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Depression in patients with mastocytosis: prevalence, features and effects of masitinib therapy.

Moura DS, Sultan S, Georgin-Lavialle S, Pillet N, Montestruc F, Gineste P, Barete S, Damaj G, Moussy A, Lortholary O, Hermine O - PLoS ONE (2011)

Bottom Line: Masitinib therapy was associated with significant improvement (67% of the cases) of overall depression, with 75% of recovery cases.Global Quality of Life slightly improved after masitinib therapy and did not predicted depression improvement.In conclusion, depression is very frequent in mastocytosis patients and masitinib therapy is associated with the reduction its psychic experiences.

View Article: PubMed Central - PubMed

Affiliation: Université Paris Descartes, Sorbonne, Paris Cité, Service d'hématologie, Centre de référence des mastocytoses, Hôpital Necker Enfants malades, Paris, France.

ABSTRACT
Depression in patients with mastocytosis is often reported but its prevalence and characteristics are not precisely described. In addition, the impact of therapies targeting mast cells proliferation, differentiation and degranulation on psychic symptoms of depression have never been investigated. Our objective was to determine the prevalence and to describe features of depression in a large cohort of mastocytosis patients (n = 288) and to investigate the therapeutic impact of the protein kinase inhibitor masitinib in depression symptoms. The description of depression was based on the analysis of a database with Hamilton scores using Principal Component Analysis (PCA). Efficacy of masitinib therapy was evaluated using non parametric Wilcoxon test for paired data within a three months period (n = 35). Our results show that patients with indolent mastocytosis present an elevated prevalence of depression (64%). Depression was moderate in 56% but severe in 8% of cases. Core symptoms (such as psychic anxiety, depressed mood, work and interests) characterized depression in mastocytosis patients. Masitinib therapy was associated with significant improvement (67% of the cases) of overall depression, with 75% of recovery cases. Global Quality of Life slightly improved after masitinib therapy and did not predicted depression improvement. In conclusion, depression is very frequent in mastocytosis patients and masitinib therapy is associated with the reduction its psychic experiences. We conclude that depression in mastocytosis may originate from processes related to mast cells activation. Masitinib could therefore be a useful treatment for mastocytosis patients with depression and anxiety symptoms.

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Related in: MedlinePlus

Symptoms of depression from the Ham-D17 in non depressed, mild-moderate and severe depressed patients with mastocytosis.Chi square test was performed to compare groups item by item. Severe depression was characterized by a huge prevalence of impairment in work and activities (97%), depressed mood (95%), somatic anxiety (83%), guilt (61%) and genital symptoms (56%). Mild-moderate depression was characterized by a higher prevalence of late insomnia (22%), agitation (37%), psychic anxiety (44%) and hypochondriasis (34%).
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pone-0026375-g001: Symptoms of depression from the Ham-D17 in non depressed, mild-moderate and severe depressed patients with mastocytosis.Chi square test was performed to compare groups item by item. Severe depression was characterized by a huge prevalence of impairment in work and activities (97%), depressed mood (95%), somatic anxiety (83%), guilt (61%) and genital symptoms (56%). Mild-moderate depression was characterized by a higher prevalence of late insomnia (22%), agitation (37%), psychic anxiety (44%) and hypochondriasis (34%).

Mentions: The prevalence rate of mild-moderate depression (Ham-D17 scores ≥ 8 and ≤22) in our sample (67% females; mean age = 47; standard deviation (S.D.)  = 13.58) was 56% and severe depression (Ham-D17 scores ≥23) was observed in 8% of cases (n = 23). In order to know which Ham-D symptoms were mostly prevalent in the sample we analyzed the frequency of patients reporting scores ≥ 2 according to the severity of depression (Fig. 1). Patients presenting severe depression differed significantly from those presenting mild-moderate depression in all items scored ≥ 2 (p≤0.005) except the following: middle insomnia which was very prevalent in both groups (37%–48% respectively), psychomotor retardation, gastrointestinal symptoms and loss of weight which were rare in both groups (2%–3%). Severe depression was characterized by a very high prevalence of impairment in work and activities (97%), depressed mood (95%), somatic anxiety (83%) and guilt (61%). Genital symptoms (56%), early insomnia (39%) and suicide ideation (30%) were also very regular. General somatic symptoms (22%), psychic anxiety (21%) and hypochondriasis (16%) were less common in this group. Others symptoms were rare or only slightly present (less than 13%). When comparing these groups, patients with mild-moderate depression presented significantly (p≤0.0005) more late insomnia (22%), agitation (37%), psychic anxiety (44%) and hypochondriasis (34%).


Depression in patients with mastocytosis: prevalence, features and effects of masitinib therapy.

Moura DS, Sultan S, Georgin-Lavialle S, Pillet N, Montestruc F, Gineste P, Barete S, Damaj G, Moussy A, Lortholary O, Hermine O - PLoS ONE (2011)

Symptoms of depression from the Ham-D17 in non depressed, mild-moderate and severe depressed patients with mastocytosis.Chi square test was performed to compare groups item by item. Severe depression was characterized by a huge prevalence of impairment in work and activities (97%), depressed mood (95%), somatic anxiety (83%), guilt (61%) and genital symptoms (56%). Mild-moderate depression was characterized by a higher prevalence of late insomnia (22%), agitation (37%), psychic anxiety (44%) and hypochondriasis (34%).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3198767&req=5

pone-0026375-g001: Symptoms of depression from the Ham-D17 in non depressed, mild-moderate and severe depressed patients with mastocytosis.Chi square test was performed to compare groups item by item. Severe depression was characterized by a huge prevalence of impairment in work and activities (97%), depressed mood (95%), somatic anxiety (83%), guilt (61%) and genital symptoms (56%). Mild-moderate depression was characterized by a higher prevalence of late insomnia (22%), agitation (37%), psychic anxiety (44%) and hypochondriasis (34%).
Mentions: The prevalence rate of mild-moderate depression (Ham-D17 scores ≥ 8 and ≤22) in our sample (67% females; mean age = 47; standard deviation (S.D.)  = 13.58) was 56% and severe depression (Ham-D17 scores ≥23) was observed in 8% of cases (n = 23). In order to know which Ham-D symptoms were mostly prevalent in the sample we analyzed the frequency of patients reporting scores ≥ 2 according to the severity of depression (Fig. 1). Patients presenting severe depression differed significantly from those presenting mild-moderate depression in all items scored ≥ 2 (p≤0.005) except the following: middle insomnia which was very prevalent in both groups (37%–48% respectively), psychomotor retardation, gastrointestinal symptoms and loss of weight which were rare in both groups (2%–3%). Severe depression was characterized by a very high prevalence of impairment in work and activities (97%), depressed mood (95%), somatic anxiety (83%) and guilt (61%). Genital symptoms (56%), early insomnia (39%) and suicide ideation (30%) were also very regular. General somatic symptoms (22%), psychic anxiety (21%) and hypochondriasis (16%) were less common in this group. Others symptoms were rare or only slightly present (less than 13%). When comparing these groups, patients with mild-moderate depression presented significantly (p≤0.0005) more late insomnia (22%), agitation (37%), psychic anxiety (44%) and hypochondriasis (34%).

Bottom Line: Masitinib therapy was associated with significant improvement (67% of the cases) of overall depression, with 75% of recovery cases.Global Quality of Life slightly improved after masitinib therapy and did not predicted depression improvement.In conclusion, depression is very frequent in mastocytosis patients and masitinib therapy is associated with the reduction its psychic experiences.

View Article: PubMed Central - PubMed

Affiliation: Université Paris Descartes, Sorbonne, Paris Cité, Service d'hématologie, Centre de référence des mastocytoses, Hôpital Necker Enfants malades, Paris, France.

ABSTRACT
Depression in patients with mastocytosis is often reported but its prevalence and characteristics are not precisely described. In addition, the impact of therapies targeting mast cells proliferation, differentiation and degranulation on psychic symptoms of depression have never been investigated. Our objective was to determine the prevalence and to describe features of depression in a large cohort of mastocytosis patients (n = 288) and to investigate the therapeutic impact of the protein kinase inhibitor masitinib in depression symptoms. The description of depression was based on the analysis of a database with Hamilton scores using Principal Component Analysis (PCA). Efficacy of masitinib therapy was evaluated using non parametric Wilcoxon test for paired data within a three months period (n = 35). Our results show that patients with indolent mastocytosis present an elevated prevalence of depression (64%). Depression was moderate in 56% but severe in 8% of cases. Core symptoms (such as psychic anxiety, depressed mood, work and interests) characterized depression in mastocytosis patients. Masitinib therapy was associated with significant improvement (67% of the cases) of overall depression, with 75% of recovery cases. Global Quality of Life slightly improved after masitinib therapy and did not predicted depression improvement. In conclusion, depression is very frequent in mastocytosis patients and masitinib therapy is associated with the reduction its psychic experiences. We conclude that depression in mastocytosis may originate from processes related to mast cells activation. Masitinib could therefore be a useful treatment for mastocytosis patients with depression and anxiety symptoms.

Show MeSH
Related in: MedlinePlus