Depression and mental adjustment in cancer patients: The role of serotonin transporter polymorphism  

Giraldi T., Capozzo M., Martinis E., Schillani G.
First author's affiliation: Dipartimento di Scienze Biomediche, Trieste, Italy

Serotonin transporter (SERT) play a crucial role in monoaminergic neurotransmission, and was shown to be associated to the development of mental disorders, such as depression, and to the mechanism of action of antidepressant drugs. The 5-HTTLPR polymorphism has been identified in the promoter region of SERT; this polymorphism has a high penetrance, significantly influences the transcriptional activity of the gene, and was shown to play a considerable role in determining difficulties in the adaptation to life events and the ensuing possible mental suffering in mental health. The aim of this study was consequently that to examine the role of 5-HTTLPR in determining the difficulties of mental adaptation to the disease in cancer patients. A series of 145 breast cancer patients (mean age 55.8 years, SD 9.00) were evaluated at two different times (T0, and T1 3 months later) by using the Hospital Anxiety and Depression Scale (HADS) in order to determine depression, and the Mini-Mental Adjustment to Cancer Scale (Mini-MAC) to examine the mechanisms of coping to the disease; the patients were also characterized for the 5-HTTLPR polymorphism. The results obtained indicate that, when the patients are stratified for the 5-HTTLPR allelic variants, at T1 the patients carrying the LL allele had higher mean scores on depression, as well as on the Hopelessness-Helplessness (HH) and Anxious Preoccupation (AP) scales of Mini-MAC, as compared with carriers of an S allele. The patients with SS and SL haplotypes, when examined at T1, diplayed HH and AP scores which were significantly lower than those observed at T0. These results seem to encourage further research aimed to study the genetic polymorphism 5-HTTLPR, and its role in contributing to depression and difficulties in mental adaptation to the disease in cancer patients.