Lifetime stressor exposure and depression among patients with pancreatic cancer: insights from the Florida Pancreas Collaborative
Bibliographic record
Abstract
BACKGROUND: Although depression is reported to be higher among patients with pancreatic cancer than in the general population, research on depression and stress levels in this population is limited. METHODS: To address this gap, we investigated the prevalence of self-reported depression and lifetime stressor exposure in a cohort of treatment-naïve patients with pancreatic ductal adenocarcinoma (PDAC) or other types of pancreatic tumors such as pancreatic neuroendocrine tumors and intraductal papillary mucinous neoplasms who received care at one of 15 institutions participating in the multi-institutional study Florida Pancreas Collaborative. Depression severity was assessed using the Edmonton Symptom Assessment System-revised (ESAS-r) and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC), and acute and chronic stressor exposure was assessed with the Stress and Adversity Inventory (STRAIN). RESULTS: PDAC patients reported higher average depression symptom severity at the time of diagnosis and after 6 months compared to non-PDAC patients (p = 0.027 and p = 0.063, respectively). On the other hand, non-PDAC patients experienced a higher mean number and severity of lifetime stressors (p = 0.021 and p = 0.039, respectively) than PDAC patients. Across the sample, greater stressor exposure (measured by stressor count, severity, and event type) was associated with higher odds of clinically significant depressive symptoms. We also observed that chronic stressors were significantly associated with lower odds of advanced disease (OR = 0.896, p = 0.002). Among PDAC patients who completed both STRAIN and ESAS-r (n = 52), greater severity of acute life events was associated with a significant increase in ESAS-r depression scores between baseline and 6-month follow-up (p = 0.015). CONCLUSIONS: These findings highlight distinct patterns of depression and stress across pancreatic tumor types and reveal a robust association between lifetime stress exposure and depressive symptoms. Together, they underscore the need for systematic screening and integrated psychosocial support for patients with pancreatic cancer.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".