Pre-transplant depressive symptoms and exploratory psychosocial associations among patients with multiple myeloma who underwent autologous hematopoietic stem cell transplantation: A cross-sectional secondary analysis
María Constanza Benavides Cáceres, Elia Francisca Espinoza de Ávila, Marta Georgina Ochoa Madrigal, Óscar Meneses Luna, Luara Luz Arana Luna, Mario Antonio Téllez González, Deldhy Nicolás Moya SánchezObjectives
To estimate the prevalence of depressive symptoms before autologous hematopoietic stem cell transplantation (HSCT) in patients with multiple myeloma, and to explore associations with clinician-documented psychosocial characteristics.
Methods
Single-center, cross-sectional secondary analysis of one pre-transplant psychiatric assessment per participant at a Mexican tertiary hospital. Eligible assessments occurred between June 2023 and April 2026. We included adults with confirmed multiple myeloma who completed the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) scale and subsequently underwent autologous HSCT. The primary threshold was PHQ-9 ≥10; PHQ-9 ≥5 (at least mild depressive symptoms) was secondary. Prevalences are reported with exact binomial 95% confidence intervals (CIs). This is a disease-specific secondary analysis of a partially overlapping institutional cohort.
Results
Among 83 participants (median age, 59 years; 42 women, 50.6%), PHQ-9 ≥10 occurred in 3 participants (3.6%; 95% CI, 0.8–10.2) and PHQ-9 ≥5 in 6 (7.2%; 95% CI, 2.7–15.1). No participant scored in the severe range; median PHQ-9 was 0 (interquartile range, 0–0). At the secondary threshold, at least mild depressive symptoms were observed in 5 of 28 participants not in paid employment and 1 of 55 employed participants (odds ratio, 11.38; 95% CI, 1.18 to 565.16; P=.02). This exploratory comparison rests on six events and is imprecise. PHQ-9 and GAD-7 scores correlated (Spearman ρ=0.62; P<.001).
Conclusions
PHQ-9 scores in the moderate-or-greater range were infrequent in this selected single-center pre-transplant sample (3.6%; 95% CI, 0.8%–10.2%). The exploratory employment-status finding identifies a question for larger studies and should not be read as a confirmed psychosocial correlate.