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Low Concentrations of Dehydroepiandrosterone Sulfate are Associated with Depression and Fatigue in Patients with Non-Small-Cell Lung Cancer After Chemotherapy

Authors Fang YH, Hsieh MJ, Hung MS, Lin YC, Kuo LT, Lu ML, Tzang BS, Chen VCH

Received 29 May 2020

Accepted for publication 24 August 2020

Published 17 September 2020 Volume 2020:16 Pages 2103—2109

DOI https://doi.org/10.2147/NDT.S265182

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Yuping Ning


Yu-Hung Fang,1 Meng-Jer Hsieh,2,3 Ming-Szu Hung,1,4,5 Yu-Ching Lin,1,3– 5 Liang-Tseng Kuo,5,6 Mong-Liang Lu,7 Bor-Show Tzang,8– 10 Vincent Chin-Hung Chen5,11

1Division of Thoracic Oncology, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; 2Department of Respiratory Therapy, College of Medicine, Chang Gung University, Chiayi, Taiwan; 3Division of Pulmonary Infection and Critical Care Medicine, Department of Pulmonary and Critical Care Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan; 4Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan; 5Department of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan; 6Division of Sports Medicine, Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan; 7Department of Psychiatry, Wan Fang Hospital, and School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan; 8Institute of Biochemistry, Microbiology and Immunology, Chung Shan Medical University, Taichung, Taiwan; 9Clinical Laboratory, Chung Shan Medical University Hospital, Taichung, Taiwan; 10Department of Biochemistry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan; 11Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi, Taiwan

Correspondence: Vincent Chin-Hung Chen
Department of Psychiatry, Chang Gung Memorial Hospital, Chiayi Branch, No. 6, W. Sec., Jiapu Road, Puzi City, Chiayi County 61363, Taiwan, Republic of China
Tel +886-5-3621000 ext. 2315
Email cch1966@gmail.com

Background: Dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS) concentrations were reported to decrease in patients with advanced cancer. However, the clinical significance of DHEA and DHEAS concentrations in patients with NSCLC receiving chemotherapy (CT) has not been sufficiently documented.
Objective: To evaluate the correlation between mental health and hormone concentrations on patients with advanced non-small-cell lung cancer (NSCLC).
Materials and Methods: The present study was a cross-sectional analysis based on a self-reported psychological investigation. Salivary samples were collected from 22 patients with advanced NSCLC after CT and 17 healthy controls. The concentrations of DHEA, DHEAS, and cortisol were analyzed to investigate their associations with the results of self-reported questionnaires on psychological health.
Results: Patients with advanced NSCLC exhibited significantly higher Patient Health Questionnaire (PHQ-9) and Startle, Physiological arousal, Anger, and Numbness-Chinese version (SPAN-C) scores, poorer health conditions, lower sleep quality, and more severe fatigue after CT than did healthy controls, and salivary concentrations of DHEA and DHEAS were significantly lower among patients after CT than among controls. DHEAS concentrations were negatively associated with depression scores (PHQ-9, r = − 0.496, P = 0.019) and fatigue scores (Brief Fatigue Inventory-Taiwan, r = − 0.562, P = 0.006).
Conclusion: Patients with advanced NSCLC after CT had lower DHEA and DHEAS concentrations than did controls. Lower DHEAS concentrations were associated with higher fatigue and depression scores.

Keywords: cancer-related fatigue, chemotherapy, DHEA, DHEAS, lung cancer

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