Depression and survival in patients with non‐small cell lung cancer after curative resection: a preliminary study

Psychological depression is thought to be a predictor of poor survival among cancer patients. The objective of the present study was to investigate the association between depression and survival in surgically treated Japanese patients with non‐small cell lung cancer (NSCLC). From June 1996 through April 1999, a total of 229 patients with postoperative lung cancer were enrolled. Three months after the patients’ surgery, the Structured Clinical Interview for DSM‐III‐R (SCID) and the Profile of Mood States (POMS) were used to assess the patient for depression, based on the interviewers’ rating and a self‐report, respectively. The follow‐up period consisted of a total of 14 342 person‐months (median = 69 months). As of January 2004, 55 deaths had occurred within the follow‐up period. A Cox regression was used to estimate the hazard ratio (HR) of mortality adjusting for age, sex, smoking status, occasion of diagnosis, pathological stage and preoperative percentage forced expiratory volume in 1 s. The depression‐dejection subscale on the POMS was divided into three score levels. The multivariate HR of survival for individuals with depression, as diagnosed by the SCID, was 2.2 (95% confidence interval 0.8–6.0) ( P ‐value = 0.14), compared with individuals without depression. The multivariate HR of survival for subjects in the highest level of the POMS Depression–Dejection subscale was 1.4 (0.7–2.6), compared with in the lowest level (trend P ‐value = 0.0502). This prospective cohort study in Japan does not support the hypothesis that depression is associated with survival among NSCLC patients after curative resection, but further analysis involving a long‐term follow‐up period is needed. ( Cancer Sci 2006; 97: 199–205)