Suicidal ideation in Chinese patients with advanced breast cancer: a multi-center mediation model study
Abstract Purpose The pathways underpinning suicide ideation (SI) and certain physical and psychological factors in patients with advanced breast cancer remain unclear. This study develops and validates a mediation model that delineates the associations between several multidimensional variables and...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | BMC Psychology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40359-024-01607-x |
| _version_ | 1797258935213752320 |
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| author | Yening Zhang Yi He Ying Pang Zhongge Su Yu Wang Yuhe Zhou Yongkui Lu Yu Jiang Xinkun Han Lihua Song Liping Wang Zimeng Li Xiaojun Lv Yan Wang Juntao Yao Xiaohong Liu Xiaoyi Zhou Shuangzhi He Lili Song Jinjiang Li Bingmei Wang Lili Tang |
| author_facet | Yening Zhang Yi He Ying Pang Zhongge Su Yu Wang Yuhe Zhou Yongkui Lu Yu Jiang Xinkun Han Lihua Song Liping Wang Zimeng Li Xiaojun Lv Yan Wang Juntao Yao Xiaohong Liu Xiaoyi Zhou Shuangzhi He Lili Song Jinjiang Li Bingmei Wang Lili Tang |
| author_sort | Yening Zhang |
| collection | DOAJ |
| description | Abstract Purpose The pathways underpinning suicide ideation (SI) and certain physical and psychological factors in patients with advanced breast cancer remain unclear. This study develops and validates a mediation model that delineates the associations between several multidimensional variables and SI in Chinese patients with advanced breast cancer. Methods Patients with advanced breast cancer (n = 509) were recruited as study participants from 10 regional cancer centers across China from August 2019 to December 2020. Participants were required to complete five questionnaires using an electronic patient-reported outcomes (ePRO) system: 9 item- Patient Health Questionnaire (PHQ-9), Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), 5-level EQ-5D (EQ-5D-5L), and MD Anderson Symptom Inventory (MDASI). Risk factors for SI were identified using multivariable logistic regression, and inputted into serial multiple mediation models to elucidate the pathways linking the risk factors to SI. Results SI prevalence was 22.8% (116/509). After adjusting for covariates, depression (odds ratio [OR] = 1.384), emotional distress (OR = 1.107), upset (OR = 0.842), and forgetfulness (OR = 1.236) were identified as significant independent risk factors (all p < 0.05). The ORs indicate that depression and distress have the strongest associations with SI. Health status has a significant indirect effect (OR=-0.044, p = 0.005) and a strong total effect (OR=-0.485, p < 0.001) on SI, mediated by insomnia severity and emotional distress. Conclusions There is a high SI prevalence among Chinese patients with advanced breast cancer. Our analysis revealed predictive pathways from poor health to heightened SI, mediated by emotional distress and insomnia. Regular management of distress and insomnia can decrease suicide risk in this vulnerable population. |
| first_indexed | 2024-04-24T23:01:26Z |
| format | Article |
| id | doaj.art-50a81eac58b548d4b4d52cddcb5dddcd |
| institution | Directory Open Access Journal |
| issn | 2050-7283 |
| language | English |
| last_indexed | 2024-04-24T23:01:26Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychology |
| spelling | doaj.art-50a81eac58b548d4b4d52cddcb5dddcd2024-03-17T12:42:24ZengBMCBMC Psychology2050-72832024-03-0112111110.1186/s40359-024-01607-xSuicidal ideation in Chinese patients with advanced breast cancer: a multi-center mediation model studyYening Zhang0Yi He1Ying Pang2Zhongge Su3Yu Wang4Yuhe Zhou5Yongkui Lu6Yu Jiang7Xinkun Han8Lihua Song9Liping Wang10Zimeng Li11Xiaojun Lv12Yan Wang13Juntao Yao14Xiaohong Liu15Xiaoyi Zhou16Shuangzhi He17Lili Song18Jinjiang Li19Bingmei Wang20Lili Tang21Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &InstituteKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &InstituteKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &InstituteKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &InstituteDepartment of Breast Cancer Radiotherapy, Cancer Hospital, Chinese Academy of Medical Sciences, Shanxi Medical UniversityKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &InstituteThe Fifth Department of Chemotherapy, The Affiliated Cancer Hospital of Guangxi Medical UniversityDepartment of Medical Oncology, Cancer Center, West China Hospital, Sichuan UniversityKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &InstituteDepartment of Breast Medical Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical SciencesDepartment of Oncology, the First Affiliated Hospital of Zhengzhou UniversityKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &InstituteDepartment of Oncology, Xiamen Humanity HospitalKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &InstituteDepartment of Integrated Chinese and Western Medicine, Shaanxi Provincial Cancer Hospital Affiliated to Medical College of Xi’an Jiaotong UniversityDepartment of Clinical Spiritual Care, The Affiliated Cancer Hospital of Xiangya School of Medicine, Hunan Cancer Hospital, Central South UniversityRadiotherapy Center, Hubei Cancer HospitalKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &InstituteKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &InstituteDepartment of Psycho-oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University, Shandong Academy of Medical SciencesKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &InstituteKey Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-oncology, Peking University Cancer Hospital &InstituteAbstract Purpose The pathways underpinning suicide ideation (SI) and certain physical and psychological factors in patients with advanced breast cancer remain unclear. This study develops and validates a mediation model that delineates the associations between several multidimensional variables and SI in Chinese patients with advanced breast cancer. Methods Patients with advanced breast cancer (n = 509) were recruited as study participants from 10 regional cancer centers across China from August 2019 to December 2020. Participants were required to complete five questionnaires using an electronic patient-reported outcomes (ePRO) system: 9 item- Patient Health Questionnaire (PHQ-9), Hospital Anxiety and Depression Scale (HADS), Insomnia Severity Index (ISI), 5-level EQ-5D (EQ-5D-5L), and MD Anderson Symptom Inventory (MDASI). Risk factors for SI were identified using multivariable logistic regression, and inputted into serial multiple mediation models to elucidate the pathways linking the risk factors to SI. Results SI prevalence was 22.8% (116/509). After adjusting for covariates, depression (odds ratio [OR] = 1.384), emotional distress (OR = 1.107), upset (OR = 0.842), and forgetfulness (OR = 1.236) were identified as significant independent risk factors (all p < 0.05). The ORs indicate that depression and distress have the strongest associations with SI. Health status has a significant indirect effect (OR=-0.044, p = 0.005) and a strong total effect (OR=-0.485, p < 0.001) on SI, mediated by insomnia severity and emotional distress. Conclusions There is a high SI prevalence among Chinese patients with advanced breast cancer. Our analysis revealed predictive pathways from poor health to heightened SI, mediated by emotional distress and insomnia. Regular management of distress and insomnia can decrease suicide risk in this vulnerable population.https://doi.org/10.1186/s40359-024-01607-xSuicidal ideationAdvanced breast cancerMediation analysisPsychological distressSymptom burden |
| spellingShingle | Yening Zhang Yi He Ying Pang Zhongge Su Yu Wang Yuhe Zhou Yongkui Lu Yu Jiang Xinkun Han Lihua Song Liping Wang Zimeng Li Xiaojun Lv Yan Wang Juntao Yao Xiaohong Liu Xiaoyi Zhou Shuangzhi He Lili Song Jinjiang Li Bingmei Wang Lili Tang Suicidal ideation in Chinese patients with advanced breast cancer: a multi-center mediation model study BMC Psychology Suicidal ideation Advanced breast cancer Mediation analysis Psychological distress Symptom burden |
| title | Suicidal ideation in Chinese patients with advanced breast cancer: a multi-center mediation model study |
| title_full | Suicidal ideation in Chinese patients with advanced breast cancer: a multi-center mediation model study |
| title_fullStr | Suicidal ideation in Chinese patients with advanced breast cancer: a multi-center mediation model study |
| title_full_unstemmed | Suicidal ideation in Chinese patients with advanced breast cancer: a multi-center mediation model study |
| title_short | Suicidal ideation in Chinese patients with advanced breast cancer: a multi-center mediation model study |
| title_sort | suicidal ideation in chinese patients with advanced breast cancer a multi center mediation model study |
| topic | Suicidal ideation Advanced breast cancer Mediation analysis Psychological distress Symptom burden |
| url | https://doi.org/10.1186/s40359-024-01607-x |
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