Naser Abdallah Y, Hameed Anas Nawfal, Mustafa Nour, Alwafi Hassan, Dahmash Eman Zmaily, Alyami Hamad S, Khalil Haya
Faculty of Pharmacy, Isra University, Amman, Jordan.
Department of Pharmacy, King Hussein Cancer Center, Amman, Jordan.
Front Psychol. 2021 Apr 15;12:585534. doi: 10.3389/fpsyg.2021.585534. eCollection 2021.
Depression and anxiety persist in cancer patients, creating an additional burden during treatment and making it more challenging in terms of management and control. Studies on the prevalence of depression and anxiety among cancer patients in the Middle East are limited and include many limitations such as their small sample sizes and restriction to a specific type of cancer in specific clinical settings. This study aimed to describe the prevalence and risk factors of depression and anxiety among cancer patients in the inpatient and outpatient settings.
A total of 1,011 patients (399 inpatients and 612 outpatients) formed the study sample. Patients' psychological status was assessed using the Hospital Anxiety and Depression Scale (HADS), the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder 7-item (GAD-7) scale. The prevalence rate of depressive and anxious symptomatology was estimated by dividing the number of patients who exceeded the borderline score: 10 or more for each subscale of the HADS scale, 15 or more for the GAD-7 scale, and 15 or more in the PHQ-9 by the total number of the patients. Risk factors were identified using logistic regression.
The prevalence of depressive and anxious symptomatology among all patients was 23.4% and 19.1-19.9%, respectively. Depressive symptomatology was more prevalent across patients who were hospitalized (37.1%) compared with patients in the outpatient setting (14.5%) ( < 0.001). Similarly, anxious symptomatology was more prevalent in the inpatient setting ( < 0.001). In the inpatient setting, depressive symptomatology was more prevalent among patients with bladder cancer, while severe anxious symptomatology was more prevalent across patients with lung cancer. In the outpatient setting, depressive and anxious symptomatology was more prevalent among breast and prostate cancer patients, respectively. Despite that, around 42.7% and 24.8% of the patients, respectively, reported that they feel anxious and depressed, and only 15.5% of them were using medications to manage their conditions.
Our study findings demonstrated a higher prevalence of depressive and anxious symptomatology in the inpatient setting and advanced disease stages. In addition, the underutilization of antidepressant therapy was observed. There is a need to consider mental disorders as part of the treatment protocol for cancer patients. Enhanced clinical monitoring and treatment of depression and anxiety of cancer patients are required.
癌症患者中抑郁和焦虑持续存在，在治疗期间造成额外负担，在管理和控制方面也更具挑战性。中东地区关于癌症患者抑郁和焦虑患病率的研究有限，且存在诸多局限性，如样本量小以及局限于特定临床环境中的特定癌症类型。本研究旨在描述住院和门诊癌症患者中抑郁和焦虑的患病率及危险因素。
共1011名患者（399名住院患者和612名门诊患者）构成研究样本。使用医院焦虑抑郁量表（HADS）、患者健康问卷（PHQ - 9）和广泛性焦虑障碍7项量表（GAD - 7）评估患者的心理状态。通过将超过临界分数的患者数量（HADS量表各子量表为10分及以上、GAD - 7量表为15分及以上、PHQ - 9为15分及以上）除以患者总数来估计抑郁和焦虑症状的患病率。使用逻辑回归确定危险因素。
所有患者中抑郁和焦虑症状的患病率分别为23.4%和19.1 - 19.9%。与门诊患者（占14.5%）相比，住院患者（占37.1%）中抑郁症状更为普遍（<0.001）。同样，焦虑症状在住院患者中也更为普遍（<0.001）。在住院患者中，膀胱癌患者中抑郁症状更为普遍，而肺癌患者中严重焦虑症状更为普遍。在门诊患者中，抑郁和焦虑症状分别在乳腺癌和前列腺癌患者中更为普遍。尽管如此，分别约有42.7%和24.8%的患者表示感到焦虑和抑郁，且其中只有15.5%的患者正在使用药物治疗。
我们的研究结果表明，住院患者和疾病晚期阶段抑郁和焦虑症状的患病率较高。此外，观察到抗抑郁治疗的利用率不足。有必要将精神障碍视为癌症患者治疗方案的一部分。需要加强对癌症患者抑郁和焦虑的临床监测与治疗。
