Depression and cancer mortality: a meta-analysis

Depression and cancer mortality: a meta-analysis

2010 November ; 40(11): 1797–1810 | M. Pinquart, P. R. Duberstein
This meta-analysis examines the association between depression and cancer mortality, testing whether these associations vary by study characteristics. The study integrated results from 76 prospective studies, involving 105 samples, to analyze the impact of depression on cancer patient mortality. Key findings include: 1. **Association Between Depression and Mortality**: Depression diagnosis and higher levels of depressive symptoms were associated with elevated mortality in cancer patients. This association was observed in studies that assessed depression before or after cancer diagnosis. 2. **Moderating Effects**: The association between depression and mortality was weaker in studies with longer intervals between assessments of depression and mortality, younger samples, and those using the Beck Depression Inventory (BDI) compared to other scales. 3. **Study Characteristics**: - **Recruitment Site**: Studies with community-based samples found stronger associations. - **Statistical Control for Confounding Variables**: Studies controlling for confounding variables had similar effect sizes to those without. - **Disease Stage**: The association was similar across early, late, and mixed stages of cancer. - **Cancer Site**: Depression predicted shorter survival in various cancer types. - **Length of Study Interval**: Stronger associations were found in studies with shorter intervals between assessments. - **Measurement of Depression**: The BDI yielded a non-significant effect size, while other scales showed significant associations. - **Age Distribution**: Stronger associations were found in older cancer patients. - **Gender Composition**: No significant associations were found based on gender. 4. **Conclusions**: The study emphasizes the importance of routine screening for depression in cancer treatment settings and considering referrals to mental health specialists. Future research should explore moderators and mediators of the relationship between depression and mortality, particularly in specific cancer sites and with more differentiated measures of confounding variables. 5. **Clinical Implications**: Effective treatments for depression in cancer patients could potentially improve medical outcomes and survival, suggesting the need for systematic research on the effects of psychosocial interventions on depressed cancer patients.This meta-analysis examines the association between depression and cancer mortality, testing whether these associations vary by study characteristics. The study integrated results from 76 prospective studies, involving 105 samples, to analyze the impact of depression on cancer patient mortality. Key findings include: 1. **Association Between Depression and Mortality**: Depression diagnosis and higher levels of depressive symptoms were associated with elevated mortality in cancer patients. This association was observed in studies that assessed depression before or after cancer diagnosis. 2. **Moderating Effects**: The association between depression and mortality was weaker in studies with longer intervals between assessments of depression and mortality, younger samples, and those using the Beck Depression Inventory (BDI) compared to other scales. 3. **Study Characteristics**: - **Recruitment Site**: Studies with community-based samples found stronger associations. - **Statistical Control for Confounding Variables**: Studies controlling for confounding variables had similar effect sizes to those without. - **Disease Stage**: The association was similar across early, late, and mixed stages of cancer. - **Cancer Site**: Depression predicted shorter survival in various cancer types. - **Length of Study Interval**: Stronger associations were found in studies with shorter intervals between assessments. - **Measurement of Depression**: The BDI yielded a non-significant effect size, while other scales showed significant associations. - **Age Distribution**: Stronger associations were found in older cancer patients. - **Gender Composition**: No significant associations were found based on gender. 4. **Conclusions**: The study emphasizes the importance of routine screening for depression in cancer treatment settings and considering referrals to mental health specialists. Future research should explore moderators and mediators of the relationship between depression and mortality, particularly in specific cancer sites and with more differentiated measures of confounding variables. 5. **Clinical Implications**: Effective treatments for depression in cancer patients could potentially improve medical outcomes and survival, suggesting the need for systematic research on the effects of psychosocial interventions on depressed cancer patients.
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Understanding Depression and cancer mortality%3A a meta-analysis