Depressive disorders in an out-patient oncology setting: prevalence, assessment, and management

Abstract

Objective: To assess the prevalence of depressive disorders among cancer patients attending the out-patient oncology clinic of a major hospital, and to initiate the development of a valid and practical psychological morbidity screening instrument suitable for local conditions.

Design: Survey utilising self-report screening scales and full psychiatric interviews.

Setting: Radiotherapy department, Groote Schuur Hospital.

Patients: Breast cancer, head and neck cancer, and lymphoma patients attending out-patient oncology clinics.

Results: A total of 456 patients completed the Hospital Anxiety and Depression Scale (HADS). Of that sample, 245 also completed the Beck Depression Inventory (BDI), and 100 were subjected to a structured psychiatric interview. The prevalence of depression in this population is approximately 14%, which is lower than estimates reported elsewhere. Only 14% of the interviewed depressed cases had been identified and treated by the existing health care system, highlighting the need for suitable screening tools. Appropriate screening tools and management strategies for this population are discussed.

Conclusion: This study highlighted the need for routine screening for depression and the implementation of cost-effective management strategies in oncology settings.