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Meta-Analysis
. 2022 Nov;31(11):1972-1987.
doi: 10.1002/pon.6012. Epub 2022 Aug 19.

The prevalence of psychological disorders among cancer patients during the COVID-19 pandemic: A meta-analysis

Lemeng Zhang  1 , Xiaohong Liu  2 , Fei Tong  2 , Ran Zhou  2 , Wanglian Peng  2 , Hui Yang  2 , Feng Liu  3 , Desong Yang  4 , Xufen Huang  2 , Minni Wen  2 , Ling Jiang  2 , Lili Yi  2
Affiliations
Meta-Analysis

The prevalence of psychological disorders among cancer patients during the COVID-19 pandemic: A meta-analysis

Lemeng Zhang et al. Psychooncology. 2022 Nov.

Abstract

Purpose: We aimed to assess the prevalence rate (PR) of depression, anxiety, posttraumatic stress disorder (PTSD), insomnia, distress, and fear of cancer progression/recurrence among patients with cancer during the COVID-19 pandemic.

Methods: Studies that reported the PR of six psychological disorders among cancer patients during the COVID-19 pandemic were searched in PubMed, Embase, PsycINFO, and Web of Science databases, from January 2020 up to 31 January 2022. Meta-analysis results were merged using PR and 95% confidence intervals, and heterogeneity among studies was evaluated using I2 and Cochran's Q test. Publication bias was examined using funnel plots and Egger's tests. All data analyses were performed using Stata14.0 software.

Results: Forty studies with 27,590 participants were included. Pooled results showed that the PR of clinically significant depression, anxiety, PTSD, distress, insomnia, and fear of cancer progression/recurrence among cancer patients were 32.5%, 31.3%, 28.2%, 53.9%, 23.2%, and 67.4%, respectively. Subgroup analysis revealed that patients with head and neck cancer had the highest PR of clinically significant depression (74.6%) and anxiety (92.3%) symptoms. Stratified analysis revealed that patients with higher education levels had higher levels of clinically significant depression (37.2%). A higher level of clinically significant PTSD was observed in employed patients (47.4%) or female with cancer (27.9%).

Conclusion: This meta-analysis evaluated the psychological disorders of cancer patients during the COVID-19 outbreak. Therefore, it is necessary to develop psychological interventions to improve the mental health of cancer patients during the pandemic.

Keywords: COVID-19; PTSD; anxiety; cancer; depression; distress; fear of cancer progression/recurrence; oncology.

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Conflict of interest statement

The authors have declared that no conflict of interest exists.

Figures

FIGURE 1
FIGURE 1
Flowchart of study selection according to the PRISMA guidelines
FIGURE 2
FIGURE 2
Forest plot of the prevalence rate (PR) of depression among patients with cancer. (A) Pooled PR of depression. (B) Subgroup analysis of the PR of depression based on different scales. (C) Subgroup analysis of the PR of depression based on different cancer types
FIGURE 3
FIGURE 3
Forest plot of the PR of anxiety among patients with cancer. (A) Pooled PR of anxiety. (B) Subgroup analysis of the PR of anxiety based on different scales. (C) Subgroup analysis of the PR of anxiety based on different cancer types
FIGURE 4
FIGURE 4
Forest plot of the PR of post‐traumatic stress disorder (PTSD) among patients with cancer. (A) Pooled PR of PTSD. (B) Subgroup analysis of the PR of PTSD based on IES‐R cut‐off values. (C) Subgroup analysis of the PR of PTSD based on different cancer types. (D) Subgroup analysis of the PR of PTSD based on risk of bias
FIGURE 5
FIGURE 5
Forest plot of the PR of distress among patients with cancer
FIGURE 6
FIGURE 6
Forest plot of the PR of insomnia among patients with cancer. (A) Pooled PR of insomnia. (B) Subgroup analysis of the PR of insomnia based on ISI cut‐off values. (C) Subgroup analysis of the PR of insomnia based on different cancer types. (D) Subgroup analysis of the PR of insomnia based on risk of bias
FIGURE 7
FIGURE 7
Forest plot of the PR of fear of cancer progression/recurrence among patients with cancer. (A) Pooled PR of fear. (B) Subgroup analysis of the PR of fear of cancer progression/recurrence based on different scales. (C) Subgroup analysis of the PR of fear of cancer progression/recurrence based on area. (D) Subgroup analysis of the PR of fear of cancer progression/recurrence based on different cancer types
FIGURE 8
FIGURE 8
Funnel plots of publication bias for six mental health issues. (A) Depression. (B) Anxiety. (C), PTSD. (D) Distress. (E) Insomnia. (F) Fear of cancer progression/recurrence
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