Prevalence of depression in a cohort of 400 patients with pancreatic neoplasm attending day hospital for major surgery: Role on depression of psychosocial functioning and clinical factors

Abstract

Objective (1) To determine the prevalence and type of depressive symptoms at day‐hospital clinical evaluation, before undergoing major surgery in patients diagnosed with pancreatic neoplasm. (2) To analyze the association between depression and sociodemographic, clinical, and psychosocial variables. (3) To understand how coping strategies, perceived social support, and self‐efficacy might affect depressive symptoms in this cohort of patients. Methods Secondary data analysis collected during the baseline phase of a randomized controlled trial performed at the Pancreas Institute of the University Hospital of Verona, Italy, between June 2017 and June 2018. Results 18.5% of pancreatic patients had a PHQ‐9 score ≥10 (cut‐off). Depressed patients were basically more often female (p = 0.07), younger (p = 0.06), and married/with a partner (p = 0.02). Depression was associated to high trait anxiety (p < 0.01), the use of anxiolytics (p < 0.01), sleep‐inducing drugs (p < 0.01), and painkillers (p < 0.01). Among psychosocial variables, depressed patients showed lower perceived self‐efficacy (p < 0.01) and family and friends’ social support (p < 0.01) and used significantly more often dysfunctional coping strategies (p < 0.01), compared to nondepressed. A logistic multivariate model using psychosocial variables as explanatory and depression as dependent was calculated and post hoc analyses were conducted to describe the contribution of each psychosocial variable on depression. Conclusions Our study advocates the need for screening for distress and depression in cancer surgery units and recommends to strengthen patients' adaptive coping, social support, and sense of effectiveness in facing the challenges related to the medical condition and treatment process.

Preoperative Anxiety in Patients with Pancreatic Cancer: What Contributes to Anxiety Levels in Patients Waiting for Surgical Intervention

“…As could be expected, we found high comorbidity between anxiety and depressive symptoms, showing that these clinical conditions frequently overlap, at least in this population [39] and both need to be considered in a screening evaluation during the day-hospital stay. A recent study by our group showed that patients, candidates for pancreatic resection [17], often present depressive symptoms related to demoralization and physical exhaustion, self-blame, denial and disengagement in coping. These are drivers of emotional distress and low self-efficacy, which in turn may contribute to triggering anxiety symptoms.…”

“…More details of sociodemographic and clinical frequency distributions are reported in Table 1 (column 1). At the time of admission to the Unit of General and Pancreatic Surgery, 41 (39%; 95% CI = 30.0-49.5) patients had clinically relevant levels of anxiety (STAI-S cut-off ≥ 45 [17]), among them 15 (14%) had severe anxiety, according to Ilardi's criterion [25]. The median score for state-anxiety STAI-S was 42 (range 33.5-49.5).…”

“…In addition, the extent of this distress may be influenced by previous psychiatric diseases, such as depression, anxiety, and minor psychiatric disorders [14,15]. Recent studies by Barnes et al [16] and Del Piccolo et al [17] reported that depression is raised in people with pancreatic cancer compared with the general population, confirming that exploring and taking care of pancreatic patients' emotional distress must be considered a top priority in order to protect their quality of life (QoL). Thus, appropriate and careful screening of the psychological conditions of patients undergoing major pancreatic surgery may contribute to identifying patients who need more help, with the aim of offering support and preventing the development of emotional distress, state anxiety and surgery worries.…”

Association of depression phenotypes and antidepressant treatment with mortality due to cancer and other causes: a community-based cohort study

“…However, an overestimation of depressive disorders due to symptom overlap derived from somatic illnesses could partly explain this association (Rayner et al, 2011 ; Saracino et al, 2020 ). In cancer patients, SDSs are common (Del Piccolo et al, 2021 ), and being depressive, anxious, and fatigued are very specific depressive phenotypes in these patients (Schellekens et al, 2020 ). For depression screening in patients with cancer, somatic items showed a less discriminatory value than non-somatic ones, although they are still useful for mild/moderate depression detection, and ignoring them would lead to an underestimation of depressive syndromes (Grapp et al, 2019 ).…”