Prediction and assessment of depression rates in patients with advanced lung cancer

Abstract

The aim of the study is to assess, in advanced lung cancer patients, the frequency of depression and the related demographic and biomedical factors before diagnosis and after the initial treatment period. Seventy-nine patients from among 105 advanced lung cancer patients diagnosed between July 1994 and April 2003 in the Division of Chest Surgery and Pulmonary at King Hussein Medical Center in Amman were included in the study. Each patient's demographic and biomedical features were recorded and all patients underwent a baseline interview by psychiatrist for assessment of a depressive state prior to diagnosis. The evaluation was repeated after completion of initial treatment. Symptoms of depression were assessed using the Beck Depression Inventory Scale. The overall frequency of depression before diagnosis and after initial treatment was 50.6% and 21.5%. Mean depression score was 16±11 and 12±9.7, respectively, before diagnosis and after initial treatment. Patients with small cell lung cancer had significantly higher depression scores than those with non-small cell lung cancer. Severe breathlessness, cough, pain, tiredness, poor nutrition and performance status were associated with an increased risk of depression. Logistic regression analysis confirmed that pain was the most important predictor of depression prior to diagnosis and after initial treatment. Our results indicate that depression may be present prior to diagnosis in-patients with advanced lung cancer and it does not necessarily increase over time. The most important risk factor in the development of depression was pain and its management is therefore essential during the clinical course. Psychological screening and evaluation of subjective physical symptoms should be part of the initial evaluation of patients with advanced lung cancer.

Keywords: lung cancer, depression, therapy

Mary Slessor Journal of Medicine Vol. 5(2) 2005: 25-34