CORRELATES OF DEPRESSION AND ANXIETY AMONG THE CANCER PATIENTS IN THE RADIOTHERAPY CLINIC IN UCH, IBADAN, NIGERIA
Keywords:
Anxiety, Depression, Cancer patients, Prevalence, RadiotherapyAbstract
The diagnosis of cancer and its management result in several problems for cancer patients. This may result from factors some of which may be modifiable. This study was aimed at identifying the prevalence of depression and anxiety in patients attending the Radiotherapy Clinic in the UCH, Ibadan and to identify the variables affecting them. The Beck’s Depression Inventory (BDI-II) and the Fear of Progression (FOP12) scales were used to assess depression and anxiety among cancer patients. The 206 diagnosed cancer patients studied were made up of 146 (79.6%) women and 42 (20.4%) men. Some 76 (36.9%) had moderate to very high anxiety while 29 (14.1%) had borderline to severe depression. The ages ranged between 10 to 85 years with a mean of 47.84 (+/_ 16.45). In prevalence of anxiety and depression, 36.9% of the cancer patients experience varying levels of anxiety and 31.6% experience varying levels of depression. On logistic regression, age, religion, educational level and treatment type significant factors for anxiety. Specifically, being older than 40years, being a Christian, not reporting educational qualification and not yet commencing treatment compared to having surgery as the current treatment type was significant risk factors for anxiety. Only treatment type was a significant risk factor for depression that is not yet commencing treatment compared to having surgery as the current treatment type was a factor for depression. Appropriate Psychological evaluation and therapy as may be needed should be administered to all oncology patients preparing for surgery and chemotherapy to enhance their emotional and psychological wellbeing. The findings of this study have implication for establishment of psycho-oncology care in all the cancer centres in Nigeria.References
Ahlberg K., Ekman T., Wallgren A., Johansson G.F. (2004). Fatigue, psy¬chological distress,coping and quality of
life in patients with uterine cancer. Journal of Advance Nursing, 45:205-213.
Beck A.T., Steer R.A., Ball R., Ranieri W. (1996). Comparison of Beck Depression Inventories -IA and -II in
psychiatric outpatients. Journal of Personality Assessment, 67(3): 588–597
Blank T.O., Bellizzi K.M. (2008). A gerontologic perspective on cancer and aging. Cancer 112:2569–76.
Bradley J.J. (2003). Severe localised pain associated with the depressive syndrome. British Journal of
Psychiatry, 109:741-5.
Breen S.J., Baravelli C.M., Schofield P.E., Jefford M., Yates P.M., & Aranda S.K., (2009). Is symptom burden a
predictor of anxiety and depression in patients with cancer about to commence chemotherapy? Medical
Journal of Australia, 190 (7): 99.
Burdette-Radoux S., Muss H.B. (2006). Adjuvant chemotherapy in the elderly: whom to treat, what regimen?
Oncologist, 11:234–42.
Capuron L., Ravaud A.& Dantzer R. (2000). Early depressive symptoms in cancer patients receiving interleukin 2
and/or interferon alfa-2b therapy. Journal of Clinical Oncology 18:2143-51.
Carvalho C.C., Chaves E.C., Iunes D.H., Simão T.P., Grasselli C.M.& Braga C.G., (2014). Effectiveness of
prayer in reducing anxiety in cancer patients. Journal of the Nursing School of the University of Sao Paulo,
(4):683-689.
Chen, H ., Cantor , A., Meyer, J., Corcoran, B. M., Grendys, D., Cavanaugh, D., Antonek, S., Camarata , A. ,
Haley, W., Balducci, L. & Extermann ,M. (2003). Can older cancer patients tolerate chemotherapy? A
prospective pilot study. Cancer, 97:1107–1114.
DiMatteo R.M., Lepper H.S.& Crogham T.W. (2000). Depression is a risk factor for noncompliance with medical
treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Archives of
Internal Medicine, 160:2101–2107.
Drageset S.& Lindstrom C.T. (2005). Coping with a possible breast can¬cer diagnosis: demographic factors and
social support. Journal of Advance Nursing, 51:217-26.
Fallowfield L., Ratcliffe D., Jenkins V. & Saul. J., (2001). Psychiatric morbidity and its recognition by doctors in
patients with cancer. British Journal of Cancer, 84: (8) 1011- 1015.
Frick E., Tyroller M.& Panzer M. (2007). Anxiety, depression and quality of life of cancer patients undergoing
radiation therapy: a cross-sectional study in a community hospital outpatient centre. European Journal of
Cancer Care (England), 16:130-136.
Hargraves, M., Yates, P., Grove, K., Aranda, S.& Mirolo, B.,(2004) Commencing adjuvant chemotherapy for early
breast cancer: what should nursing assessment involve? Oncological Nursing Forum 31:388
Hopwood P.& Stephens R.J. (2000). Depression in patients with lung cancer: prevalence and risk factors derived
from quality-of-life data. Journal of Clinical Oncology, 18: 893- 903.
Jacobsen P.B.& Jim H.S. (2008). Psychosocial interventions for anxiety and depression in adult cancer patients:
achievements and challenges. CA: Cancer Journal for Clinicians, 58:214-230.
Jadoon N.A., Munir W., Shahzad M.A.& Choudhry Z.S., (2010) Assessment of depression and anxiety in adult
cancer outpatients: a cross-sectional study. BioMedCentral Cancer,10 (594): 1471-2407.
Kadan-Lottick N.S., Vanderwerker L.C., Block S.D., Zhang, B, & Prigerson, H.G.(2005). Psychiatric disorders and
mental health service use in pa¬tients with advanced cancer: a report from coping with cancer study.
Cancer, 104: 2872-2881.
Karabulutlu E., Bilici M., Çayır K., Tekin S.B.& Kantarcı R. (2010). Coping, anxiety and depression in Turkish
cancer patients. European Journal of General Medicine, 7(3):296-302
Keuter, K., Classen, C.C., Roscoe, J.A., Morrow,G.R., Kirshner, J.J., Rosenbluth, R., Flynn, P.J., Shedlock, K., &
Spiegel, D. (2006) Association of coping style, pain, age and depression with Fatigue in women with
primary breast cancer. Psycho-Oncology 15(9): 772-9
Kim, Y., Wellisch D.K., Spillers, R.L.& Crammer, C. (2007). Psychological distress of female cancer caregivers:
effects of type of cancer and caregivers' spirituality. Support Care Cancer, 15 (12): 1367-1374.
Kurtz, M., Kurtz J., Stommel M., Given, C.& Given, B. (2001). Physical functioning and depression among older
persons with cancer. Cancer Practice, 9:11–18.
Levine, E.G., Yoo, G., Aviv, C., Ewing, C. & Au, A. (2007). Ethnicity and spirituality in breast cancer survivors. Journal of Cancer Survivor, 1 (3): 212-225.
Lloyd-Williams M. (2001). Screening for depression in palliative care patients: a review. European Journal of
Cancer Care, 10:31-35.
Lloyd-Williams, M. (2000). Difficulties in diagnosing and treating depression in the terminally ill cancer patient.
Postgraduate Medical Journal, 76:555-558.
Lynch, M.E. (1995). The assessment and prevalence of affective disorders in advanced cancer. Journal of
Palliative Care, 11:10-18.
Matsushita, T., Matsushima, E.& Maruyama, M. (2005). Psychological state, quality of life, and coping style in
patients with digestive cancer. General Hospital Psychiatry, 27:125-132
Matsushita, T., Matsushima, E.& Maruyama, M. (2005). Anxiety and depression of patients with digestive cancer.
Psychiatry of Clinical Neuroscience, 59:576-583.
Mehnert, A., Herschbach, P., Berg, P., Henrich, G.& Koch, U. (2006). Fear of progression in breast cancer
patients - validation of the short form of the Fear of Progression Questionnaire (FoP-Q-SF). Z
Psychosomatic Medicine and Psychotherapy, 52:274-288.
Mystakidou, K., Tsilika, E., Parpa, E., Katsouda, E., Galanos, A.& Vlahos L. (2005). Assessment of anxiety
and depression in advanced cancer patients and their relationship with quality of life. Quality of Life
Research, 14:1825-1833.
National Breast Cancer Centre and National Cancer Control Initiative. (2003) Clinical practice guidelines for the
psychosocial care of adults with cancer. Sydney: NBCC, National Comprehensive Cancer Network. Clinical
practice guidelines in oncology. Distress management.Vol.1.2008. http://www.nccn.org/professionals/physician_gls/PDF/distress.pdf
National Institute for Clinical Excellence. Guidance on cancer services. Improving supportive and palliative care
for adults with cancer. The manual. London: NICE, 2004. http://www.nice.org.uk/nicemedia/pdf/csgspmanual.pdf .
Nelson, C.J., Weinberger, M.I., Balk E., Holland J., Breitbart W.& Roth A.J., (2009). The chronology of distress,
anxiety, and depression in older prostate cancer patients. Oncologist, 14(9): 891–899.
Nikbakhsh, N., Moudi, S., Abbasian S., & Khafri, S., (2014). Prevalence of depression and anxiety among
cancer patients. Caspian Journal of Internal Medicine, 5(3): 167–170.
Norton, T.R., Manne, S.L., Rubin, S., Carlson, J., Hermandez, E., Edelson, M.I., Rosenblum,N., Warshal,D. &
Bergman, C. (2004). Prevalence and predictors of psychological distress among women with ovarian
cancer. Journal of Clinical Oncology, 22:919-926.
O’Mahony S., Goulet J., Kornblith A., Abbatiello G., Clarke B., Kless-Siegel S., Breitbart W.& Payne R. (2005).
Desire for hastened death, cancer pain and depression: report of a longitudinal observational study.
Journal of Pain Symptom Management, 29:446-457.
Pandey, M., Sarita G.P.& Devi N., Thomas B.C., Hussain B.M., Krishnan R. (2006). Distress, anxiety and
depression in cancer patients undergoing chemotherapy. World Journal of Surgical Oncology, 4:68.
Pasquin, M.& Biondi M. (2007). Depression in cancer patients: a critical review. Clinical Practice Epidemiology
of Mental Health, 52:513–521.
Pinquart M.& Duberstein P.R. (2010). Depression and cancer mortality: a metaanalysis. Psychological Medicine,
(11):1797-810.
Pirl, W.F. (2004). Evidence report on the occurrence, assessment, and treatment of depression in cancer
patients. Journal of National Cancer Institute Monograph, 32:32-39.
Pirl, W.F., Siegel G.I., Goode M.L., & Smith, M.R. (2002). Depression in men receiving androgen deprivation
therapy for prostate cancer: a pilot study. Psychooncology, 11:518–523.
Rezaei,M., Adib-Hajbaghery M., Seyedfatemi N.& Hoseini F. (2008). Prayer in Iranian cancer patients
undergoing chemotherapy. Complementary Therapy and Clinical Practice,14(2):90-97.
Redeker, N.S., Lev E.L.& Ruggiero J. (2000). Insomnia, fatigue, anxiety, depression, and quality of life of cancer
patients undergoing chemotherapy. Scholarly Inquiry for Nursing Practice 14:275-290.
Reuter K., Classen C.C., Roscoe J.A., Morrow, G.R., Kirshner, J.J., Rosenbluth, R., Flynn, P.J., Shedlock ,K., &
Spiegel, D. (2006). Association of coping style, pain, age, and depression with fatigue in women with
primary breast cancer. PsychoOncology, 15:772-779.
Satin J.R., Linden W.& Phillips M.J. (2009). Depression as a predictor of disease progression and mortality in
cancer patients: a meta-analysis. Cancer, 115(22):5349-5361.
Singer S., Das-Munshi J., Brahler E. (2009). Prevalence of mental health conditions in cancer patients in acute
care--a meta-analysis. Annals of Oncology, 21(5): 925–930.
Tavoli A., Mohagheghi M.A., Montazeri A., Roshan R., Tavoli Z.& Omidvari S. (2007) Anxiety and depression in
patients with gastrointestinal cancer: does knowledge of cancer diagnosis matter? BioMedCentral
Gastroenterology, 14(7):28.
Waller A., Williams A., Groff S.L., Bultz B.D.& Carlson L.E. (2011). Screening for distress, the sixth vital sign:
examining self-referral in people with cancer over a one-year period. Psycho-oncology, 2:388-395.
Watson M., Haviland J.S., Greer S., Davidson, J & Bliss, J.M. (1999). Influence of psychological response on
survival in breast cancer: a population-based cohort study. Lancet, 354:1331–1336.
Whitford H.S., Olver I.N.& Peterson M.J. (2008). Spirituality as a core domain in the assessment of quality of life
in oncology. Psycho-oncology, 17 (11): 1121-1128.
Vodermaier A., Linden W., MacKenzie R., Greig D. & Marshall D. (2011). Disease stage predicts post-diagnosis
anxiety and depression only in some types of cancer. British Journal of Cancer, 105, 1814–1817.
Wedding, U., Koch, A. Röhrig, B. Pientka, L. Sauer, H. Höffken, K. & Maurer I (2008). Depression and functional
impairment independently contribute to decreased quality of life in cancer patients before chemotherapy.
Acta Oncological, 47: 56-62.
Zabalegui A., Sanchez S., Juando C. (2005). Nursing and cancer support groups. Journal of Advance Nursing,
:369-381
Zenevicz L., Moriguchi Y., Madureira V.S.F. (2013). The religiosity in the process of living getting old. Journal of
the Nursing School of the University of Sao Paulo, 47(2):433-439
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