patients with cancer: a cross-sectional analysis of routinely collected clinical data. Lancet Psychiatry. 2014;1(5):343–50.CrossRefPubMed

37.

Berard RMF, Boermeester F, Viljoen G. Depressive disorders in an outpatient oncology setting: prevalence, assessment and management. Psychooncology. 1998;7:112–20.CrossRefPubMed

38.

Grassi L, Nanni MG, Uchitomi Y, Riba M. Pharmacotherapy of depression in people with cancer. In: Kissane DW, Maj M, Sartorius N, editors. Depression and cancer. Chichester: Wiley; 2011. p. 151–76.

39.

Ng CG, Boks MP, Zainal NZ, de Wit NJ. The prevalence and pharmacotherapy of depression in cancer patients. J Affect Disord. 2011;131:1–7.CrossRefPubMed

40.

Alenzi EO, Sambamoorthi U. Depression treatment and health-related quality of life among adults with diabetes and depression. Qual Life Res. 2016;25:1517–25.CrossRefPubMed

41.

Strong V, Waters R, Hibberd C, Murray G, Wall L, Walker J, et al. Management of depression for people with cancer (SMaRT oncology 1): a randomized trial. Lancet. 2008;372(9632):40–8.CrossRefPubMed

42.

Kroenke K, Theobald D, Wu J, Norton K, Morrison G, Carpenter J, et al. Effect of telecare management on pain and depression in patients with cancer: a randomized trial. JAMA. 2010;304(2):163–71.CrossRefPubMedPubMedCentral

43.

Daniels J, Kissane DW. Psychosocial interventions for cancer patients. Curr Opin Oncol. 2008;20:367–71.CrossRefPubMed

44.

Jacobsen PB, Jim HS. Psychosocial interventions for anxiety and depression in adult cancer patients: achievements and challenges. CA Cancer J Clin. 2008;58:214–30.CrossRefPubMed

45.

Williams S, Dale J. The effectiveness of treatment for depression/depressive symptoms in adults with cancer: A systematic review. Br J Cancer. 2006;94:372–90.CrossRefPubMedPubMedCentral

46.

Utah Department of Health. Interpreting the SF-12. 2001 Utah Health Status Survey. Available at http://healthutahgov/opha/publications/2001hss/sf12/SF12_Interpretingpdf Accessed June 15, 2017.

Title: Impact of depression treatment on health-related quality of life among adults with cancer and depression: a population-level analysis
Authors: Ami Vyas
Zachary Babcock
Stephen Kogut
Publication date: 01-10-2017
Publisher: Springer US
Published in: Journal of Cancer Survivorship / Issue 5/2017
Print ISSN: 1932-2259
Electronic ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-017-0635-y

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Implications for cancer survivors

Please log in to get access to this content

Other articles of this Issue 5/2017

Specialized survivor clinic attendance increases adherence to cardiomyopathy screening guidelines in adult survivors of childhood cancer

Outcomes of preexisting diabetes mellitus in breast, colorectal, and prostate cancer

Associations between treatment, scoliosis, pulmonary function, and physical performance in long-term survivors of sarcoma

Intervention for patient reported urinary symptoms in prostate cancer survivors: Systematic review

Benefits of marriage on relative and conditional relative cancer survival differ between males and females in the USA

The pervasive nature of uncertainty—a qualitative study of patients with advanced cancer and their informal caregivers

Keynote webinar | Spotlight on antibody–drug conjugates in cancer