Brian Tran - Department of Otolaryngology
Sickness behavior syndrome is characterized by behavioral changes in individuals due to the increase of proinflammatory cytokines in the brain. The cluster of symptoms includes fatigue, depression, loss of appetite, social withdrawal, and cognitive impairment. This is commonly seen in patients with cancer due to anxiety and stress associated with their condition. These symptoms can compromise quality of life, symptom burden, and survival. Pro-inflammatory markers are utilized in Polygenic Risk Scores (PRS) to understand the impact of inflammation and depression on survival rates and symptom burden.
A longitudinal study of 223 adults diagnosed with primary head and neck cancer was done using PRS to investigate the contribution of genetic predispositions to inflammation and depression on levels of symptom burden and patient survival. The study used psychiatric questionnaires like SCID-I, FACT-G, and HADS and DNA to determine PRS. The participants were evaluated after 3 and 36 months of the initial screening to determine their total symptom burden (TSB). After three months, the PRS for depression showed direct correlations to increased levels of fatigue (FACT-G) and depression (HADS), whereas the PRS for inflammation correlated with feeling ill (FACT-G) and psychomotor slowing (HADS). The findings after 36 months showed for every one standard deviation increase in the PRS for depression patients were 574% less likely to survive, and for every standard deviation increase in the PRS for anti-inflammatory markers, patients were 15% less likely to survive. However, additional compounding factors like epigenetics and treatment make total inflammation less predictive compared to depression.
By understanding these correlations, physicians can improve health outcomes for patients suffering from cancer by treating mental health bringing up the importance of multidisciplinary treatment approaches. Psychologists, physical therapists, and oncologists can provide vital education for the patient leading to healthy lifestyle changes that can reduce the symptoms associated with sickness behavior syndrome.
References:
Henry M, Harvey R, Chen LM, et al. Genetic predisposition to depression and inflammation impacts symptom burden and survival in patients with head and neck cancer: A longitudinal study. J Affect Disord. 2023;331:149-157. doi:10.1016/j.jad.2023.03.007
Edited By: Firas Batrash, Editor-in-Chief
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