The study found that patients with Hodgkin’s lymphoma (HL) were at an increased risk of any mental health disorder, which was associated with worse long-term outcomes.
Addressing the mental health of patients with Hodgkin’s lymphoma (HL) may have implications for survival, say new study findings that have indicated that these patients, especially those undergoing hematopoietic stem cell transplantation (HSCT), are at increased risk of mental health disorders.
The study found that patients with HL were at increased risk of any mental health disorder (HR, 1.77; 95% CI, 1.57-2.00), which was associated with worse long-term outcomes. Among patients with HL, those who also had a mental health diagnosis had a 2.7-fold increased risk of death compared to patients without a mental health diagnosis.
Among patients who had an HL diagnosis for less than 2 years, those who also received a mental health diagnosis had inferior 5-year (77% vs. 90%) and 10-year (70% vs. 86%) OS compared with patients who did. don’t also get a mental health diagnosis.
According to the researchers, they were not surprised to find an increased risk of a mental health diagnosis among these patients due to the stress associated with a cancer diagnosis and treatment.
“However, it is interesting to note our finding that patients with HL who had a mental health diagnosis in the acute time period (< 2 years after HL diagnosis), when they had the most appointments for treatment and follow-up, had a sustained decrease in OS . This indicates that the higher incidence of mental health disorders in patients with HL may not only be caused by acute stresses of treatment or increased interaction with the health care system.”
The study included nearly 800 patients with HL and nearly 3600 individuals from the general population. Patients with HL had a higher risk of anxiety (HR, 1.84; 95% CI, 1.54–2.20), depression (HR, 1.57; 95% CI, 1.33–1.87), substance-related disorders (HR, 1.63; 95% CI , 1.08–2.46), and suicide and intentional self-inflicted injuries (HR, 1.87; 95% CI, 1.07–3.28). The researchers also observed increased risks of all combinations of various mental health disorders among patients with HL compared to the general population.
The only treatment-related risk factor for being diagnosed with any mental health disorder was undergoing HSCT, with a hazard ratio of 2.06 (95% CI, 1.53–2.76). According to the researchers, this was the case for all mental health disorders after adjusting for age, body mass index, race, gender and disease stage.
“Our findings are consistent with several survey-based studies of mental health in patients with lymphoma, and we also present some unique findings,” the researchers wrote. “The majority of previous studies have focused on anxiety and depression, finding that patient-reported rates of anxiety ranged from 15% to 40% and that depression rates ranged from 10% to 35%. Our results fit within the range of these patients reported: 21% of our HL patients were diagnosed with an anxiety disorder, and 23% were diagnosed with a depressive disorder.The previous studies generally showed no improvement in the prevalence of anxiety or depression over time, while we found , that the highest risk period for both anxiety and depression was <2 years after diagnosis."
Tao R, Chen Y, Kim S, et al. Mental health disorders are more common in patients with Hodgkin’s lymphoma and can negatively affect overall survival. Cancer. Published online August 2, 2022. doi: 10.1002/cncr.34359
