Screening for psychosocial distress and depression among cancer patients in a regional cancer centre in Nigeria: a cross-sectional study

Abstract

INTRODUCTION: Psychosocial distress and depression have been associated with poorer outcomes in cancer care, and routine screening is recommended. We aimed to determine the prevalence, pattern, and predictors of psychosocial distress and depression among cancer patients. 

METHODS: The participants were 382 cancer patients (324 outpatients, 58 inpatients) who were recruited between February 2020 and November 2022. Each patient completed a structured questionnaire incorporating the patient-reported measures that screen for health status (Self-rated health), psychosocial distress (Distress thermometer), and depression (Two-item patient health questionnaire). We applied a threshold of ≥4, and ≥3 to define distress and depression, respectively. Correlation and binary logistic regression were used in the analysis. Statistical significance was defined by p<0.05. 

RESULTS: The mean age of the patients was 49.7±14.5 years, and 45.6% (174/382) perceived their health status as poor. Concomitant illnesses were present in 29% of the patients. The mean distress score was 5.3 ± 2.5, with a range 0-10. The cancer patients who screened positive for distress selected more items from the “Problem List” compared to those without distress. The prevalence of psychosocial distress and depression were 77% (294/382) and 33% (126/382), respectively. The predictors of psychosocial distress were the presence of co-morbidities (AOR=2.6; 95%CI: 1.3- 5.1) and good self-rated health status (AOR= 0.2; 95%CI: 0.1-0.3). The predictors of depression were the outpatient setting of care (AOR=0.4; 95%CI: 0.2-0.7) and good self-rated health (AOR= 0.3; 95%CI: 0.2-0.4). 

CONCLUSION: Our findings support ambulatory care for cancer patients and the implementation of psychosocial screening guidelines in the oncology service.