Depression and survival in patients with non-small cell lung cancer after curative resection: a preliminary study.
Psychological depression is thought to be a predictor of poor survival among cancer patients. The objective of the present study was to investigate the association between depression and survival in surgically treated Japanese patients with non-small cell lung cancer (NSCLC). From June 1996 through April 1999, a total of 229 patients with postoperative lung cancer were enrolled. Three months after the patients' surgery, the Structured Clinical Interview for DSM-III-R (SCID) and the Profile of Mood States (POMS) were used to assess the patient for depression, based on the interviewers' rating and a self-report, respectively. The follow-up period consisted of a total of 14 342 person-months (median=69 months). As of January 2004, 55 deaths had occurred within the follow-up period. A Cox regression was used to estimate the hazard ratio (HR) of mortality adjusting for age, sex, smoking status, occasion of diagnosis, pathological stage and preoperative percentage forced expiratory volume in 1 s. The depression-dejection subscale on the POMS was divided into three score levels. The multivariate HR of survival for individuals with depression, as diagnosed by the SCID, was 2.2 (95% confidence interval 0.8-6.0) (P-value=0.14), compared with individuals without depression. The multivariate HR of survival for subjects in the highest level of the POMS Depression-Dejection subscale was 1.4 (0.7-2.6), compared with in the lowest level (trend P-value=0.0502). This prospective cohort study in Japan does not support the hypothesis that depression is associated with survival among NSCLC patients after curative resection, but further analysis involving a long-term follow-up period is needed.
Nakaya
Naoki
N
Psycho-Oncology Division, National Cancer Center Research Institute East, Kashiwa 277-8577, Japan.
Saito-Nakaya
Kumi
K
Akizuki
Nobuya
N
Yoshikawa
Eisho
E
Kobayakawa
Makoto
M
Fujimori
Maiko
M
Nagai
Kanji
K
Nishiwaki
Yutaka
Y
Fukudo
Shin
S
Tsubono
Yoshitaka
Y
Uchitomi
Yosuke
Y
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality* / Q000523:psychology* / Q000601:surgery; D003863:Depression / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000401:mortality* / Q000523:psychology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies