Prevalence, correlates of depression, and its impact on quality of life of cancer patients attending a palliative care setting in South India

Abstract

Objective Depression is an easily treatable yet frequently underdiagnosed affliction in palliative population with deleterious implications on their quality of life. It has been studied poorly in developing countries like India. Methods A cross‐sectional study was done with 234 consenting subjects attending a palliative care unit. Patient Health Questionnaire‐9 (PHQ‐9), World Health Organization Quality of Life (WHOQOL‐BREF), and semi‐structured proforma were used by trained nonmental health professional to collect data. Results The prevalence of major depression was 70%. Being a resident of nuclear family (p = .004), absence of insurance coverage (p = .01), presence of financial difficulties (p = .002), and absence of cancer recurrence (p = .001) were significantly associated with major depression in univariate analysis. In multivariate analysis, presence of financial difficulties (OR = 3.9; 95% CI, 2.00‐7.61) and absence of health insurance (OR = 1.92; 95% CI, 1.02‐3.7) were independently associated with major depression. The presence of depression showed significant negative correlation with physical health (p = .03), psychological health (p = .002), and environmental (p = .002) domains of the WHOQOL‐BREF. Conclusion This study brings to the fore the high rates of depression and its negative impact on the quality of life of terminally ill cancer patients. An improvement in their quality of life requires measures to reduce the rate of underdiagnosed psychiatric morbidities, especially in those who are financially burdened and lack insurance coverage.

Effects of anxiety, depression, and fatigue on quality of life in early esophageal cancer patients following endoscopic submucosal dissection

“…It is understandable that an inability to pay the cost of treatment acted as a key cause of emotional distress. Several studies have also highlighted the important role of financial difficulties in the development of emotional problems in cancer patients (18,19). Thus, measurements in the present study were taken to ensure that the rate of underdiagnosed psychiatric morbidities was reduced, especially for patients that are financially-burdened.…”

Preferences of quality delivery of palliative care among cancer patients in low- and middle-income countries: A review

“…Simply being able to go out from their bed or their home was a source of relief (Aebischer et al, 2018; Pareek et al, 2019). A cross-sectional study on 234 individuals with advanced stages of cancer, who attended palliative care in South India, reported prevalence major depression (70%) among patients (Sudarisan et al, 2019). Sudarisan reported that the presence of financial difficulties (3.9; 95% Cl, 2.00–7.61) and the absence of health insurance (OR = 1.92, 95% Cl, 1.02–3.7) were significantly associated with major depression (Sudarisan et al, 2019).…”

“…Simply being able to go out from their bed or their home was a source of relief (Aebischer et al, 2018;Pareek et al, 2019). A cross-sectional study on 234 individuals with advanced stages of cancer, who attended palliative care in South India, reported prevalence major depression (70%) among patients (Sudarisan et al, 2019).…”

“…Sudarisan reported that the presence of financial difficulties (3.9; 95% Cl, 2.00-7.61) and the absence of health insurance (OR = 1.92, 95% Cl, 1.02-3.7) were significantly associated with major depression (Sudarisan et al, 2019). Explaining that the higher baseline prevalence of depression was due to the type of medium human development index (HDI) in the country compared with a developed country (Sudarisan et al, 2019).…”

Global, regional, and national prevalence of depression among cancer patients: A systematic review and meta-analysis

“…Psychological conditions such as depression can greatly affect the progression of the disease. [ 13 ] Many cancer patients as well as physicians believe that the patient's mental state can affect the outcome of treatment. [ 14 ] Cancer patients with depression have a higher mortality prevalence than nondepressed patients, which highlights the importance of preventing and treating depression in these patients.…”