Depression and anxiety that are already present within 2 years prior to a diagnosis of diffuse large B-cell lymphoma (DLBCL) worsen the prognosis of the disease, according to a new study published in The Lancet Haematology

“Our data underscore the need for universal and systematic mental health screening for this population,” the researchers wrote, “as mental health disorders are manageable, and improvements in this prevalent comorbidity might affect lymphoma-specific survival and overall survival.”

Read more about DLBCL comorbidities

Information is scarce about the effect of mental health problems on the survival of patients with DLBCL.

In the present study, a team of researchers from the United States led by Oreofe O. Odejide, MD, evaluated the effect of pre-existing depression and anxiety on survival in 13,244 patients with DLBCL, aged 67 years and above.

Of these, 2094 (15.8%) had depression, anxiety, or both. 

The 5-year overall survival of the patients who had these mental health problems was lower than that of those without mental health problems (27% vs 37.4%).

Patients who had depression had the worst survival. This was followed by patients who had depression and anxiety, and then anxiety alone. 

Patients who had these mental health disorders before a diagnosis of DLBCL also had lower 5-year lymphoma-specific survival. Once again, the greatest effect was seen with depression, then with depression and anxiety followed by anxiety alone.

“These data suggest that comprehensive psychosocial assessment should be an essential component of evaluation at time of DLBCL diagnosis,” the researchers wrote.

DLBCL comprises around 30% to 40% of all nonHodgkin lymphoma cases, and it is the most common cancer of the lymphatic system. It is characterized by B cells infiltrating tissues and organs in a widespread, diffuse pattern. The disease grows rapidly and can be fatal, with a median overall survival time of less than 1 year if left untreated.


Kuczmarski TM, Tramontano AC, Mozessohn L, et al. Mental health disorders and survival among older patients with diffuse large B-cell lymphoma in the USA: a population-based study. Lancet Haematol. Published online June 1, 2023. doi:10.1016/S2352-3026(23)00094-7