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Depression as a risk factor for mortality and disease progression in cancer patients : a meta-analysis

University of British Columbia

Depression is the most common psychological problem affecting cancer patients. While there is a growing body of research linking depression to physiological mediators of cancer progression, evidence for the effect of depression on cancer mortality and progression is mixed. Researchers continue to investigate the impact of psychological intervention on physical outcomes of cancer before resolving whether depression affects these outcomes in the first place. The present meta-analysis synthesizes the body of work that has examined the effect of depression on cancer mortality and progression. Using two databases (PsycInfo and Medline), a search was performed to identify articles that examined the effect of depression on cancer mortality or progression. The references of the identified articles were then examined for other relevant articles. The inclusion criteria were met by 42 publications reporting on 41 studies and 14 publications reporting on 13 studies measuring progression. Using a random-effects model, odds ratios (OR), risk ratios (RR), and hazard ratios (HR) are presented as estimates of the combined overall effect of depression. There is some support for the effect of depression on mortality in cancer patients, (OR = 1.281 ;CI, 1.077-1.523, p=.005; HR = 1.095; 1.027, 1.027-1.167, p = .006), but not on progression (OR=1.043; CI, .860-1.265, p = .668: HR = 1.038; CI, .999-1.078, p = .053). There is a significant effect of depression on cancer mortality, though the magnitude is small. Difficulties in interpretation are discussed. This finding fuels future work to identify subgroups of patients for whom depression has a greater effect on physical outcomes in cancer.

Text

2011-03-16

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http://hdl.handle.net/2429/32501

Psychology

University of British Columbia

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