DEPRESSION

Depression In Newly Diagnosed Cancer Patient

Depression in Newly Diagnosed Cancer Patient

Background

Gastrointestinal cancer is the first leading cause of cancer related deaths in men and the second among women in Iran. An investigation was carried out to examine anxiety and depression in this group of patients and to investigate whether the knowledge of cancer diagnosis affect their psychological distress.

Methods

This was a cross sectional study of anxiety and depression in patients with gastrointestinal cancer attending to the Tehran Cancer Institute. Anxiety and depression was measured using the Hospital Anxiety and Depression Scale (HADS).

Results

In all 142 patients were studied. The mean age of patients was 54.1 (SD = 14.8), 56% were male, 52% did not know their cancer diagnosis, and their diagnosis was related to esophagus (29%), stomach (30%), small intestine (3%), colon (22%) and rectum (16%). The mean anxiety score was 7.6 (SD = 4.5) and for the depression this was 8.4 (SD = 3.8). Overall 47.2% and 57% of patients scored high on both anxiety and depression. There were no significant differences between gender, educational level, marital status, cancer site and anxiety and depression scores whereas those who knew their diagnosis showed a significant higher degree of psychological distress [mean (SD) anxiety score: knew diagnosis 9.1 (4.2) vs. 6.3 (4.4) did not know diagnosis, P < 0.001; mean (SD) depression score: knew diagnosis 9.1 (4.1) vs. 7.9 (3.6) did not know diagnosis, P = 0.05]. Performing logistic regression analysis while controlling for demographic and clinical variables studied the results indicated that those who knew their cancer diagnosis showed a significant higher risk of anxiety [OR: 2.7, 95% CI: 1.1-6.8] and depression [OR: 2.8, 95% CI: 1.1-7.2]. (Kathleen Ramming 2003)

Background

Cancer is well known to be a difficult disease, affecting patients and their families both physically and emotionally. Despite biomedical progress, cancer is still often considered synonymous with death, pain and suffering Montazeri A, Milroy R, Hole D, McEwean J, Gills 1994. It is argued that cancer is not just a single event with a certain end but a permanent condition characterized by ongoing ambiguity,

Methods

Design and data collection

An interview based prospective study was carried out to measure anxiety and depression in patients with gastrointestinal cancer. Data were collected during November 2005 and April 2006. The intention was to interview all gastrointestinal cancer inpatients attending a large teaching hospital (Imam Hospital) in Tehran, Iran. A psychologist in a face-to-face interview administered the questionnaire. Data on demographic characteristics and clinical information including age, gender, educational status, cancer site and time since diagnosis were extracted from case records. To assess patients' knowledge of the cancer diagnosis, both patients and relatives were investigated separately. Knowledge was assessed by patients' ability to acknowledge the illness and use the terms "cancer "or "tumor".

All participants in the study were gastrointestinal cancer patients who were diagnosed during one year ago. Patients who had cognitive problems or were too sick to participate in the interview were excluded. Verbal consents obtained from all patients prior to ...