Hostname: page-component-7c8c6479df-995ml Total loading time: 0 Render date: 2024-03-28T13:08:27.147Z Has data issue: false hasContentIssue false

Prevalence, correlates, and impact of depressive and anxiety disorder in cancer: Findings from a multicenter study

Published online by Cambridge University Press:  25 September 2017

Eun-Jung Shim
Affiliation:
Department of Psychology, Pusan National University, Busan, Republic of Korea
Bong-Jin Hahm
Affiliation:
Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
Eun-Seung Yu
Affiliation:
Mental Health Clinic, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
Ha Kyoung Kim
Affiliation:
Department of Psychiatry, Incheon Medical Center, Incheon, Republic of Korea
Seong Jin Cho
Affiliation:
Department of Psychiatry, Korea Cancer Center Hospital, Seoul, Republic of Korea
Sung Man Chang
Affiliation:
Department of Psychiatry, Kyungpook National University Hospital, Daegu, Republic of Korea
Jong-Chul Yang
Affiliation:
Department of Psychiatry, Chonbuk National University Hospital, Jeonju-si, Jeollabuk-do, Republic of Korea
Jong-Heun Kim*
Affiliation:
Mental Health Clinic, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
*
Address correspondence and reprint requests to: Jong-Heun Kim, Mental Health Clinic, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si Gyeonggi-do, 10408, Republic of Korea. E-mail: psy@ncc.re.kr.

Abstract

Objective:

Our aim was to examine the prevalence, correlates, and association of depressive and anxiety disorders with quality of life (QoL) and such other outcomes as the need for psychosocial services in cancer patients.

Method:

A total of 400 patients participated in a multicenter survey involving five cancer centers located throughout Korea. The Short-Form Health Survey, the MD Anderson Symptom Inventory, the Mini-Mental Adjustment to Cancer (MINI-MAC), and Mini-International Neuropsychiatric Interview were administered.

Results:

The prevalence rates for depressive and anxiety disorders were 16 and 17.1%, respectively. Younger age and poor Eastern Cooperative Oncology Group performance status, and all physical symptoms, as well as helplessness/hopelessness, anxious preoccupation (AP), and cognitive avoidance (CA) on the MINI-MAC were found to be significantly related to depressive disorder (DD) in a univariate logistic regression analysis. Metastases, the symptoms of disturbed sleep, dry mouth, and numbness or tingling, as well as AP and CA were significantly correlated with anxiety disorder (AD) in the univariate analysis. In the multivariate analyses, only AP was significant for AD (odds ratio = 2.94, p < 0.001), while none reached statistical significance for DD. Psychiatric comorbidity status had a detrimental effect on various dimensions of QoL. Patients with DD or AD reported a significantly higher need for professional psychosocial services.

Significance of results:

Given the substantial prevalence and pervasive impact of DD and AD on various aspects of QoL, its assessment and care should be integrated as a regular part of oncological care throughout the cancer continuum.

Type
Original Article
Copyright
Copyright © Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Eun-Jung Shim and Bong-Jin Hahm contributed equally to this work.

References

REFERENCES

Akechi, T., Nakano, T., Okamura, H., et al. (2001). Psychiatric disorders in cancer patients: Descriptive analysis of 1721 psychiatric referrals at two Japanese cancer center hospitals. Japanese Journal of Clinical Oncology, 31(5), 188194.Google Scholar
Akechi, T., Okuyama, T., Sugawara, Y., et al. (2004). Major depression, adjustment disorders, and post-traumatic stress disorder in terminally ill cancer patients: Associated and predictive factors. Journal of Clinical Oncology, 22(10), 19571965.Google Scholar
Andersen, B.L., DeRubeis, R.J., Berman, B.S., et al. (2014). Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation. Journal of Clinical Oncology, 32(15), 16051619.Google Scholar
Anderson, K.O., Getto, C.J., Mendoza, T.R., et al. (2003). Fatigue and sleep disturbance in patients with cancer, patients with clinical depression, and community-dwelling adults. Journal of Pain and Symptom Management, 25(4), 307318.Google Scholar
Andreu, Y., Galdón, M.J., Durá, E., et al. (2012). A longitudinal study of psychosocial distress in breast cancer: Prevalence and risk factors. Psychology & Health, 27(1), 7287.Google Scholar
Argyriou, A.A., Koltzenburg, M., Polychronopoulos, P., et al. (2008). Peripheral nerve damage associated with administration of taxanes in patients with cancer. Critical Reviews in Oncology/Hematology, 66(3), 218228.Google Scholar
Arrieta, Ó., Angulo, L.P., Núñez-Valencia, C., et al. (2013). Association of depression and anxiety on quality of life, treatment adherence, and prognosis in patients with advanced non-small-cell lung cancer. Annals of Surgical Oncology, 20(6), 19411948.Google Scholar
Berger, A.M., Gerber, L.H. & Mayer, D.K. (2012). Cancer-related fatigue. Cancer, 118(S8), 22612269.Google Scholar
Bower, J.E., Ganz, P.A., Irwin, M.R., et al. (2011). Inflammation and behavioral symptoms after breast cancer treatment: Do fatigue, depression, and sleep disturbance share a common underlying mechanism? Journal of Clinical Oncology, 29(26), 35173522.Google Scholar
Boyes, A.W., Girgis, A., D'Este, C., et al. (2012). Prevalence and correlates of cancer survivors' supportive care needs 6 months after diagnosis: A population-based cross-sectional study. BMC Cancer, 12(1), 150. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430551/.Google Scholar
Brown, L.F., Kroenke, K., Theobald, D.E., et al. (2010). The association of depression and anxiety with health-related quality of life in cancer patients with depression and/or pain. Psycho-Oncology, 19(7), 734741.Google Scholar
Burgess, C., Cornelius, V., Love, S., et al. (2005). Depression and anxiety in women with early breast cancer: Five-year observational cohort study. BMJ, 330(7493), 702. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC555631/.Google Scholar
Carlson, L.E., Angen, M., Cullum, J., et al. (2004). High levels of untreated distress and fatigue in cancer patients. British Journal of Cancer, 90(12), 22972304.Google Scholar
Chang, S.M., Hahm, B.J., Lee, J.Y., et al. (2008). Cross-national difference in the prevalence of depression caused by the diagnostic threshold. Journal of Affective Disorders, 106(1–2), 159167.Google Scholar
Chen, M.L. & Chang, H.K. (2004). Physical symptom profiles of depressed and nondepressed patients with cancer. Palliative Medicine, 18(8), 712718.Google Scholar
Cho, J., Choi, E.K., Kim, S.Y., et al. (2013). Association between cancer stigma and depression among cancer survivors: A nationwide survey in Korea. Psycho-Oncology, 22(10), 23722378.Google Scholar
Cho, M.J., Seong, S.J., Park, J.E., et al. (2015). Prevalence and correlates of DSM–IV mental disorders in South Korean adults: The Korean Epidemiologic Catchment Area Study 2011. Psychiatry Investigation, 12(2), 164170.Google Scholar
Cleeland, C.S., Zhao, F., Chang, V.T., et al. (2013). The symptom burden of cancer: Evidence for a core set of cancer-related and treatment-related symptoms from the Eastern Cooperative Oncology Group Symptom Outcomes and Practice Patterns study. Cancer, 119(24), 43334340.Google Scholar
Delgado-Guay, M., Parsons, H.A., Li, Z., et al. (2009). Symptom distress in advanced cancer patients with anxiety and depression in the palliative care setting. Supportive Care in Cancer, 17(5), 573579.Google Scholar
Eom, C.S., Shin, D.W., Kim, S.Y., et al. (2013). Impact of perceived social support on the mental health and health-related quality of life in cancer patients: Results from a nationwide, multicenter survey in South Korea. Psycho-Oncology, 22(6), 12831290.Google Scholar
Fiszer, C., Dolbeault, S., Sultan, S., et al. (2014). Prevalence, intensity, and predictors of the supportive care needs of women diagnosed with breast cancer: a systematic review. Psycho-Oncology, 23(4), 361374.Google Scholar
Fujisawa, D., Park, S., Kimura, R., et al. (2010). Unmet supportive needs of cancer patients in an acute care hospital in Japan: A census study. Supportive Care in Cancer, 18(11), 13931403.Google Scholar
Grabsch, B., Clarke, D.M., Love, A., et al. (2006). Psychological morbidity and quality of life in women with advanced breast cancer: A cross-sectional survey. Palliative & Supportive Care, 4(01), 4756.Google Scholar
Grassi, L., Gritti, P., Rigatelli, M., et al. (2000). Psychosocial problems secondary to cancer: An Italian multicentre survey of consultation-liaison psychiatry in oncology. European Journal of Cancer, 36(5), 579585.Google Scholar
Grassi, L., Travado, L., Moncayo, F.L.G., et al. (2004). Psychosocial morbidity and its correlates in cancer patients of the Mediterranean area: Findings from the Southern European Psycho-Oncology Study. Journal of Affective Disorders, 83(2), 243248.Google Scholar
Härter, M., Reuter, K., Aschenbrenner, A., et al. (2001). Psychiatric disorders and associated factors in cancer: Results of an interview study with patients in inpatient, rehabilitation and outpatient treatment. European Journal of Cancer, 37(11), 13851393.Google Scholar
Hegel, M.T., Moore, C.P., Collins, E.D., et al. (2006). Distress, psychiatric syndromes, and impairment of function in women with newly diagnosed breast cancer. Cancer, 107(12), 29242931.Google Scholar
Jeon, H.J., Shim, E.J., Shin, Y.W., et al. (2007). Discrepancies in performance status scores as determined by cancer patients and oncologists: Are they influenced by depression? General Hospital Psychiatry, 29(6), 555561.Google Scholar
Jeong, A., Shin, D.W., Kim, S.Y., et al. (2016). Avoidance of cancer communication, perceived social support, and anxiety and depression among patients with cancer. Psycho-Oncology, 25(11), 13011307.Google Scholar
Johansson, M., Rydén, A. & Finizia, C. (2011). Mental adjustment to cancer and its relation to anxiety, depression, HRQoL and survival in patients with laryngeal cancer: A longitudinal study. BMC Cancer, 11(1), 283. Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3136424/.Google Scholar
Kadan-Lottick, N.S., Vanderwerker, L.C., Block, S.D., et al. (2005). Psychiatric disorders and mental health service use in patients with advanced cancer. Cancer, 104(12), 28722881.Google Scholar
Kang, J.I., Chung, H.C., Kim, S.J., et al. (2008). Standardization of the Korean version of the Mini-Mental Adjustment to Cancer (K–MINI–MAC) scale: Factor structure, reliability and validity. Psycho-Oncology, 17(6), 592597.Google Scholar
Kang, J.I., Sung, N.Y., Park, S.J., et al. (2014). The epidemiology of psychiatric disorders among women with breast cancer in South Korea: Analysis of National Registry data. Psycho-Oncology, 23(1), 3539.Google Scholar
Kawase, E., Karasawa, K., Shimotsu, S., et al. (2006). Evaluation of a one-question interview for depression in a radiation oncology department in Japan. General Hospital Psychiatry, 28(4), 321322.Google Scholar
Kissane, D.W., Grabsch, B., Love, A., et al. (2004). Psychiatric disorder in women with early stage and advanced breast cancer: A comparative analysis. The Australian and New Zealand Journal of Psychiatry, 38(5), 320326.Google Scholar
Lee, B.O., Choi, W.J., Sung, N.Y., et al. (2015). Incidence and risk factors for psychiatric comorbidity among people newly diagnosed with cancer based on Korean National Registry data. Psycho-Oncology, 24(12), 18081814.Google Scholar
Lloyd-Williams, M., Dennis, M. & Taylor, F. (2004). A prospective study to determine the association between physical symptoms and depression in patients with advanced cancer. Palliative Medicine, 18(6), 558563.Google Scholar
Lo, C., Zimmermann, C., Rydall, A., et al. (2010). Longitudinal study of depressive symptoms in patients with metastatic gastrointestinal and lung cancer. Journal of Clinical Oncology, 28(18), 30843089.Google Scholar
Mehnert, A. & Koch, U. (2008). Psychological comorbidity and health-related quality of life and its association with awareness, utilization, and need for psychosocial support in a cancer register-based sample of long-term breast cancer survivors. Journal of Psychosomatic Research, 64(4), 383391.Google Scholar
Miovic, M. & Block, S. (2007). Psychiatric disorders in advanced cancer. Cancer, 110(8), 16651676.Google Scholar
Mitchell, A.J., Chan, M., Bhatti, H., et al. (2011). Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: A meta-analysis of 94 interview-based studies. The Lancet. Oncology, 12(2), 160174.Google Scholar
Mosher, C.E. & Danoff-Burg, S. (2006). A review of age differences in psychological adjustment to breast cancer. Journal of Psychosocial Oncology, 23(2–3), 101114.Google Scholar
Mystakidou, K., Tsilika, E., Parpa, E., et al. (2005). Assessment of anxiety and depression in advanced cancer patients and their relationship with quality of life. Quality of Life Research, 14(8), 18251833.Google Scholar
Okamura, M., Yamawaki, S., Akechi, T., et al. (2005). Psychiatric disorders following first breast cancer recurrence: prevalence, associated factors and relationship to quality of life. Japanese Journal of Clinical Oncology, 35(6), 302309.Google Scholar
Oken, M.M., Creech, R.H., Tormey, D.C., et al. (1982). Toxicity and response criteria of the Eastern Cooperative Oncology Group. American Journal of Clinical Oncology, 5(6), 649656.Google Scholar
Oniszczenko, W. & Laskowska, A. (2014). Emotional reactivity, coping style and cancer trauma symptoms. Archives of Medical Science, 10(1), 110116.Google Scholar
Patrick, D., Ferketich, S., Frame, P., et al. (2003). National Institutes of Health State-of-the-Science Conference Statement. Symptom management in cancer: Pain, depression, and fatigue, July 15–17, 2002. Journal of the National Cancer Institute, 95(15), 11101117.Google Scholar
Pinquart, M. & Duberstein, P. (2010). Depression and cancer mortality: A meta-analysis. Psychological Medicine, 40(11), 17971810.Google Scholar
Prieto, J.M., Blanch, J., Atala, J., et al. (2002). Psychiatric morbidity and impact on hospital length of stay among hematologic cancer patients receiving stem-cell transplantation. Journal of Clinical Oncology, 20(7), 19071917.Google Scholar
Ryan, D.A., Gallagher, P., Wright, S., et al. (2012). Sensitivity and specificity of the Distress Thermometer and a two-item depression screen (Patient Health Questionnaire–2) with a “help” question for psychological distress and psychiatric morbidity in patients with advanced cancer. Psycho-Oncology, 21(12), 12751284.Google Scholar
Sheehan, D.V., Lecrubier, Y., Sheehan, K.H., et al. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for the DSM–IV and ICD–10. Journal of Clinical Psychiatry, 59(Suppl. 20), 2233; quiz 34–57.Google Scholar
Shim, E.J. & Hahm, B.J. (2011). Anxiety, helplessness/hopelessness and “desire for hastened death” in Korean cancer patients. European Journal of Cancer Care, 20(3), 395402.Google Scholar
Spencer, R., Nilsson, M., Wright, A., et al. (2010). Anxiety disorders in advanced cancer patients. Cancer, 116(7), 18101819.Google Scholar
Stark, D.P.H. & House, A. (2000). Anxiety in cancer patients. British Journal of Cancer, 83(10), 12611267.Google Scholar
Tojal, C. & Costa, R. (2015). Depressive symptoms and mental adjustment in women with breast cancer. Psycho-Oncology, 24(9), 10601065.Google Scholar
Tsunoda, A., Nakao, K., Hiratsuka, K., et al. (2005). Anxiety, depression and quality of life in colorectal cancer patients. International Journal of Clinical Oncology, 10(6), 411417.Google Scholar
Vodermaier, A., Linden, W., MacKenzie, R., et al. (2011). Disease stage predicts post-diagnosis anxiety and depression only in some types of cancer. British Journal of Cancer, 105(12), 18141817.Google Scholar
Ware, J.E., Kosinski, M., Dewey, J.E., et al. (2001). How to Score and Interpret Single-Item Health Status Measures: A Manual for Users of the SF–8 Health Survey. Lincoln, RI: QualityMetric Inc.Google Scholar
Whitaker, K.L., Brewin, C.R. & Watson, M. (2008). Intrusive cognitions and anxiety in cancer patients. Journal of Psychosomatic Research, 64(5), 509517.Google Scholar
Wilson, K.G., Chochinov, H.M., Skirko, M.G., et al. (2007). Depression and anxiety disorders in palliative cancer care. Journal of Pain and Symptom Management, 33(2), 118129.Google Scholar
Yi, M., Cho, J., Noh, D.Y., et al. (2007). Informational needs of Korean women with breast cancer: Cross-cultural adaptation of the Toronto Informational Needs Questionnaire for breast cancer. Asian Nursing Research, 1(3), 176186.Google Scholar
You, S.W., Kim, Y.S., Noh, J.S., et al. (2006). Validity of the Korean version of the Mini-International Neuropsychiatric Interview. Anxiety and Mood, 2(1), 5055.Google Scholar
Yun, Y.H., Mendoza, T.R., Kang, I.O., et al. (2006). Validation study of the Korean version of the MD Anderson Symptom Inventory. Journal of Pain and Symptom Management, 31(4), 345352.Google Scholar