Reiner Anne S, Alici Yesne, Correa Denise D, Bossert Dana, Sigler Allison M, Fournier Deanna, Brewer Kathleen, Goyal Gaurav, Atkinson Thomas M, Marathe Priya, Mao Jun J, Panageas Katherine S, Diamond Eli L
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY.
Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY.
Blood Adv. 2025 Mar 25;9(6):1376-1386. doi: 10.1182/bloodadvances.2024014850.
Anxiety and depression are common in many cancers but, to our knowledge, have not been systematically studied in patients with histiocytic neoplasms (HNs). We sought to estimate rates of anxiety and depression and identify clinical features and patient-reported outcomes (PROs) associated with anxiety and depression in patients with HNs. A registry-based cohort of patients with HNs completing PROs including the hospital anxiety and depression scale (HADS) from 2018 to 2023 was identified. Moderate or severe anxiety or depression were respectively defined as a score of ≥11 on the HADS anxiety or depression subscales. Associations of variables, including other validated PROs, with moderate or severe anxiety or depression were modeled with logistic regression to estimate odds ratios and 95% confidence intervals. In 215 patients, ∼1 in 3 met the criteria for anxiety or depression, and 1 in 7 met the criteria for moderate or severe anxiety or depression. These estimates remained stable over a 12-month trajectory. Rates of depression, but not anxiety, significantly differed across HN types, with patients with Erdheim-Chester disease experiencing the highest rate. In addition, neurologic involvement, unemployment, and longer undiagnosed illness interval were significantly associated with increased risk of depression. Financial burden, financial worry, and severe disease-related symptoms were correlated with increased risk of both anxiety and depression. Conversely, increased general and cognitive health-related quality of life (HRQoL) were correlated with decreased risk of both anxiety and depression. In patients with HN, anxiety and depression are prevalent, stable over time, and correlated with financial burden, symptom severity, and HRQoL. This trial was registered at www.clinicaltrials.gov as #NCT03329274.
焦虑和抑郁在许多癌症中很常见，但据我们所知，尚未在组织细胞肿瘤（HN）患者中进行系统研究。我们试图估计HN患者的焦虑和抑郁发生率，并确定与焦虑和抑郁相关的临床特征及患者报告结局（PRO）。我们确定了一个基于登记处的HN患者队列，这些患者在2018年至2023年期间完成了包括医院焦虑抑郁量表（HADS）在内的PRO。中度或重度焦虑或抑郁分别定义为HADS焦虑或抑郁子量表得分≥11分。使用逻辑回归对包括其他经过验证的PRO在内的变量与中度或重度焦虑或抑郁之间的关联进行建模，以估计比值比和95%置信区间。在215名患者中，约三分之一符合焦虑或抑郁标准，七分之一符合中度或重度焦虑或抑郁标准。这些估计在12个月的时间轨迹上保持稳定。不同类型的HN患者抑郁发生率存在显著差异，但焦虑发生率无显著差异，其中埃尔德海姆-切斯特病患者的抑郁发生率最高。此外，神经系统受累、失业和未确诊疾病间隔时间较长与抑郁风险增加显著相关。经济负担、经济担忧和严重的疾病相关症状与焦虑和抑郁风险增加均相关。相反，总体和与认知健康相关的生活质量（HRQoL）提高与焦虑和抑郁风险降低相关。在HN患者中，焦虑和抑郁很普遍，随时间稳定，且与经济负担、症状严重程度和HRQoL相关。该试验已在www.clinicaltrials.gov上注册，注册号为#NCT03329274。
