Socioeconomic disparities of depressive symptoms and cytokines in hepatocellular carcinoma.

Abstract

To examine the associations among socioeconomic factors, depressive symptoms, and cytokines in patients diagnosed with hepatocellular carcinoma (HCC). 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. 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, Padj =.028). Being unemployed/disabled (Kruskal-Wallis=14.732, P=.001, Padj =.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, Padj =.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. 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.