Depression--an independent predictor of early death in patients with advanced cancer

Abstract

Objective: Depression is common in patients with late stage cancer. This study was carried out to investigate whether depression is associated with survival, measuring physical symptoms as a potential confounding variable.

Patients and methods: One hundred and thirty two patients formed the study sample and eighty-seven patients participated in the study. The Edinburgh Depression Scale (EDS) and self-rated symptoms list were completed three times over an eight-week period and analyzed, together with relevant demographic and clinical factors.

Results: Depression was self-rated in 29% (25/87) of patients at the initial screen and 54.5% of surviving patients remained depressed at eight-week follow-up. No significant associations were found between baseline EDS 'caseness' and demographic factors or tumour type. However EDS scores were significantly correlated with four symptoms measures. Sixty two percent (54/87) of patients died during the 12 month period of the study. The EDS score had a significant independent effect upon risk of death in study period - a one-point increase in EDS score raises risk of outcome (death) by 7%.

Conclusions: Depression is an independent predictor of poor survival in patients with advanced cancer. It is important that patients with advanced cancer are screened for depression and appropriate interventions offered.