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

Anna Vilalta-Lacarra; Joan Vilalta-Franch; Domènec Serrano-Sarbosa; Ruth Martí-Lluch; Jaume Marrugat; Josep Garre-Olmo

doi:10.3389/fpsyg.2023.1192462

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

Front Psychol. 2023 Aug 24:14:1192462. doi: 10.3389/fpsyg.2023.1192462. eCollection 2023.

Authors

Anna Vilalta-Lacarra¹, Joan Vilalta-Franch², Domènec Serrano-Sarbosa^{2

3

4}, Ruth Martí-Lluch^{2

5}, Jaume Marrugat^{6

7}, Josep Garre-Olmo^{2

8}

Affiliations

¹ Department of Medical Oncology, Clinica Universidad de Navarra, Pamplona, Spain.
² Girona Biomedical Research Institute (IDIBGI), Girona, Spain.
³ Institut d'Assistencia Sanitaria, Girona, Spain.
⁴ Department of Medical Sciences, University of Girona, Girona, Spain.
⁵ Vascular Health Research Group (ISV-Girona), Foundation University Institute for Primary Health Care Research Jordi Gol i Gurina, Girona, Spain.
⁶ IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.
⁷ CIBERCV de Investigación en Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain.
⁸ Department of Nursing, University of Girona, Girona, Spain.

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.

Keywords: antidepressant drug; cancer; depressive syndrome; mortality; somatic symptoms.

Grants and funding

This study was supported by the research grant STL006/17/00234 from the Strategic Plan for Health Research and Innovation (PERIS) 2016–2020 of the Department of Health, Government of Catalonia. The funding sources played no role in the design and conduct of the study, collection, management, analysis, and interpretation of the data, nor in the preparation, review, or approval of the manuscript.