Assessment of depression and anxiety in adult cancer outpatients: a cross-sectional study

Abstract

BackgroundThe prevalence of anxiety and depressive disorders in cancer patients and its associated factors in Pakistan is not known. There is a need to develop an evidence base to help introduce interventions as untreated depression and anxiety can lead to significant morbidity. We assessed the prevalence of depression and anxiety among adult outpatients with and without cancer as well as the effect of various demographic, clinical and behavioral factors on levels of depression and anxiety in cancer patients.MethodsThis cross-sectional study was carried out in outpatient departments of Multan Institute of Nuclear Medicine and Radiotherapy and Nishtar Medical College Hospital, Multan. Aga Khan University Anxiety and Depression Scale (AKUADS) was used to define the presence of depression and anxiety in study participants. The sample consisted of 150 diagnosed cancer patients and 268 participants without cancer (control group).ResultsThe mean age of cancer patients was 40.85 years (SD = 16.46) and median illness duration was 5.5 months, while the mean age of the control group was 39.58 years (SD = 11.74). Overall, 66.0% of the cancer patients were found to have depression and anxiety using a cutoff score of 20 on AKUADS. Among the control group, 109 subjects (40.7%) had depression and anxiety. Cancer patients were significantly more likely to suffer from distress compared to the control group (OR = 2.83, 95% CI = 1.89-4.25, P = 0.0001). Performing logistic regression analysis showed that age up to 40 years significantly influenced the prevalence of depression and anxiety in cancer patients. There was no statistically significant difference between gender, marital status, locality, education, income, occupation, physical activity, smoking, cancer site, illness duration and mode of treatment, surgery related to cancer and presence of depression and anxiety. Cancers highly associated with depression and anxiety were gastrointestinal malignancies, chest tumors and breast cancer.ConclusionsThis study highlights high prevalence rates of depression and anxiety in cancer patients. Younger age was associated with a higher likelihood of meeting criteria for psychological morbidity. The findings support screening patients for symptoms of depression and anxiety as part of standard cancer care and referring those at a higher risk of developing psychological morbidity for appropriate care.

Effectiveness of prayer in reducing anxiety in cancer patients

“…In oncology, patients' lives are changed after diagnosis and treatment; moreover, each patient responds differently to situations experienced during hospitalization, which can generate anxiety (2)(3) . This was the case for the subjects of this study, who required hospitalization in order to receive continuous intravenous chemotherapy.…”

Factors Associated with Psychological Characteristics in Patients with Hepatic Malignancy before Interventional Procedures

“…Patients often experience pain and anxiety that may exceed their coping mechanisms. Previous studies suggest that several factors, including cancer diagnosis and interventional procedures, contribute to psychological distress of patients (Massie et al, 2004;Martin et al, 2005;Schupp et al, 2005;Sims et al, 2006;Wang et al, 2008;Jadoon et al, 2010;Hulbert-Williams et al, 2011). Minagawa et al (1996) and Godding et al (Aqarwal et al, 2010) reported that about 30% -60% cancer patients have psychiatric disorders.…”

“…For the patients, there are many physical and social factors that that may compound the diagnosis of hepatic carcinoma, making it more difficult to cope and contemplate different treatment options. It is demonstrated a stressful and life-changing event causing significant psychological distress (Jadoon et al, 2010;Pirl et al, 2004).…”

“…From the literature, previous studies have evaluated the psychological status throughout all phases of cancer and highlight several symptoms, such as anxiety and depression, in patients with cancer (Pirl et al, 2004;Tavoli et al, 2007;Nelson et al, 2009;Jadoon et al, 2010;Dempster et al, 2011;Hulbert-Williams et al, 2011). In past decades, a growing number of studies, looking at cancer patients undergoing interventional procedure, suggest severe psychological distress occurs in patients with cancer (Wang et al, 2008) and some symptoms can inhibit healing and interfere with clinical outcomes (Martin et al, 2005;Schupp et al, 2005;Sims et al, 2006).…”

Pacientes em uso de quimioterápicos: depressão e adesão ao tratamento

“…A er a cancer diagnosis is disclosed, the physical and psychological changes that are triggered by cancer are evident and have signifi cant eff ects, leading primarily to anxiety and depression (2) . These psychological condi ons o en persist throughout treatment and may be related to the treatment's side eff ects.…”