Risk of Depression after Venous Thromboembolism in Patients with Hematological Cancer: A Population-Based Cohort Study.

ABSTRACT

BACKGROUND: Venous thromboembolism (VTE) may complicate the clinical course of cancer patients and add to their psychological burden. OBJECTIVES: We aimed to investigate the association between VTE and risk of subsequent depression in patients with hematological cancer. PATIENTS AND METHODS: We conducted a population-based cohort study using Danish national health registries. Between 1995 and 2020, we identified 1,190 patients with hematological cancer and incident VTE diagnosed within 6 months before to 1 year after cancer diagnosis. A comparison cohort of patients with hematological cancer without VTE (n = 5,325) was matched by sex, year of birth, cancer type, and year of cancer diagnosis. Patients were followed until diagnosis of depression, emigration, death, study end (2021), or for a maximum of 3 years. Depression was defined as hospital discharge diagnosis of depression or ≥1 prescription for antidepressants. Absolute risks of depression were computed with cumulative incidence functions, treating death as competing event. Hazard ratios (HRs) with 95% confidence intervals (CIs) were computed using Cox proportional hazards regression models, adjusting for comorbidities. RESULTS: Depression was observed in 158 hematological cancer patients with and 585 without VTE. The 3-year absolute risks of depression were 13.3% (95% CI 11.5-15.3%) in the VTE cancer cohort and 11.1% (95% CI 10.3-12.0%) in the comparison cancer cohort, corresponding to a risk difference of 2.2% (95% CI -1.8-6.5%). VTE was associated with an increased relative risk of depression (adjusted HR 1.56, 95% CI 1.28-1.90). CONCLUSION: VTE was associated with an elevated risk of subsequent depression in patients with hematological cancer.