Clinical lore, case reports and a few prospective studies all have provided data consistent with the hypothesis that there is an extraordinarily high rate of depressive symptoms in patients with pancreatic cancer. It is frequently stated that psychiatric morbidity may in fact precede any of the other signs and symptoms of this carcinoma. The goals of this study are: (1) to determine whether the prevalence of major depression and other psychiatric disorders is, in fact, increased in newly diagnosed cases of pancreatic cancer as compared to patients with esophageal or gastric cancer; (2) to determine, using well established biological markers of major depression [reduced density of H-imipramine platelet binding sites, non-suppression of cortisol to dexamethasone and increased cerebrospinal fluid concentrations of corticotropin-releasing factor (CRF) and thyrotropin-releasing hormone (TRH)], whether depressed patients with pancreatic cancer exhibit these alterations when compared to groups of normal controls, patients with major depression without cancer, patients with esophageal or gastric cancer and patients with pancreatic cancer without depression; (3) to determine, in view of recent studies suggesting that depressed patients may have impaired immune function, whether the depressed cancer patients we shall study exhibit alterations in immune function compared to non-depressed patients; and (4) to determine whether pancreatic carcinoma produces interleukin-1 and other lymphokines that may contribute to depression and pituitary-adrenal hyperactivity. These studies, taken together, will provide novel data concerning the prevalence and biology of depression in patients with pancreatic cancer.
| Musselman, D L; Nemeroff, C B (1996) Depression and endocrine disorders: focus on the thyroid and adrenal system. Br J Psychiatry Suppl :123-8 |
| McDaniel, J S; Musselman, D L; Porter, M R et al. (1995) Depression in patients with cancer. Diagnosis, biology, and treatment. Arch Gen Psychiatry 52:89-99 |
