Advertisement

Factors associated with anxiety and depression in cancer patients prior to initiating adjuvant therapy

  • P. Jimenez-Fonseca
  • C. Calderón
  • R. Hernández
  • T. Ramón y Cajal
  • M. Mut
  • A. Ramchandani
  • O. Donnay
  • A. Carmona-Bayonas
Research Article

Abstract

Objective

Anxiety and depression affect cancer patients’ quality of life. Our objectives were to determine the prevalence of anxiety and depression and analyze the association between positive psychological factors, sociodemographic factors, and clinical factors in oncological patients initiating adjuvant treatment.

Methods

A prospective, multicenter cohort of 600 consecutive patients completed the Brief Symptom Inventory, Mini-Mental Adjustment to Cancer, Life Orientation Scale-Revised, and Multidimensional Scale of Perceived Social Support questionnaires.

Results

Prevalence of anxiety and depression was 49.8 and 36.6%, respectively. Women and younger individuals were more anxious and depressed than men and seniors. Employed participants suffered more anxiety than retirees, and singles exhibited more depression than married or partnered subjects. Logistic regression analysis showed that hope, optimism, social support, being male, and older were significantly associated with a lower risk of anxiety and depression (p < 0.001).

Conclusions

The high prevalence of anxiety and depression among Spaniards with cancer starting adjuvant chemotherapy suggests that more attention should be paid to mental health in these individuals. These findings are important for cancer patients because they can benefit from interventions that increase positive psychological factors such as hope, optimism, and social support to reduce anxiety and depression.

Keywords

Anxiety Cancer Depression Hope Optimism Social support 

Notes

Funding

The study was supported by the FSEOM-Onvida for Projects on Long Survivors and Quality of Life. SEOM (Spanish Society of Medical Oncology) 2015.

Compliance with ethical standards

Conflict of interest

All authors declare that they have no conflict of interest. This is an academic study.

Ethical statement

The study has been performed in accordance with the ethical standards of the Declaration of Helsinki and its subsequent amendments. This study is an observational trial without intervention.

Informed consent

Signed informed consent was obtained from all patients.

References

  1. 1.
    Linden W, Vodermaier A, MacKenzie R, Greig D. Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age. J Affect Disord. 2012;141(2):343–51.CrossRefPubMedGoogle Scholar
  2. 2.
    Vyas A, Babcock Z, Kogut S. Impact of depression treatment on health-related quality of life among adults with cancer and depression: a population-level analysis. J Cancer Surviv. 2017;11(5):624–33.CrossRefPubMedGoogle Scholar
  3. 3.
    Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12(2):160–74.CrossRefPubMedGoogle Scholar
  4. 4.
    Lee MS, Tyson DM, Gonzalez BD, Small BJ, Lechner SC, Antoni MH, et al. Anxiety and depression in Spanish-speaking Latina cancer patients prior to starting chemotherapy. Psychooncology. 2017;1–6.Google Scholar
  5. 5.
    Holden AEC, Ramirez AG, Gallion K. Depressive symptoms in Latina breast cancer survivors: a barrier to cancer screening. Heal Psychol. 2014;33(3):242.CrossRefGoogle Scholar
  6. 6.
    Hernández Blázquez M, Cruzado JA. A longitudinal study on anxiety, depressive and adjustment disorder, suicide ideation and symptoms of emotional distress in patients with cancer undergoing radiotherapy. J Psychosom Res. 2016;87:14–21.CrossRefPubMedGoogle Scholar
  7. 7.
    González-Fernández S, Fernández-Rodríguez C, Mota-Alonso MJ, García-Teijido P, Pedrosa I, Pérez-Álvarez M. Emotional state and psychological flexibility in breast cancer survivors. Eur J Oncol Nurs. 2017;30:75–83.CrossRefPubMedGoogle Scholar
  8. 8.
    Aguado Loi CX, Baldwin JA, McDermott RJ, McMillan S, Martinez Tyson D, Yampolskaya S, et al. Risk factors associated with increased depressive symptoms among Latinas diagnosed with breast cancer within 5 years of survivorship. Psycho-Oncology. 2013;22(12):2779–88.CrossRefPubMedGoogle Scholar
  9. 9.
    Bao Y, Li L, Guan Y, Wang W, Liu Y, Wang P, et al. Prevalence and associated positive psychological variables of anxiety and depression among patients with central nervous system tumors in China: a cross-sectional study. 2017;269:262–9.Google Scholar
  10. 10.
    Rajandram RK, Ho SMY, Samman N, Chan N, McGrath C, Zwahlen RA. Interaction of hope and optimism with anxiety and depression in a specific group of cancer survivors: a preliminary study. BMC Res Notes. 2011;4(1):519.CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Thompson T, Rodebaugh TL, Pérez M, Schootman M, Jeffe DB. Perceived social support change in patients with early-stage breast cancer and controls. Health Psychol. 2013;32(8):886–95.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Zenger M, Brix C, Borowski J, Stolzenburg J, Hinz A. The impact of optimism on anxiety, depression and quality of life in urogenital cancer patients. Psycho-Oncology. 2010;19(8):879–86.CrossRefPubMedGoogle Scholar
  13. 13.
    Vodermaier A, Linden W, Siu C. Screening for emotional distress in cancer patients: a systematic review of assessment instruments. J Natl Cancer Inst. 2009;101(21):1464–88.CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Derogatis LR. BSI 18, Brief Symptom Inventory 18: administration, scoring and procedures manual. NCS Pearson, Incorporated; 2001.Google Scholar
  15. 15.
    Merport A, Recklitis CJ. Does the Brief Symptom Inventory-18 case rule apply in adult survivors of childhood cancer?: comparison with the symptom checklist-90. 2012;37(6):650–9.Google Scholar
  16. 16.
    Andreu Y, Galdón MJ, Dura E, Ferrando M, Murgui S, García A, et al. Psychometric properties of the Brief Symptoms Inventory-18 (Bsi-18) in a Spanish sample of outpatients with psychiatric disorders. Psicothema. 2008;20(4):844–50.PubMedGoogle Scholar
  17. 17.
    Watson M, Law MG, dos Santos M, Greer S, Baruch J, Bliss J. The Mini-MAC: further development of the mental adjustment to cancer scale. J Psychosoc Oncol. 1994;12(3):33–46.CrossRefGoogle Scholar
  18. 18.
    Costa-Requena G, Gil F. The Mental Adjustment to Cancer scale: a psychometric analysis in Spanish cancer patients. Psychooncology. 2009;18(9):984–91.CrossRefPubMedGoogle Scholar
  19. 19.
    Scheier MF, Carver CS, Bridges MW. Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the Life Orientation Test. J Pers Soc Psychol. 1994;67(6):1063.CrossRefPubMedGoogle Scholar
  20. 20.
    Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the multidimensional scale of perceived social support. J Pers Assess. 1990;55(3–4):610–7.CrossRefPubMedGoogle Scholar
  21. 21.
    Nagelkerke NJD. A note on a general definition of the coefficient of determination. Biometrika. 1991;78(3):691–2.CrossRefGoogle Scholar
  22. 22.
    Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S. The prevalence of psychological distress by cancer site. Psycho-Oncology. 2001;10(1):19–28.CrossRefPubMedGoogle Scholar
  23. 23.
    Carlson LE, Angen M, Cullum J, Goodey E, Koopmans J, Lamont L, et al. High levels of untreated distress and fatigue in cancer patients. Br J Cancer. 2004;90(12):2297–304.CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Lee MS, Martinez D, Gonzales BD, Small BJ, Lechner SC, Antoni MH, et al. Anxiety and depression in Spanish‐Speaking Latina cancer patients prior to starting chemotherapy. Psycho‐Oncology. 2017 (Epub ahead of print).Google Scholar
  25. 25.
    Krebber AMH, Buffart LM, Kleijn G, Riepma IC, de Bree R, Leemans CR, et al. Prevalence of depression in cancer patients: a meta-analysis of diagnostic interviews and self-report instruments. Psychooncology. 2014;23(2):121–30.CrossRefPubMedGoogle Scholar
  26. 26.
    Class ML, Duarte JG, Graves K, Giwa KA. A contextual approach to understanding breast cancer survivorship among Latinas. 2012;124:115–24.Google Scholar
  27. 27.
    Janz NK, Mujahid MS, Hawley ST, Griggs JJ, Alderman A, Hamilton AS, et al. Racial/ethnic differences in quality of life after diagnosis of breast cancer. J Cancer Surviv. 2009;3(4):212–22.CrossRefPubMedGoogle Scholar
  28. 28.
    Galván N, Buki LP, Garcés DM. Suddenly, a carriage appears: social support needs of Latina breast cancer survivors. J Psychosoc Oncol. 2009;27(3):361–82.CrossRefPubMedGoogle Scholar
  29. 29.
    Aizer AA, Chen M, McCarthy EP, Mendu ML, Koo S, Wilhite TJ, et al. Marital status and survival in patients with cancer. J Clin Oncol. 2013;31(31):3869–76.CrossRefPubMedPubMedCentralGoogle Scholar
  30. 30.
    Zhang W, Wang X, Huang R, Jin K, Zhangyuan G, Yu W, et al. Prognostic value of marital status on stage at diagnosis in hepatocellular carcinoma. Sci Rep. 2017;7:41695.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Harris J, Cornelius V, Ream E, Cheevers K, Armes J. Anxiety after completion of treatment for early-stage breast cancer: a systematic review to identify candidate predictors and evaluate multivariable model development. Support Care Cancer. 2017;25(7):2321–33.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Hong JS, Tian J. Prevalence of anxiety and depression and their risk factors in Chinese cancer patients. Support Care Cancer. 2014;22(2):453–9.CrossRefPubMedGoogle Scholar

Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2018

Authors and Affiliations

  1. 1.Department of Medical OncologyHospital Universitario Central de AsturiasOviedoSpain
  2. 2.Department of Clinical Psychology and Psychobiology, Faculty of PsychologyUniversity of BarcelonaBarcelonaSpain
  3. 3.Department of Medical OncologyHospital Universitario de CanariasTenerifeSpain
  4. 4.Department of Medical OncologyHospital Universitario Santa Creu i Sant PauBarcelonaSpain
  5. 5.Department of Medical OncologyHospital Universitario Son EspasesMallorcaSpain
  6. 6.Department of Medical OncologyHospital Universitario Insular de Gran CanariaLas PalmasSpain
  7. 7.Department of Medical OncologyHospital Universitario La PrincesaMadridSpain
  8. 8.Department of Medical OncologyHospital Universitario Morales MeseguerMurciaSpain

Personalised recommendations