C Shi1, Nayan Lamba2, L J Zheng3, D Cote2, Q R Regestein4, C M Liu5, Q Tran5, S Routh5, T R Smith6, R A Mekary7, M L D Broekman8. 1. Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, United States; Harvard T.H. Chan School of Public Health, Boston, MA, United States. 2. Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States. 3. CVS Health, Woonsocket, RI, United States. 4. Department of Psychiatry, Brigham and Women's Hospital, 1249 Boylston St., Boston, MA 02215, United States. 5. Department of Pharmaceutical Business and Administrative Sciences MCPHS University, Boston, MA, United States. 6. Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, United States. 7. Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, United States; Department of Pharmaceutical Business and Administrative Sciences MCPHS University, Boston, MA, United States. 8. Computational Neurosciences Outcomes Center, Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, United States; Department of Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: M.L.D.Broekman-4@umcutrecht.nl.
Abstract
INTRODUCTION: There is currently a lack of a well-formed consensus regarding the effects of depression on the survival of glioma patients. A more thorough understanding of such effects may better highlight the importance of recognizing depressive symptoms in this patient population and guide treatment plans in the future. OBJECTIVE: The aim of this meta-analysis was to study the effect of depression on glioma patients' survival. METHODS: A meta-analysis was conducted according to the PRISMA guidelines. PubMed, Embase, and Cochrane databases were searched for studies that reported depression and survival among glioma patients through 11/06/2016. Both random-effects (RE) and fixed-effect (FE) models were used to compare survival outcomes in glioma patients with and without depression. RESULTS: Out of 619 identified articles, six were selected for the meta-analysis. Using RE model, the various measures for survival outcomes displayed worsened outcomes for both high and low-grade glioma patients with depression compared to those without depression. For binary survival outcomes, the overall pooled risk ratio for survival was 0.70 (95% CI: 0.47, 1.04; 6 studies; I2 = 54.9%, P-heterogeneity = 0.05) for high grade gliomas (HGG) and 0.28 (95% CI: 0.04, 1.78; I2 = 0%, P-heterogeneity = 1.00; one study) for low grade gliomas (LGG) was. A sub-group analysis in the HGG group by depression timing (pre- versus post-operative) revealed no differences between depression and survival outcomes (P-interaction = 0.47). For continuous survival outcomes, no statistically significant difference was found among the high and low-grade glioma groups (P-interaction = 0.31). The standardized mean difference (SMD) in survival outcomes was -0.56 months (95%CI: -1.13, 0.02; 4 studies, I2 = 89.4%, P-heterogeneity < 0.01) for HGG and -1.69 months (95%CI: -3.26, -0.13; one study; I2 = 0%, P-heterogeneity = 1.00) for LGG. In patients with HGG, the pooled HR of death also showed a borderline significant increased risk of death among depressive patients (HR 1.42, 95% CI: 1.00, 2.01). Results using the FE model were not materially different. CONCLUSIONS: Depression was associated with significantly worsened survival regardless of time of diagnosis, especially among patients with high-grade glioma.
INTRODUCTION: There is currently a lack of a well-formed consensus regarding the effects of depression on the survival of gliomapatients. A more thorough understanding of such effects may better highlight the importance of recognizing depressive symptoms in this patient population and guide treatment plans in the future. OBJECTIVE: The aim of this meta-analysis was to study the effect of depression on gliomapatients' survival. METHODS: A meta-analysis was conducted according to the PRISMA guidelines. PubMed, Embase, and Cochrane databases were searched for studies that reported depression and survival among gliomapatients through 11/06/2016. Both random-effects (RE) and fixed-effect (FE) models were used to compare survival outcomes in gliomapatients with and without depression. RESULTS: Out of 619 identified articles, six were selected for the meta-analysis. Using RE model, the various measures for survival outcomes displayed worsened outcomes for both high and low-grade gliomapatients with depression compared to those without depression. For binary survival outcomes, the overall pooled risk ratio for survival was 0.70 (95% CI: 0.47, 1.04; 6 studies; I2 = 54.9%, P-heterogeneity = 0.05) for high grade gliomas (HGG) and 0.28 (95% CI: 0.04, 1.78; I2 = 0%, P-heterogeneity = 1.00; one study) for low grade gliomas (LGG) was. A sub-group analysis in the HGG group by depression timing (pre- versus post-operative) revealed no differences between depression and survival outcomes (P-interaction = 0.47). For continuous survival outcomes, no statistically significant difference was found among the high and low-grade glioma groups (P-interaction = 0.31). The standardized mean difference (SMD) in survival outcomes was -0.56 months (95%CI: -1.13, 0.02; 4 studies, I2 = 89.4%, P-heterogeneity < 0.01) for HGG and -1.69 months (95%CI: -3.26, -0.13; one study; I2 = 0%, P-heterogeneity = 1.00) for LGG. In patients with HGG, the pooled HR of death also showed a borderline significant increased risk of death among depressivepatients (HR 1.42, 95% CI: 1.00, 2.01). Results using the FE model were not materially different. CONCLUSIONS:Depression was associated with significantly worsened survival regardless of time of diagnosis, especially among patients with high-grade glioma.
Authors: Sebastian Otto-Meyer; Jan Lumibao; Eugene Kim; Erik Ladomersky; Lijie Zhai; Kristen L Lauing; Denise M Scholtens; Frank Penedo; Christina Amidei; Rimas V Lukas; Derek A Wainwright Journal: Curr Opin Behav Sci Date: 2019-02-26
Authors: Ryan T Merrell; Kelly Claire Simon; Nina Martinez; Rosa Maria Vazquez; Bryce Hadsell; Alexander Epshteyn; Gary Wilk; Roberta Frigerio; Demetrius M Maraganore Journal: Mayo Clin Proc Innov Qual Outcomes Date: 2021-06-05
Authors: Sebastian Otto-Meyer; Rian DeFaccio; Corey Dussold; Erik Ladomersky; Lijie Zhai; Kristen L Lauing; Lakshmi R Bollu; Christina Amidei; Rimas V Lukas; Denise M Scholtens; Derek A Wainwright Journal: Brain Behav Immun Health Date: 2019-12-16