title: The Association Between Depressive Symptoms and Age in Cancer Patients: A Multicenter Cross-Sectional Study.
abstract: BACKGROUND
  There is controversy around the association between depressive symptoms and age in adult cancer patients.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the following hypotheses: 1) cancer patients' depressive symptoms decrease with age, and 2) in individuals aged 65 years or older, depressive symptoms increase because of the effect of somatic symptoms.
  
  
  METHODS
  We retrospectively analyzed a database of 356 cancer patients who were consecutively recruited in a previous multicenter cross-sectional study. Depressive symptoms were assessed by the Patient Health Questionnaire-9 (PHQ-9), and correlations with age and other factors were assessed by hierarchical multivariate regression analysis. Age was entered as the dependent variable in the first step, patient characteristics and cancer-related variables were entered in the second step, and somatic symptoms were entered in the last step. We analyzed this model for both the total sample and the subpopulation aged 65 years or older.
  
  
  RESULTS
  In the total sample, the PHQ-9 score was significantly associated with lower age, fatigue, and shortness of breath (adjusted R(2) 14.2%). In the subpopulation aged 65 years or older, no factor was associated with the PHQ-9 score (adjusted R(2) 7.3%).
  
  
  CONCLUSIONS
  The finding that depressive symptoms in cancer patients decreased with age was concordant with our first hypothesis, but the second hypothesis was not supported. Younger cancer patients were vulnerable to depressive symptoms and should be monitored carefully. Further studies using more representative samples are needed to examine in detail the association between depressive symptoms and age in older cancer patients.
authors: Department of Psycho-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan; Section of Liaison, Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.
authors: Saho
authors: S
authors: Wada
authors: Department of Psycho-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan. Electronic address: keshimiz@ncc.go.jp.
authors: Ken
authors: K
authors: Shimizu
authors: Department of Psycho-Oncology, National Cancer Center Hospital, Chuo-ku, Tokyo, Japan.
authors: Hironobu
authors: H
authors: Inoguchi
authors: Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan; Department of Mental Health Policy and Evaluation, National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira-shi, Tokyo, Japan.
authors: Haruki
authors: H
authors: Shimoda
authors: Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
authors: Kazuhiro
authors: K
authors: Yoshiuchi
authors: Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Nagoya-shi, Aichi, Japan; Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya-shi, Aichi, Japan.
authors: Tatsuo
authors: T
authors: Akechi
authors: Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya-shi, Aichi, Japan.
authors: Megumi
authors: M
authors: Uchida
authors: Division of Psycho-Oncology, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa-shi, Chiba, Japan; Department of Psycho-Oncology Service, National Cancer Center Hospital East, Kashiwa-shi, Chiba, Japan.
authors: Asao
authors: A
authors: Ogawa
authors: Division of Psycho-Oncology, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa-shi, Chiba, Japan; Department of Psycho-Oncology Service, National Cancer Center Hospital East, Kashiwa-shi, Chiba, Japan.
authors: Daisuke
authors: D
authors: Fujisawa
authors: Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama-shi, Okayama, Japan.
authors: Shinichirou
authors: S
authors: Inoue
authors: Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center, Chuo-ku, Tokyo, Japan.
authors: Yosuke
authors: Y
authors: Uchitomi
authors: Section of Liaison, Psychiatry and Palliative Medicine, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan.
authors: Eisuke
authors: E
authors: Matsushima
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D004417:Dyspnea / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D005221:Fatigue / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009369:Neoplasms / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D055815:Young Adult
keywords: Age; cancer; depression; oncology; somatic symptoms