Psychological Medicine

Original Articles

Depression and cancer mortality: a meta-analysis

M. Pinquarta1 c1 and P. R. Dubersteina2

a1 Department of Psychology, Philipps University, Marburg, Germany

a2 Laboratory of Personality and Development, Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA


Background The goal of the present study was to analyze associations between depression and mortality of cancer patients and to test whether these associations would vary by study characteristics.

Method Meta-analysis was used for integrating the results of 105 samples derived from 76 prospective studies.

Results Depression diagnosis and higher levels of depressive symptoms predicted elevated mortality. This was true in studies that assessed depression before cancer diagnosis as well as in studies that assessed depression following cancer diagnosis. Associations between depression and mortality persisted after controlling for confounding medical variables. The depression–mortality association was weaker in studies that had longer intervals between assessments of depression and mortality, in younger samples and in studies that used the Beck Depression Inventory as compared with other depression scales.

Conclusions Screening for depression should be routinely conducted in the cancer treatment setting. Referrals to mental health specialists should be considered. Research is needed on whether the treatment of depression could, beyond enhancing quality of life, extend survival of depressed cancer patients.

(Received March 11 2009)

(Revised December 01 2009)

(Accepted December 01 2009)

(Online publication January 20 2010)


c1 Address for correspondence: Professor M. Pinquart, Philipps University, Department of Psychology, Gutenbergstrasse 18, D-35032 Marburg, Germany. (Email: