Abstract 2657: Younger age correlates with depression but not adaptive maturity in adult cancer patients

Abstract

Abstract Background: In a previous study, we found that Immature adaptive mechanism (ego defense mechanism) endorsement independently predicted 5-year survival in adult cancer patients. Depression symptom severity, however, did not predict survival in the same sample. While empirical evidence suggests that adaptive maturity increases with age in the general population, the influence of age on depression in cancer patients remains unclear. In this investigation, we hypothesized that increased age would be associated with 1) mature adaption and with 2) fewer depression symptoms. Methods: Participants in this IRB approved study included adult cancer outpatients at the University of Colorado Cancer Center (N=293). All participants provided informed consent and demographic data, and completed the Defense Style Questionnaire (DSQ) and Beck Depression Inventory (BDI). Exclusion criteria were extreme pain, delirium, and neuroendocrine neoplasm that could mimic depression. Additional data collected included gender, cancer type and stage, time since diagnosis, treatment modality, psychiatric history, current medications, and current antidepressant use. For analysis, we used Spearman's correlation statistic with probability set at p<0.05. Results: Data analysis indicated no statistical association between age and adaptive maturity. By contrast, age correlated significantly and negatively with total BDI scores (r= −0.23, p<0.0001), as well as BDI sub-scale mood symptom scores (r= −0.26, p<0.0001), and somatic symptom scores (r= −0.12, p=0.037). Factors associated with BDI mood symptom scores included self-reported current medications that affect mood (r= 0.21, p<0.001), psychiatric history (r= 0.15, p=0.009), current antidepressants (r= 0.14, p=0.02), and ratio of Mature/Immature DSQ scores (r= −0.24, p<0.0001). Gender, cancer stage, time since diagnosis, and treatment modality did not reach correlation significance with age, adaptive maturity, or BDI score. Conclusion: These data suggest that depression symptoms may occur more frequently in younger rather than older cancer patients, and that age does not appear associated with adaptive maturity in this clinical sample. Mood symptoms of depression stood out as highly and inversely correlated with age. Possible variables that may affect this relationship include medications that affect mood, as well as measured adaptive maturity level, with probable contributions from previous psychiatric history and current antidepressant use. Unexpectedly, antidepressant use appeared associated with more, rather than fewer, depressive mood symptoms. Further prospective research should focus on investigating the factors that affect depression in younger adult cancer patients. For example, antidepressant treatment in this age group will require trials to establish an age specific clinical improvement. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2657. doi:1538-7445.AM2012-2657