Association Between Mortality and Antidepressant Use After HCC Diagnosis
HCC
The crude overall mortality rate was 10.03 per 100 person-years in the antidepressant use group after HCC diagnosis, lower than 15.45 per 100 person-years in the nonuse group. The crude overall mortality rate for antidepressant subgroups was even lower, ranging from 3.62 to 5.00 per 100 person-years. After adjustment for confounders, use of any antidepressant after diagnosis was associated with lower overall mortality (adjusted HR, 0.69; 95% CI, 0.68-0.70). When examining specific subgroups of antidepressants, the lower overall mortality were associated with postdiagnosis use of SSRI (adjusted HR, 0.62; 95% CI, 0.61-0.64), SNRI (adjusted HR, 0.60; 95% CI, 0.57-0.62), or TCA (adjusted HR, 0.60; 95% CI, 0.59-0.60).The crude cancer-specific mortality rates were 0.32 per 100 person-years in the combined antidepressant group, 0.12 to 0.15 per 100 person-years in different antidepressant subgroups, and 0.54 per 100 person-years in nonusers. Postdiagnosis antidepressant use was associated with a lower cancer-specific mortality (adjusted HR, 0.63; 95% CI, 0.59-0.68). The antidepressant subgroups, including SSRI (adjusted HR, 0.53; 95% CI, 0.47-0.61), SNRI (adjusted HR, 0.54; 95% CI, 0.42-0.68), and TCA (adjusted HR, 0.54; 95% CI, 0.49-0.59), demonstrated an inverse association with cancer-specific mortality.There was no apparent difference observed between short-term (≤90 days) and long-term (>90 days) antidepressant use in terms of overall mortality (adjusted HRs, 0.69 [95% CI, 0.68-0.70] and 0.68 [95% CI, 0.66-0.69], respectively) and cancer-specific mortality (adjusted HRs, 0.65 [95% CI, 0.59-0.71] and 0.61 [95% CI, 0.54-0.67], respectively). The statistical significance inferred using the false discovery rate for multiple comparisons remained the same as it did with the 95% CIs.To examine the possible influence of the length of the induction period, we used different induction periods (0 days and 180 days) to examine the association of postdiagnosis antidepressant use, including the use of different antidepressant types, with overall and cancer-specific mortality. The results were similar to those for a 90-day induction period (eTable 1 in 