Association of depression phenotypes and antidepressant treatment with mortality due to cancer and other causes: a community-based cohort study

Abstract

Objective: This study aimed to assess the association of somatic depressive symptoms (SDS), cognitive/emotional depressive symptoms (C-EDS), and antidepressant treatment on mortality due to cancer and other causes in a community cohort.Methods: A community-based sample recruited in 1995, 2000, and 2005 aged between 35 and 75 years was examined in two waves and followed for a median of 6.7 years. SDS and C-EDS phenotypes were assessed using the Patient Health Questionnaire-9. Medication used by participants was collected. Deaths and their causes were registered during follow-up. Cox proportional hazard models stratified by sex were performed to determine the association between depressive phenotypes and mortality.Results: The cohort consisted of 5,646 individuals (53.9% women) with a mean age of 64 years (SD = 11.89). During the follow-up, 392 deaths were recorded, of which 27.8% were due to cancer. C-EDS phenotype was associated with an increased risk of cancer mortality in both men (HR = 2.23; 95% CI = 1.11–4.44) and women (HR = 3.69; 95% CI = 1.69–8.09), and SDS was significantly associated with non-cancer mortality in men (HR = 2.16; 95 CI % = 1.46–3.18). Selective serotonin reuptake inhibitors (SSRIs) were significantly associated with both cancer (HR = 2.78; 95% CI = 1.10–6.98) and non-cancer mortality (HR = 2.94; 95% CI = 1.76–4.90) only in the male population.Conclusion: C-EDS phenotype was related to an increased risk of cancer mortality at 6 years. In addition, the use of SSRIs in the male population was associated with cancer and all-cause mortality.

Objectiu: aquest estudi pretenia avaluar l'associació de símptomes depressius somàtics (SDS), símptomes depressius cognitius/emocionals (C-EDS) i tractament antidepressiu sobre la mortalitat per càncer i altres causes en una cohort comunitària.

Mètodes: una mostra basada en la comunitat reclutada el 1995, 2000 i 2005 d'entre 35 i 75 anys es va examinar en dues onades i es va seguir durant una mitjana de 6,7 anys. Els fenotips SDS i C-EDS es van avaluar mitjançant el Patient Health Questionnaire-9. Es van recollir els medicaments utilitzats pels participants. Durant el seguiment es van registrar les morts i les seves causes. Es van realitzar models de risc proporcional de Cox estratificats per sexe per determinar l'associació entre fenotips depressius i mortalitat.

Resultats: La cohort estava formada per 5.646 individus (53,9% dones) amb una edat mitjana de 64 anys (DE = 11,89). Durant el seguiment es van registrar 392 defuncions, de les quals el 27,8% van ser per càncer. El fenotip C-EDS es va associar amb un augment del risc de mortalitat per càncer tant en homes (HR = 2,23; IC 95% = 1,11-4,44) com en dones (HR = 3,69; IC 95% = 1,69-8,09), i el SDS es va associar significativament. amb mortalitat no per càncer en homes (HR = 2,16; IC 95 % = 1,46–3,18). Els inhibidors selectius de la recaptació de serotonina (ISRS) es van associar significativament tant amb el càncer (HR = 2,78; IC 95% = 1,10-6,98) com amb la mortalitat no per càncer (HR = 2,94; IC 95% = 1,76-4,90) només a la població masculina.

Conclusió: el fenotip C-EDS es va relacionar amb un augment del risc de mortalitat per càncer als 6 anys. A més, l'ús d'ISRS a la població masculina es va associar amb càncer i mortalitat per totes les causes.