National estimates of mental health needs among non-elderly adult cancer survivors.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19103-e19103
Author(s):  
Xu Ji ◽  
Janet Cummings ◽  
Jordan Gilleland Marchak ◽  
Xuesong Han ◽  
Ann C. Mertens
Keyword(s):  
Mental Illness ◽  
Cancer Survivors ◽  
Age Groups ◽  
Adult Survivors ◽  
Major Depressive ◽  
Adult Cancer Survivors ◽  
Young Adult Survivors ◽  
Major Depressive Episodes ◽  
Depressive Episodes

e19103 Background: As advancements in cancer therapies expand the population of long-term cancer survivors, it is important to understand long-term mental health (MH) outcomes associated with cancer experience. This study used a U.S. nationally-representative sample of adult cancer survivors to assess and compare MH outcomes across age groups. Methods: We used the 2015-2017 National Survey of Drug Use and Health to identify respondents aged 18-64 years who reported a history of cancer (survivors) or never had cancer. MH outcomes were operationalized as events in past year of: major depressive episodes, serious psychological distress, suicidal thoughts, suicidal plans, suicidal attempts, any mental illness, and serious mental illness. We compared these outcomes between survivors and those without cancer in adjusted regression analyses, controlling for respondents’ demographic (gender, race/ethnicity) and socioeconomic (health insurance, employment, education status, marital status) characteristics. All analyses were stratified by age group (18-34, 35-49, and 50-64 years). Results: When comparing 2,656 survivors and 112,952 adults without cancer within each age group, survivors had elevated prevalence of MH problems in in five of the seven domains of adverse MH measures. Among young adults (aged 18-34 years), survivors were more likely than their noncancer counterparts to experience major depressive episodes (18.1% versus 9.6%, p< 0.001), serious psychological distress (34.2% versus 17.9, p< 0.001), suicidal thoughts (10.5% versus 7.0%, p= 0.011), any mental illness (41.1% versus 23.3%, p< 0.001), and serious mental illness (13.2% versus 5.9%, p< 0.001) in the past year. These differences persisted in adjusted analyses ( p-values < 0.01). While similar survivor-comparison differences were observed among older groups, the magnitude of these differences was smaller. When comparing MH outcomes across age groups among survivors, young adult survivors had the highest likelihood of experiencing MH problems across all seven domains of adverse MH measures ( p-values < 0.05). Conclusions: This population-based study shows elevated prevalence of MH problems among adult cancer survivors, as compared to the general noncancer population. We also identified a clear age gradient in the prevalence of MH problems, with young adult survivors exhibiting the highest prevalence of adverse MH outcomes. Our findings highlight the importance of developing strategies to ensure early detection and screening of mental illness and improve access to MH treatment for cancer survivors.

scholarly journals A Controlled Study of Major Depressive Episodes in Long-Term Childhood, Adolescence, and Young Adult Cancer Survivors (The NOR-CAYACS Study)

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5800
Author(s):  
Alv A. Dahl ◽  
Cecilie Essholt Kiserud ◽  
Sophie D. Fosså ◽  
Jon Håvard Loge ◽  
Kristin Valborg Reinertsen ◽  
...  
Keyword(s):  
Young Adult ◽  
Cancer Survivors ◽  
Controlled Study ◽  
Prevalence Rates ◽  
Major Depressive ◽  
Adult Cancer Survivors ◽  
Young Adult Cancer ◽  
Major Depressive Episodes ◽  
Depressive Episodes

Background: A major depressive episode (MDE) is typically self-rated by screening forms identifying probable MDE (pMDE). This population-based cross-sectional questionnaire study examined the prevalence rates of pMDE identified by the PHQ-9 screener in long-term survivors of childhood and adolescence (CACSs) and young adult cancer (YACSs) and a normative sample (NORMs). Methods: Data from 488 CACSs, 1202 YACSs, and 1453 NORMs were analyzed, and pMDE was defined both by cut-off ≥10 on the total PHQ-9 score and by an algorithm. Results: The prevalence rates of pMDE among CACSs were 21.5%, 16.6% in YACSs, and 9.2% among NORMs using the cut-off definition. With the algorithm, the prevalence rates of pMDE were 8.0% among CACSs, 8.1% among YACSs, and 3.9% among NORMs. Independent of definition, CACSs and YACSs had significantly increased prevalence rates of pMDE compared to NORMs. Psychosocial factors and self-rated health were significantly associated with both definitions of pMDE in multivariable analyses, while survivor groups, cancer types, and adverse events were not. Conclusion: Since pMDE has negative health consequences and is amenable to treatment, healthcare providers should be attentive and screen for pMDE in young cancer survivors. For PHQ-9, the preferred type of definition of pMDE should be determined.

A comparison of short- and long-term cortisol levels in melancholic and non-melancholic major depressive episodes using hair and saliva specimens

2019 ◽  
Vol 254 ◽  
pp. 127-128
Author(s):  
Andrés Herane-Vives ◽  
Allan H Young ◽  
Toby Wise ◽  
Juan Aguirre ◽  
Valeria de Angel ◽  
...  
Keyword(s):  
Major Depressive ◽  
Short And Long Term ◽  
Cortisol Levels ◽  
Major Depressive Episodes ◽  
Depressive Episodes

scholarly journals Risk stratification of young adult survivors of cancer to estimate hospital morbidity burden: applicability of a pediatric therapy-based approach

2020 ◽  
Author(s):  
Christopher Clements ◽  
Kirsten J. Cromie ◽  
Lesley Smith ◽  
Richard G. Feltbower ◽  
Nicola Hughes ◽  
...  
Keyword(s):  
Young Adults ◽  
Risk Stratification ◽  
Cancer Survivors ◽  
Adult Survivors ◽  
Morbidity Burden ◽  
Risk Levels ◽  
The North ◽  
Late Morbidity ◽  
Young Adult Survivors

Abstract Purpose Children and young adults (CYA) are at risk of late morbidity following cancer treatment, with risk varying by disease type and treatment received. Risk-stratified levels of aftercare which stratify morbidity burden to inform the intensity of long-term follow-up care, are well established for survivors of cancer under the age of 18 years, utilizing the National Cancer Survivor Initiative (NCSI) approach. We investigated the applicability of risk-stratified levels of aftercare in predicting long-term morbidity in young adults (YA), aged 18–29 years. Methods Long-term CYA survivors followed-up at a regional center in the North of England were risk-stratified by disease and treatments received into one of three levels. These data were linked with local cancer registry and administrative health data (Hospital Episode Statistics), where hospital activity was used as a marker of late morbidity burden. Results Poisson modelling with incident rate ratios (IRR) demonstrated similar trends in hospital activity for childhood (CH) and YA cancer survivors across NCSI risk levels. NCSI levels independently predicted long-term hospitalization risk in both CH and YA survivors. Risk of hospitalization was significantly reduced for levels 1 (CH IRR 0.32 (95% CI 0.26–0.41), YA IRR 0.06 (95% CI 0.01–0.43)) and 2; CH IRR 0.46 (95% CI 0.42-0.50), YA IRR 0.49 (95% CI 0.37-0.50)), compared with level 3. Conclusions The NCSI pediatric late-effects risk stratification system can be effectively and safely applied to cancer patients aged 18–29, independent of ethnicity or socioeconomic position. Implications for Cancer Survivors To enhance quality of care and resource utilization, long-term aftercare of survivors of YA cancer can and should be risk stratified through adoption of approaches such as the NCSI risk-stratification model.

scholarly journals Physical Comorbidities and Depression in Recent and Long-Term Adult Cancer Survivors: NHANES 2007–2018

Cancers ◽  
2021 ◽  
Vol 13 (13) ◽  
pp. 3368
Author(s):  
Dafina Petrova ◽  
Andrés Catena ◽  
Miguel Rodríguez-Barranco ◽  
Daniel Redondo-Sánchez ◽  
Eloísa Bayo-Lozano ◽  
...  
Keyword(s):  
Cancer Survivors ◽  
Cancer Patients ◽  
Cancer Diagnosis ◽  
Depression Symptoms ◽  
Depression Risk ◽  
Adult Cancer Survivors ◽  
Before And After ◽  
Nationally Representative ◽  
Risk Of Cancer

Many adult cancer patients present one or more physical comorbidities. Besides interfering with treatment and prognosis, physical comorbidities could also increase the already heightened psychological risk of cancer patients. To test this possibility, we investigated the relationship between physical comorbidities with depression symptoms in a sample of 2073 adult cancer survivors drawn from the nationally representative National Health and Nutrition Examination Survey (NHANES) (2007–2018) in the U.S. Based on information regarding 16 chronic conditions, the number of comorbidities diagnosed before and after the cancer diagnosis was calculated. The number of comorbidities present at the moment of cancer diagnosis was significantly related to depression risk in recent but not in long-term survivors. Recent survivors who suffered multimorbidity had 3.48 (95% CI 1.26–9.55) times the odds of reporting significant depressive symptoms up to 5 years after the cancer diagnosis. The effect of comorbidities was strongest among survivors of breast cancer. The comorbidities with strongest influence on depression risk were stroke, kidney disease, hypertension, obesity, asthma, and arthritis. Information about comorbidities is usually readily available and could be useful in streamlining depression screening or targeting prevention efforts in cancer patients and survivors. A multidimensional model of the interaction between cancer and other physical comorbidities on mental health is proposed.

What is the role of conventional antidepressants in the treatment of major depressive episodes with Mixed Features Specifier?

CNS Spectrums ◽  
2016 ◽  
Vol 22 (2) ◽  
pp. 120-125 ◽  
Author(s):  
Gianni L. Faedda ◽  
Ciro Marangoni
Keyword(s):  
Clinical Trials ◽  
Unipolar Depression ◽  
Preliminary Evidence ◽  
Major Depressive ◽  
Pharmacological Management ◽  
Diagnostic And Statistical Manual ◽  
Mixed Features ◽  
Effective Use ◽  
Major Depressive Episodes ◽  
Depressive Episodes

The newly introduced Mixed Features Specifier of Major Depressive Episode and Disorder (MDE/MDD) is especially challenging in terms of pharmacological management. Prior to the publication of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, the symptoms of the mixed features specifier were intradepressive hypomanic symptoms, always and only associated with bipolar disorder (BD).Intradepressive hypomanic symptoms, mostly referred to as depressive mixed states (DMX), have been poorly characterized, and their treatment offers significant challenges. To understand the diagnostic context of DMX, we trace the nosological changes and collocation of intradepressive hypomanic symptoms, and examine diagnostic and prognostic implications of such mixed features.One of the reasons so little is known about the treatment of DMX is that depressed patients with rapid cycling, substance abuse disorder, and suicidal ideation/attempts are routinely excluded from clinical trials of antidepressants. The exclusion of DMX patients from clinical trials has prevented an assessment of the safety and tolerability of short- and long-term use of antidepressants. Therefore, the generalization of data obtained in clinical trials for unipolar depression to patients with intradepressive hypomanic features is inappropriate and methodologically flawed.A selective review of the literature shows that antidepressants alone have limited efficacy in DMX, but they have the potential to induce, maintain, or worsen mixed features during depressive episodes in BD. On the other hand, preliminary evidence supports the effective use of some atypical antipsychotics in the treatment of DMX.

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