Depression and anxiety following hematopoietic stem cell transplantation: a prospective population-based study in Germany

• Published in: Bone marrow transplantation (Basingstoke) Vol. 52; no. 12; pp. 1651 - 1657
• Main Authors: Kuba, K, Esser, P, Mehnert, A, Johansen, C, Schwinn, A, Schirmer, L, Schulz-Kindermann, F, Kruse, M, Koch, U, Zander, A, Kröger, N, Götze, H, Scherwath, A
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-12-2017; Nature Publishing Group
• Subjects: 692/1807; 692/700/784; Adult; Anxiety; Anxiety - etiology; Care and treatment; Case-Control Studies; Cell Biology; Chemotherapy; Confidence intervals; Demographics; Depression (Mood disorder); Depression - etiology; Diagnosis; Female; Germany - epidemiology; Hematology; Hematopoietic stem cell transplantation; Hematopoietic Stem Cell Transplantation - adverse effects; Hematopoietic Stem Cell Transplantation - psychology; Hematopoietic stem cells; Humans; Internal Medicine; Male; Medicine; Medicine & Public Health; Mental depression; Middle Aged; original-article; Patients; Population studies; Population-based studies; Prospective Studies; Public Health; Risk management; Stem cell transplantation; Stem Cells; Time Factors; Transplantation; Germany
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2017.190

In this prospective multicenter study, we investigated the course of depression and anxiety during hematopoietic stem cell transplantation (HSCT) until 5 years after transplantation adjusting for medical information. Patients were consulted before HSCT (
n
=239), at 3 months (
n
=150), 12 months (
n
=102) and 5 years (
n
=45) after HSCT. Depression and anxiety were assessed with the Hospital Anxiety and Depression Scale (HADS). Detailed medical and demographic information was collected. Prevalence rates were compared with an age- and gender-matched control group drawn from a large representative sample (
n
=4110). The risk of depression before HSCT was lower for patients than for the control group (risk ratio (RR), 0.56; 95% confidence interval (CI), 0.39/0.81). Prevalence rates of depression increased from 12 to 30% until 5 years post HSCT. Anxiety rates were most frequently increased before HSCT (29%, RR, 1.31; 95% CI, 1.02/1.68) and then reached a stable level comparable to the background population (RR 0.83, 95% CI, 0.56/1.22). This study confirms the low levels of depression in the short term after HSCT and identifies depression as a long-term effect. Furthermore, it confirms previous results of heightened anxiety before HSCT. Surveillance of symptoms of anxiety during the short-term phase of HSCT and of depression during the following years is crucial.