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The psychological symptom burden in partners of pancreatic cancer patients: a population-based cohort study

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Abstract

Purpose

Pancreatic cancer (PC) has high morbidity and mortality and is stressful for patients and their partners. We investigated the psychological symptom burden in partners of PC patients.

Methods

We followed 5774 partners of PC patients diagnosed from 2000 to 2016 up for first redeemed prescriptions of antidepressants or hospital admission, anxiolytics, and hypnotics as proxies for clinical depression, anxiety, and insomnia and compared them with 59,099 partners of cancer-free spouses. Data were analysed using Cox regression and multistate Markov models.

Results

The cumulative incidence proportion of first depression was higher in partners of PC patients compared to comparisons. The highest adjusted HR of first depression was seen the first year after diagnosis (HR 3.2 (95% CI: 2.9; 3.7)). Educational level, chronic morbidity, and bereavement status were associated with an increased risk of first depression. There was a significantly higher first acute use (1 prescription only) of both anxiolytics and hypnotics and chronic use (3+ prescriptions) of hypnotics in partners of PC patients than in comparisons.

Conclusion

Being a partner to a PC patient carries a substantial psychological symptom burden and increases the risk for first depression and anxiolytic use and long-term use of hypnotics. Attention should be given to the psychological symptom burden of partners of PC patients, as this may pose a barrier for the optimal informal care and support of the PC patient, as well as a risk for non-optimal management of symptoms in the partner.

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Data availability

The availability of the data is restricted as the study was performed under licence and is only available with permission from Statistics Denmark.

Code availability

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Acknowledgements

We would like to thank Anja Krøyer for supporting the data management.

Funding

This study was funded by the Novo Nordisk Foundation [NNF15OC0017022 and NNF16OC0022680] and Copenhagen University Hospital Rigshospitalet [PSP E-22647-02].

Author information

Authors and Affiliations

  1. Department of Surgery, Rigshospitalet, Copenhagen University, Copenhagen, Denmark

    Kristine Elberg Dengsø, Carsten Palnæs Hansen, Bo Marcel Christensen & Jens Hillingsø

  2. Unit of Survivorship & Inequality in Cancer, Danish Cancer Society Research Centre, Danish Cancer Society, Copenhagen, Denmark

    Kristine Elberg Dengsø & Susanne Oksbjerg Dalton

  3. Herlev Acute, Critical and Emergency Care Science Unit, Department of Anaesthesiology, Herlev and Gentofte Hospital, Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

    Thordis Thomsen

  4. Statistics and Data Analysis, Danish Cancer Society Research Centre, Danish Cancer Society, Copenhagen, Denmark

    Elisabeth Wreford Andersen

  5. Department of Clinical Oncology & Palliative Care, Zealand University Hospital, Naestved, Denmark

    Susanne Oksbjerg Dalton

Authors
  1. Kristine Elberg Dengsø
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  2. Thordis Thomsen
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  3. Elisabeth Wreford Andersen
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  4. Carsten Palnæs Hansen
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  5. Bo Marcel Christensen
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  6. Jens Hillingsø
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  7. Susanne Oksbjerg Dalton
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Contributions

Conception and design: All authors. Collection and assembly of data: KD, EWA, and SOD. Data analysis: KD, EWA, and SOD. Interpretation of results: All authors. Manuscript writing: All authors. Final approval of the manuscript: All authors

Corresponding author

Correspondence to Kristine Elberg Dengsø.

Ethics declarations

Ethics approval

The study is approved by the Danish Data Protection Agency (Journal number 2017-41-5244) and the Danish Health Data Authority. The study is performed according to the Helsinki Declaration [41].

Consent to participate

As the study is a purely registry-based study and approved by The Danish Data Protection Agency and Danish Health Data Authority, no consent to participate is needed according to Danish legislation.

Consent for publication

As the study is a purely registry-based study and approved by The Danish Data Protection Agency and Danish Health Data Authority, no consent to publish is needed according to Danish legislation.

Conflict of interest

The authors declare no competing interests.

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Supplementary Information

Supplementary Figure 1

The Multistate Markov model with five states and seven transitions used in the analysis of anxiolytic or hypnotic use among partners to PC patients and comparison partners. (PNG 60 kb)

High resolution image (TIF 54 kb)

Supplementary Figure 2

a, Cumulative incidence of first depression with 95% confidence interval in male and female partners of pancreatic cancer patients (exposed) and male and female comparison partners (unexposed) by time since diagnosis, Denmark 2000-2016, b Cumulative incidence of first depression by age at entry in partners of pancreatic cancer patients (exposed) and comparison partners (unexposed), Denmark 2000-2016, c Cumulative incidence of first depression by education in partners of pancreatic cancer patients (exposed) and comparison partners (unexposed), Denmark 2000-2016, d Cumulative incidence of first depression by Charlson comorbidity score in in partners of pancreatic cancer patients (exposed) and comparison partners (unexposed), Denmark 2000-2016. (PNG 695 kb)

High resolution image (TIF 307 kb)

Supplementary Figure 3

Estimated hazard ratios of first depression in male and female partners of pancreatic cancer patients separately, with age as the underlying time-scale. Adjusted for year group, children at home, labour market affiliation, morbidity and education, Denmark 2000-2016. (PNG 207 kb)

High resolution image (TIF 110 kb)

Supplementary Figure 4

Probabilities for anxiolytic or hypnotic use for a male partner, age 60-69 at entry in 2000-2004. State 1: No anxiolytic/hypnotic prescription. State 2: One anxiolytic/hypnotic prescription. State 3: Two anxiolytic/hypnotic prescription within 3 months. State 4: 3+ anxiolytic/hypnotic prescription within 3 months of the second. State 5: Death. Exposed are partners of pancreatic cancer patients, and unexposed are comparison partners, Denmark 2000-2016. (PNG 274 kb)

High resolution image (TIF 139 kb)

Supplementary Table 1

(DOCX 15 kb)

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Dengsø, K.E., Thomsen, T., Andersen, E.W. et al. The psychological symptom burden in partners of pancreatic cancer patients: a population-based cohort study. Support Care Cancer 29, 6689–6699 (2021). https://doi.org/10.1007/s00520-021-06251-4

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  • DOI: https://doi.org/10.1007/s00520-021-06251-4

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