Tuberc Respir Dis.  2019 Jul;82(3):217-226. 10.4046/trd.2018.0048.

Depressive Symptoms in Newly Diagnosed Lung Carcinoma: Prevalence and Associated Risk Factors

• Shahedah K
• How SH
• Jamalludin AR
• Mohd Faiz
• Kuan YC
• Ong CK

• KMID: 2450899
• DOI: http://doi.org/10.4046/trd.2018.0048

Abstract

BACKGROUND
Depression is a recognized complication of lung cancer underreported in developing countries such as Malaysia. Treating and identifying depression in cancer patients increases survival and quality of life. Our objectives are to study prevalence of depressive symptoms in newly diagnosed lung carcinoma, and examine the relationship of depressive symptoms with other influencing risk factors.
METHODS
A 2-year, cross sectional study February 2015-February 2017, was conducted at Hospital Tengku Ampuan Afzan, and Penang General Hospital. One hundred and three patients with newly diagnosed, biopsy confirmed primary lung carcinoma were recruited. Self-rated patient's identification sheet, validated Center for Epidemiologic Studies Depression (CES-D), and Dukes University Religion Index score from three different main languages were used.
RESULTS
Prevalence of current depressive symptoms (CES-D total score ≥16) is 37.9%. The result suggests prevalence of those at high risk of moderate to major depression, may need treatment. Multivariate analysis reveals those with good Eastern Cooperation Oncology Group factor (η2=0.24, p<0.001) married (η2=0.14, p<0.001) with intrinsic religiosity (IR) (η2=0.07, p<0.02) are more resistant to depression.
CONCLUSION
One in three of lung carcinoma patients, are at increased risk for depression. Clinicians should be aware that risk is highest in those with poor performance status, single, and with poor IR. We suggest routine screening of depression symptoms as it is feasible, to be performed during a regular clinic visit with immediate referral to psychiatrist when indicated.

Keyword

Lung Neoplasms; Depressive Symptoms; Depression; Carcinoma; Prevalence; Risk Factors

MeSH Terms

Ambulatory Care
Biopsy
Depression*
Developing Countries
Epidemiologic Studies
Hospitals, General
Humans
Lung Neoplasms
Lung*
Malaysia
Mass Screening
Multivariate Analysis
Prevalence*
Psychiatry
Quality of Life
Referral and Consultation
Risk Factors*

Figure

• 

  Figure 1 Prevalence of depressive symptoms in newly diagnosed lung carcinoma. CES-D: Center for Epidemiologic Studies Depression.

Reference

1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015; 65:87–108.

2. Molina JR, Adjei AA, Jett JR. Advances in chemotherapy of non-small cell lung cancer. Chest. 2006; 130:1211–1219.

3. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015; 65:5–29.

4. Spiegel D. Cancer and depression. Br J Psychiatry Suppl. 1996; (30):109–116.

5. Walker J, Cassidy J, Sharpe M. SMaRT Oncology-3 Trialists. The third symptom management research trial in oncology (SMaRT oncology-3): a randomised trial to determine the efficacy of adding a complex intervention for major depressive disorder (depression care for people with lung cancer) to usual care, compared to usual care alone in patients with lung cancer. Trials. 2009; 10:92.

6. Hopwood P, Stephens RJ. Depression in patients with lung cancer: prevalence and risk factors derived from quality-of-life data. J Clin Oncol. 2000; 18:893–903.

7. Vilagut G, Forero CG, Barbaglia G, Alonso J. Screening for depression in the general population with the center for Epidemiologic Studies Depression (CES-D): a systematic review with meta-analysis. PLoS One. 2016; 11:e0155431.

8. Montazeri A, Gillis CR, McEwen J. Quality of life in patients with lung cancer: a review of literature from 1970 to 1995. Chest. 1998; 113:467–481.

9. Pinquart M, Duberstein PR. Depression and cancer mortality: a meta-analysis. Psychol Med. 2010; 40:1797–1810.

10. Pirl WF, Greer JA, Traeger L, Jackson V, Lennes IT, Gallagher ER, et al. Depression and survival in metastatic non-small-cell lung cancer: effects of early palliative care. J Clin Oncol. 2012; 30:1310–1315.

11. Spiegel D, Bloom JR, Kraemer HC, Gottheil E. Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet. 1989; 2:888–891.

12. Hann D, Winter K, Jacobsen P. Measurement of depressive symptoms in cancer patients: evaluation of the Center for Epidemiological Studies Depression Scale (CES-D). J Psychosom Res. 1999; 46:437–443.

13. Pirl WF, Temel JS, Billings A, Dahlin C, Jackson V, Prigerson HG, et al. Depression after diagnosis of advanced non-small cell lung cancer and survival: a pilot study. Psychosomatics. 2008; 49:218–224.

14. Koenig HG. Research on religion, spirituality, and mental health: a review. Can J Psychiatry. 2009; 54:283–291.

15. Koenig HG, Hays JC, George LK, Blazer DG, Larson DB, Landerman LR. Modeling the cross-sectional relationships between religion, physical health, social support, and depressive symptoms. Am J Geriatr Psychiatry. 1997; 5:131–144.

16. American Psychiatric Association. Guidelines regarding possible conflict between psychiatrists' religious commitment and psychiatric practice. Am J Psychiatry. 1990; 147:542.

17. Ginsburg ML, Quirt C, Ginsburg AD, MacKillop WJ. Psychiatric illness and psychosocial concerns of patients with newly diagnosed lung cancer. CMAJ. 1995; 152:701–708.

18. Koenig HG, Bussing A. The Duke University Religion Index (DUREL): a five-item measure for use in epidemological studies. Religions. 2010; 1:78–85.

19. Nurasikin MS, Aini A, Aida Syarinaz AA, Ng CG. Validity and reliability of the Malay version of Duke University Religion Index (DUREL-M) among a group of nursing student. Malays J Psychiatr. 2010; 19:MJP-02-12-10.

20. Wang J, Sun YL, Rong Y, Zhang YH, Wang ZZ. The reliability of Chinese version DUREL scale. J Ningxia Med Univ. 2013; 35:550–552.

21. Rodin D, Banihashemi B, Wang L, Lau A, Harris S, Levin W, et al. The Brain Metastases Symptom Checklist as a novel tool for symptom measurement in patients with brain metastases undergoing whole-brain radiotherapy. Curr Oncol. 2016; 23:e239–e247.

22. Shi Y, Gu F, Hou LL, Hu YQ. Self-reported depression among patients with non-small cell lung cancer. Thorac Cancer. 2015; 6:334–337.

23. Abhishekh HA, Balaji AL, Mehta RM. Depression in lung cancer patients. Indian J Psychiatry. 2014; 56:307.

24. Maneeton B, Maneeton N, Reungyos J, Intaprasert S, Leelarphat S, Thongprasert S. Prevalence and relationship between major depressive disorder and lung cancer: a cross-sectional study. Onco Targets Ther. 2014; 7:815–821.

25. Chen J, Li W, Cui L, Qian Y, Zhu Y, Gu H, et al. Chemotherapeutic response and prognosis among lung cancer patients with and without depression. J Cancer. 2015; 6:1121–1129.

26. Sullivan DR, Forsberg CW, Ganzini L, Au DH, Gould MK, Provenzale D, et al. Longitudinal changes in depression symptoms and survival among patients with lung cancer: a national cohort assessment. J Clin Oncol. 2016; 34:3984–3991.

27. Montazeri A, Milroy R, Hole D, McEwen J, Gillis CR. Anxiety and depression in patients with lung cancer before and after diagnosis: findings from a population in Glasgow, Scotland. J Epidemiol Community Health. 1998; 52:203–204.

28. Massie MJ. Prevalence of depression in patients with cancer. In : NIH State-of-the-Science Conference on Symptom Management in Cancer: Pain, Depression, and Fatigue; 2002 Jul 15–17; Bethesda, MD, USA.

29. Sullivan DR, Forsberg CW, Ganzini L, Au DH, Gould MK, Provenzale D, et al. Depression symptom trends and health domains among lung cancer patients in the CanCORS study. Lung Cancer. 2016; 100:102–109.

30. Vodermaier A, Linden W, Siu C. Screening for emotional distress in cancer patients: a systematic review of assessment instruments. J Natl Cancer Inst. 2009; 101:1464–1488.

31. Krebber AM, Buffart LM, Kleijn G, Riepma IC, de Bree R, Leemans CR, et al. Prevalence of depression in cancer patients: a meta-analysis of diagnostic interviews and self-report instruments. Psychooncology. 2014; 23:121–130.

32. Mystakidou K, Tsilika E, Parpa E, Katsouda E, Galanos A, Vlahos L. Assessment of anxiety and depression in advanced cancer patients and their relationship with quality of life. Qual Life Res. 2005; 14:1825–1833.

33. Kader Maideen SF, Sidik SM, Rampal L, Mukhtar F. Prevalence, associated factors and predictors of depression among adults in the community of Selangor, Malaysia. PLoS One. 2014; 9:e95395.

34. Rosenstein DL. Depression and end-of-life care for patients with cancer. Dialogues Clin Neurosci. 2011; 13:101–108.

35. McCullough ME, Larson DB. Religion and depression: a review of the literature. Twin Res. 1999; 2:126–136.

36. DiMatteo MR, Lepper HS, Croghan TW. Depression is a risk factor for noncompliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 2000; 160:2101–2107.