Prevalence of and factors associated with anxiety and depression in Korean patients with newly diagnosed advanced gastrointestinal cancer

Abstract

Background/aims: The purpose of the present study was to assess the prevalence of and factors associated with anxiety and depression in Korean patients with advanced gastrointestinal cancer.

Methods: One hundred and twenty consecutive patients with newly diagnosed, advanced gastrointestinal cancer who were scheduled to receive palliative chemotherapy between July 2012 and June 2014 were enrolled in this observational prospective study. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) and Patient Health Questionnaire-9 (PHQ-9).

Results: Thirty-seven patients (30.8%) had anxiety or depression with clinical significance according to HADS or PHQ-9. Multivariate analysis identified lower performance status (odds ratio [OR], 4.19; 95% confidence interval [CI], 1.22 to 14.35; p = 0.023), gastric cancer (OR, 5.39; 95% CI, 0.37 to 78.23; p = 0.018), and knowledge of advanced cancer (OR, 15.07; 95% CI, 1.80 to 125.90; p = 0.012) as significantly associated with anxiety or depression. Twenty-one patients with anxiety or depression visited the psycho-oncologic clinic. In these patients, PHQ-9 score (p = 0.008), global health status (p = 0.023), fatigue (p = 0.047), and appetite loss (p = 0.006) improved from baseline to 3 months after study enrollment.

Conclusions: Approximately 30% of Korean patients with advanced gastrointestinal cancer had anxiety or depression. The prevalence of anxiety or depression was higher in patients with poor performance status, gastric cancer, or knowledge of advanced cancer. Psychiatric interventions may be effective in reducing depression and improving quality of life in cancer patients with anxiety or depression.

Keywords: Anxiety; Depression; Gastrointestinal; Neoplasms.

Figure 1.

Flow diagram showing patient selection. QOL, quality of life.

Figure 2.

Anxiety and depression at baseline and 3 months after enrollment. (A) Hospital Anxiety and Depression Scale-Anxiety (HADS-A) score, Hospital Anxiety and Depression Scale-Depression (HADS-D) score, and Patient Health Questionnaire-9 (PHQ-9) score in patients without anxiety or depression at baseline, (B) patients with anxiety or depression at baseline who did not visit the psycho-oncology clinic, and (C) patients with anxiety or depression at baseline who did visit the psycho-oncology clinic. Gray bars indicate score at baseline and black bars indicate score at 3 months after enrollment. ^ap & 0.05.