Impact of Psychiatric Disorders on Treatment Adherence and Overall Survival in Patients with Hodgkin Lymphoma: A Retrospective Cohort Study

Background: Psychiatric comorbidities are common in patients with Hodgkin lymphoma (HL) and may influence treatment adherence and survival outcomes. This study aimed to evaluate the impact of psychiatric disorders on overall survival and treatment adherence in HL patients. Methods: A retrospective cohort study was conducted including 139 HL patients treated at the General Hospital of Mexico "Dr Eduardo Liceaga". Clinical, demographic, and psychiatric data were collected. Overall survival was analyzed using Kaplan-Meier curves and Cox proportional hazards models adjusted for Ann Arbor stage, treatment adherence, and psychiatric disorders. Treatment adherence was assessed and its association with survival was explored using time-varying hazard ratios. Findings: Among 139 patients, those with psychiatric disorders exhibited significantly worse overall survival (HR 6.80, 95% CI 1.32–34.95, p = 0.022). Adherence to treatment was independently associated with improved survival (HR 0.05, 95% CI 0.02–0.16, p < 0.001). Time-varying analysis showed the highest hazard ratio for psychiatric disorders during the early follow-up period. Conclusion: Psychiatric disorders substantially impair survival outcomes in HL, primarily through reduced treatment adherence. Early psychiatric evaluation and integrated care are critical to improve adherence and prognosis. These findings highlight the need for multidisciplinary management in HL patients with psychiatric comorbidities.