Depressive Symptoms in Danish Patients With Glioma and a Cancer-Free Comparison Group

Authors:
Katrine Løppenthin Danish Cancer Society Research Center, Copenhagen;

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Christoffer Johansen Danish Cancer Society Research Center, Copenhagen;
Department of Oncology, Finsen Center, Rigshospitalet, Copenhagen;

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Matilde Bille Larsen Copenhagen University Hospital GCP Unit, Bispebjerg Hospital, Copenhagen; and

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Birgitte Hysse Forchhammer National Study on Young Brain Injury Survivors, Department of Neurology, and

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Jannick Brennum Neurosurgery Clinic, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark;

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Karin Piil Department of Oncology, Finsen Center, Rigshospitalet, Copenhagen;

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Neil Aaronson Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands; and

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Birthe Krogh Rasmussen Department of Neurology, Nordsjællands Hospital, Hillerød, Denmark.

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Pernille Bidstrup Danish Cancer Society Research Center, Copenhagen;

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Background: It is well established that patients with glioma may experience adverse general (eg, headache) or focal symptoms (eg, personality changes) and neurocognitive deficits (eg, planning), but they may also experience severe emotional distress. We investigated the prevalence of depressive symptoms in patients with newly diagnosed glioma and in matched cancer-free persons. Methods: For this study, we recruited patients with glioma diagnosed within 12 months at all 4 neurosurgical clinics in Denmark. The cancer-free comparison group was identified through the Danish Central Person Register and matched on sex and age. Participants’ depressive symptoms were evaluated using the Center for Epidemiologic Studies Depression Scale (CES-D; score range, 0–60), with a cutoff score ≥16 indicating moderate-to-severe depressive symptoms. Results: In this study, 363 of 554 patients with glioma and 481 of 1,304 cancer-free persons participated. Mean age of all patients was 55 years and 60% of the population was male. Mean scores for depressive symptoms were statistically significantly higher among patients with glioma, with a mean CES-D score of 10.9 (95% CI, 10.1–11.8) compared with 5.3 (95% CI, 4.7–5.8) among cancer-free persons (P<.0001). Overall, 92 patients with glioma (25%) and 30 cancer-free persons (6%) had moderate-to-severe depressive symptoms. After adjustment for marital status, education level, and comorbidity, the prevalence of depressive symptoms was 5 times higher among patients with glioma compared with cancer-free persons. Conclusions: A substantially higher prevalence of moderate-to-severe depressive symptoms was identified in patients with glioma compared with cancer-free persons. This indicates the importance of programs to systematically identify and manage depressive symptoms in patients with glioma.

Submitted July 30, 2019; accepted for publication April 1, 2020.

Author contributions: Study design: Løppenthin, Johansen, Larsen, Bidstrup. Data collection and interpretation: Løppenthin, Johansen, Larsen, Bidstrup. Interpretation of results: All authors. Manuscript editing: All authors. Approval of final manuscript: All authors.

Disclosures: The authors have disclosed that they have not received any financial consideration from any person or organization to support the preparation, analysis, results, or discussion of this article.

Correspondence: Katrine Løppenthin, PhD, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark. Email: katrine.bjerre.loeppenthin@regionh.dk

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