Depressive symptoms and shorter survival in lung cancer: the role of leukocyte telomere length

Psychol Health. 2023 Nov-Dec;38(12):1649-1664. doi: 10.1080/08870446.2022.2040500. Epub 2022 Mar 3.

Abstract

Objective: To examine the association between depressive symptoms, leukocyte telomere length-a marker of cellular ageing, and survival amongst lung cancer patients.

Design: Patients with non-small cell lung cancer were recruited from a university-affiliated cancer center clinic.

Main outcome: Patients (N = 67) reported on depressive symptoms and provided a blood sample for leukocyte telomere length assessment at baseline and at a 3-month follow-up. Survival status was tracked over 3 years.

Results: Age at diagnosis and depressive symptoms, as measured by the CES-D, were associated with shorter leukocyte telomere length (p < .05), although only age at diagnosis contributed statistical significance to the model. Depressive symptoms predicted shorter survival from date of diagnosis (p < .01). Patients who reported experiencing clinically meaningful levels of depressive symptoms (CES-D scores ≥ 16) demonstrated shorter survival than those who reported sub-clinical levels of depressive symptoms (p < .05). Leukocyte telomere length did not emerge as a predictor of shorter survival.

Conclusion: Clinically meaningful levels of depressive symptoms are associated with shorter survival amongst lung cancer patients. These findings support the on-going efforts to screen all cancer patients for low mood and to investigate mechanisms linking depressive symptoms and shorter survival in cancer contexts.

Keywords: Lung cancer; depression; leukocyte telomere length; survival.