12 July 2019

Depressive symptoms in people with newly diagnosed lymphoma or multiple myeloma could be linked to shorter survival, Japanese researchers have reported.

One-third of participants in their study reported depressive symptoms around the time of beginning chemotherapy treatment. They found that these symptoms were linked with shorter overall survival in patients who remained depressed, as well as those who recovered from depressive symptoms.

The team, led by Toru Okuyama of Nagoya City University, carried out a prospective analysis of 255 patients who were newly diagnosed with malignant lymphoma or multiple myeloma, enrolled between September 2010 and March 2016.

They evaluated depression symptoms before starting chemotherapy and one month later, with 83 patients showing symptoms of depression at either time point.

These patients were divided into groups according to the change in depressive symptoms between the two time points. The ‘new-onset’ group had no depressive symptoms before starting chemotherapy but had developed them by one month later; the ‘remission’ group had depressive symptoms before but none one month later; and the ‘persistent’ group had depressive symptoms both before chemotherapy and one month later.

Over a median follow-up of approximately 3.5 years, 61 patients died – including 30 patients in the ‘never depression’ group, six patients in the ‘new-onset’ group, 16 patients in the ‘remission’ group, and nine patients in the ‘persistent’ group.

Writing in the journal Psycho-Oncology, the researchers reveal that the risk of death was three times higher in the ‘remission’ group, and two times higher in the ‘persistent’ group, compared to the ‘never depression’ group. This was based on multivariate analysis which took into account factors such as age, sex, performance status, disease stage, and the intensity of chemotherapy.

However, the risk of death was not significantly different in the ‘new-onset’ group compared with the ‘never depression’ group.

They conclude that among patients with mature lymphoid malignancy, the group with depressive symptoms at baseline had a poorer survival, both in the group that remained depressive and the group that recovered from depressive symptoms.


Hasegawa, T., Okuyama, T., Uchida, M., Aiki, S., Imai, F., Nishioka, M., Suzuki, N., Iida, S., Komatsu, H., Kusumoto, S., Ri, M., Osaga, S., Akechi, T. (2019) “Depressive symptoms during the first month of chemotherapy and survival in patients with hematological malignancies: A prospective cohort study”, Psycho-Oncology, available from doi: 10.1002/pon.5143