Premium
Socioeconomic disparities of depressive symptoms and cytokines in hepatocellular carcinoma
Author(s) -
Cheng Hoyee H.,
Kamarck Thomas W.,
Gianaros Peter J.,
Roecklein Kathryn A.,
Vanegas Yanet,
Tsung Allan,
Geller David A.,
Marsh James W.,
Ahmed Nadia S.,
Steel Jennifer L.
Publication year - 2019
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.5127
Subject(s) - socioeconomic status , medicine , analysis of variance , hepatocellular carcinoma , psychological intervention , mann–whitney u test , demography , gastroenterology , psychiatry , population , environmental health , sociology
Objective To examine the associations among socioeconomic factors, depressive symptoms, and cytokines in patients diagnosed with hepatocellular carcinoma (HCC). Methods A total of 266 patients diagnosed with HCC were administered a battery of questionnaires including a sociodemographic questionnaire and the Center for Epidemiologic StudiesDepression (CES‐D) scale. Blood samples were collected to assess serum levels of cytokines using Luminex. Descriptive statistics, Mann‐Whitney U , Kruskal‐Wallis, linear regression, and Bonferroni corrections were performed to test the hypotheses. Results Of the 266 patients, 24% reported depressive symptoms in the clinical range (CES‐D ≥ 22). Females had higher CES‐D score than males (Mann‐Whitney U = 7135, P = .014, P adj = .028). Being unemployed/disabled (Kruskal‐Wallis = 14.732, P = .001, P adj = .005) was found to be associated with higher depressive symptoms in males but not in females. Serum level of IL‐2 (Kruskal‐Wallis = 17.261, P = .001, P adj = .005) were found to be negatively associated with education level. Gender ( β = .177, P = .035), income ( β = −.252, P = .004), whether the patient's income met their basic needs ( β = .180, P = .035), and IL‐1β ( β = −.165, P = .045) independently predicted depressive symptoms and together explained 19.4% of variance associated with depressive symptoms. Conclusions Sociodemographic and socioeconomic factors were predictive of inflammation and depressive symptoms. Recommendations include the development of gender‐targeted interventions for patients diagnosed with HCC who have low socioeconomic status (SES) and may suffer from depressive symptoms.