Department of Medicine, Nishtar Medical College Hospital, Multan, Pakistan.
BMC Cancer. 2010 Oct 29;10:594. doi: 10.1186/1471-2407-10-594.
The prevalence of anxiety and depressive disorders in cancer patients and its associated factors in Pakistan is not known. There is a need to develop an evidence base to help introduce interventions as untreated depression and anxiety can lead to significant morbidity. We assessed the prevalence of depression and anxiety among adult outpatients with and without cancer as well as the effect of various demographic, clinical and behavioral factors on levels of depression and anxiety in cancer patients.
This cross-sectional study was carried out in outpatient departments of Multan Institute of Nuclear Medicine and Radiotherapy and Nishtar Medical College Hospital, Multan. Aga Khan University Anxiety and Depression Scale (AKUADS) was used to define the presence of depression and anxiety in study participants. The sample consisted of 150 diagnosed cancer patients and 268 participants without cancer (control group).
The mean age of cancer patients was 40.85 years (SD = 16.46) and median illness duration was 5.5 months, while the mean age of the control group was 39.58 years (SD = 11.74). Overall, 66.0% of the cancer patients were found to have depression and anxiety using a cutoff score of 20 on AKUADS. Among the control group, 109 subjects (40.7%) had depression and anxiety. Cancer patients were significantly more likely to suffer from distress compared to the control group (OR = 2.83, 95% CI = 1.89-4.25, P = 0.0001). Performing logistic regression analysis showed that age up to 40 years significantly influenced the prevalence of depression and anxiety in cancer patients. There was no statistically significant difference between gender, marital status, locality, education, income, occupation, physical activity, smoking, cancer site, illness duration and mode of treatment, surgery related to cancer and presence of depression and anxiety. Cancers highly associated with depression and anxiety were gastrointestinal malignancies, chest tumors and breast cancer.
This study highlights high prevalence rates of depression and anxiety in cancer patients. Younger age was associated with a higher likelihood of meeting criteria for psychological morbidity. The findings support screening patients for symptoms of depression and anxiety as part of standard cancer care and referring those at a higher risk of developing psychological morbidity for appropriate care.
在巴基斯坦，癌症患者中焦虑和抑郁障碍的患病率及其相关因素尚不清楚。需要建立循证基础，以帮助引入干预措施，因为未经治疗的抑郁和焦虑会导致显著的发病率。我们评估了癌症患者和非癌症患者门诊成人中抑郁和焦虑的患病率，以及各种人口统计学、临床和行为因素对癌症患者抑郁和焦虑水平的影响。
本横断面研究在木尔坦核医学与放射治疗研究所和木尔坦尼扎尔医学学院医院的门诊部门进行。使用 Aga Khan 大学焦虑和抑郁量表（AKUADS）来确定研究参与者是否存在抑郁和焦虑。样本包括 150 名确诊的癌症患者和 268 名无癌症的参与者（对照组）。
癌症患者的平均年龄为 40.85 岁（SD=16.46），中位病程为 5.5 个月，而对照组的平均年龄为 39.58 岁（SD=11.74）。总体而言，使用 AKUADS 的 20 分截断值，66.0%的癌症患者被发现患有抑郁和焦虑。在对照组中，有 109 名患者（40.7%）患有抑郁和焦虑。与对照组相比，癌症患者明显更容易出现困扰（OR=2.83，95%CI=1.89-4.25，P=0.0001）。进行逻辑回归分析显示，40 岁以下的年龄显著影响癌症患者抑郁和焦虑的患病率。性别、婚姻状况、居住地、教育程度、收入、职业、体力活动、吸烟、癌症部位、病程和治疗方式、与癌症相关的手术以及抑郁和焦虑的存在之间无统计学差异。与抑郁和焦虑高度相关的癌症是胃肠道恶性肿瘤、胸部肿瘤和乳腺癌。
本研究强调了癌症患者中抑郁和焦虑的高患病率。年轻的年龄与更有可能符合心理发病标准相关。研究结果支持对癌症患者进行抑郁和焦虑症状筛查，作为标准癌症护理的一部分，并将那些更有可能出现心理发病风险的患者转介给适当的护理。
