Jia-Nan Sun, Yi-Zi Li, Lan Wang, Xin-Jian Song, Jia-Xin Liu, Jia-Cheng Liu, Jia-Yi Wang, Yu Li, Yu-Han Chen, Jia-Ming Liu, Jin Xu, Ke-Xin Liu, Qi Bao, Ming-Li Sun, Lang Wu, Song Gao, Xiao-Ying Li, Dong-Hui Huang, Qi-Peng Ma, Tao Tao, Qi-Jun Wu, Ting-Ting Gong
{"title":"卵巢癌患者抑郁相关症状和睡眠质量与总体生存率的个体和联合关联：来自前瞻性队列研究的证据","authors":"Jia-Nan Sun, Yi-Zi Li, Lan Wang, Xin-Jian Song, Jia-Xin Liu, Jia-Cheng Liu, Jia-Yi Wang, Yu Li, Yu-Han Chen, Jia-Ming Liu, Jin Xu, Ke-Xin Liu, Qi Bao, Ming-Li Sun, Lang Wu, Song Gao, Xiao-Ying Li, Dong-Hui Huang, Qi-Peng Ma, Tao Tao, Qi-Jun Wu, Ting-Ting Gong","doi":"10.1155/da/4907389","DOIUrl":null,"url":null,"abstract":"<div>\n <p><b>Background:</b> As the evidence linking depression and sleep quality to overall survival (OS) is lacking, we aim to evaluate the individual and joint associations of depression-related symptoms and sleep quality with OS among patients with ovarian cancer (OC).</p>\n <p><b>Method:</b> A total of 554 patients with OC were included. Depression-related symptoms and sleep quality were measured using the Patient Health Questionnaire (PHQ-9) and the Pittsburgh Sleep Quality Index (PSQI). The primary analysis utilized the average levels of depression-related symptoms and sleep quality by averages of PSQI score and PHQ score between pre-diagnosis and post-diagnosis. Deaths were ascertained until February 16, 2023, via medical records and active follow-up. Cox proportional hazard regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the joint and individual associations of sleep quality and depression-related symptoms with OC survival.</p>\n <p><b>Result:</b> A total of 205 deaths occurred during a median follow-up of 44.6 months. The average level of depression-related symptoms and sleep quality were independently associated with OS (HR<sub>depression vs. no depression</sub> = 1.55, 95% CI = 1.10–2.17; HR<sub>poor sleep vs. good sleep</sub> = 2.05, 95% CI = 1.51–2.75). We documented multiplicative and additive interactions between these two factors in relation to OS (<i>P</i><sub>interaction</sub> < 0.01; relative excess risk due to interaction = 0.16, 95% CI = 0.01–0.31). Combinations of depression-related symptoms and poor sleep quality were positively associated with OC mortality (HR = 2.61, 95% CI = 1.70–4.00), compared to patients with good sleep quality and without depression-related symptoms.</p>\n <p><b>Conclusion:</b> Poor OC survival was observed among patients with poor sleep quality and depression-related symptoms, independently and jointly.</p>\n </div>","PeriodicalId":55179,"journal":{"name":"Depression and Anxiety","volume":"2025 1","pages":""},"PeriodicalIF":4.7000,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/4907389","citationCount":"0","resultStr":"{\"title\":\"Individual and Joint Associations of Depression-Related Symptoms and Sleep Quality With Overall Survival Among Patients With Ovarian Cancer: Evidence From a Prospective Cohort Study\",\"authors\":\"Jia-Nan Sun, Yi-Zi Li, Lan Wang, Xin-Jian Song, Jia-Xin Liu, Jia-Cheng Liu, Jia-Yi Wang, Yu Li, Yu-Han Chen, Jia-Ming Liu, Jin Xu, Ke-Xin Liu, Qi Bao, Ming-Li Sun, Lang Wu, Song Gao, Xiao-Ying Li, Dong-Hui Huang, Qi-Peng Ma, Tao Tao, Qi-Jun Wu, Ting-Ting Gong\",\"doi\":\"10.1155/da/4907389\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n <p><b>Background:</b> As the evidence linking depression and sleep quality to overall survival (OS) is lacking, we aim to evaluate the individual and joint associations of depression-related symptoms and sleep quality with OS among patients with ovarian cancer (OC).</p>\\n <p><b>Method:</b> A total of 554 patients with OC were included. Depression-related symptoms and sleep quality were measured using the Patient Health Questionnaire (PHQ-9) and the Pittsburgh Sleep Quality Index (PSQI). The primary analysis utilized the average levels of depression-related symptoms and sleep quality by averages of PSQI score and PHQ score between pre-diagnosis and post-diagnosis. Deaths were ascertained until February 16, 2023, via medical records and active follow-up. Cox proportional hazard regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the joint and individual associations of sleep quality and depression-related symptoms with OC survival.</p>\\n <p><b>Result:</b> A total of 205 deaths occurred during a median follow-up of 44.6 months. The average level of depression-related symptoms and sleep quality were independently associated with OS (HR<sub>depression vs. no depression</sub> = 1.55, 95% CI = 1.10–2.17; HR<sub>poor sleep vs. good sleep</sub> = 2.05, 95% CI = 1.51–2.75). We documented multiplicative and additive interactions between these two factors in relation to OS (<i>P</i><sub>interaction</sub> < 0.01; relative excess risk due to interaction = 0.16, 95% CI = 0.01–0.31). Combinations of depression-related symptoms and poor sleep quality were positively associated with OC mortality (HR = 2.61, 95% CI = 1.70–4.00), compared to patients with good sleep quality and without depression-related symptoms.</p>\\n <p><b>Conclusion:</b> Poor OC survival was observed among patients with poor sleep quality and depression-related symptoms, independently and jointly.</p>\\n </div>\",\"PeriodicalId\":55179,\"journal\":{\"name\":\"Depression and Anxiety\",\"volume\":\"2025 1\",\"pages\":\"\"},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2025-01-11\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1155/da/4907389\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Depression and Anxiety\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1155/da/4907389\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Depression and Anxiety","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1155/da/4907389","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
摘要
背景：由于缺乏将抑郁和睡眠质量与总生存期（OS）联系起来的证据，我们旨在评估卵巢癌（OC）患者中抑郁相关症状和睡眠质量与OS的个体和联合关联。方法：共纳入554例OC患者。采用患者健康问卷（PHQ-9）和匹兹堡睡眠质量指数（PSQI）测量抑郁相关症状和睡眠质量。初步分析采用抑郁相关症状和睡眠质量的平均水平，即诊断前和诊断后PSQI评分和PHQ评分的平均值。截至2023年2月16日，通过医疗记录和积极随访确定了死亡人数。使用Cox比例风险回归来估计睡眠质量和抑郁相关症状与OC生存的联合和个体关联的风险比（hr）和95%置信区间（CIs）。结果：在中位44.6个月的随访期间，共发生205例死亡。抑郁相关症状和睡眠质量的平均水平与OS独立相关(hrp：抑郁vs.无抑郁= 1.55,95% CI = 1.10-2.17；睡眠差vs睡眠好= 2.05,95% CI = 1.51-2.75)。我们记录了这两个因素与OS之间的乘法和加性相互作用(p - interaction < 0.01；相互作用导致的相对过量风险= 0.16,95% CI = 0.01-0.31)。与睡眠质量良好且无抑郁相关症状的患者相比，抑郁相关症状和睡眠质量差的组合与OC死亡率呈正相关（HR = 2.61, 95% CI = 1.70-4.00）。结论：睡眠质量差并伴有抑郁相关症状的患者单独或共同存在较差的OC生存率。
Individual and Joint Associations of Depression-Related Symptoms and Sleep Quality With Overall Survival Among Patients With Ovarian Cancer: Evidence From a Prospective Cohort Study
Background: As the evidence linking depression and sleep quality to overall survival (OS) is lacking, we aim to evaluate the individual and joint associations of depression-related symptoms and sleep quality with OS among patients with ovarian cancer (OC).
Method: A total of 554 patients with OC were included. Depression-related symptoms and sleep quality were measured using the Patient Health Questionnaire (PHQ-9) and the Pittsburgh Sleep Quality Index (PSQI). The primary analysis utilized the average levels of depression-related symptoms and sleep quality by averages of PSQI score and PHQ score between pre-diagnosis and post-diagnosis. Deaths were ascertained until February 16, 2023, via medical records and active follow-up. Cox proportional hazard regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of the joint and individual associations of sleep quality and depression-related symptoms with OC survival.
Result: A total of 205 deaths occurred during a median follow-up of 44.6 months. The average level of depression-related symptoms and sleep quality were independently associated with OS (HRdepression vs. no depression = 1.55, 95% CI = 1.10–2.17; HRpoor sleep vs. good sleep = 2.05, 95% CI = 1.51–2.75). We documented multiplicative and additive interactions between these two factors in relation to OS (Pinteraction < 0.01; relative excess risk due to interaction = 0.16, 95% CI = 0.01–0.31). Combinations of depression-related symptoms and poor sleep quality were positively associated with OC mortality (HR = 2.61, 95% CI = 1.70–4.00), compared to patients with good sleep quality and without depression-related symptoms.
Conclusion: Poor OC survival was observed among patients with poor sleep quality and depression-related symptoms, independently and jointly.
期刊介绍：
Depression and Anxiety is a scientific journal that focuses on the study of mood and anxiety disorders, as well as related phenomena in humans. The journal is dedicated to publishing high-quality research and review articles that contribute to the understanding and treatment of these conditions. The journal places a particular emphasis on articles that contribute to the clinical evaluation and care of individuals affected by mood and anxiety disorders. It prioritizes the publication of treatment-related research and review papers, as well as those that present novel findings that can directly impact clinical practice. The journal's goal is to advance the field by disseminating knowledge that can lead to better diagnosis, treatment, and management of these disorders, ultimately improving the quality of life for those who suffer from them.
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