Korean J Intern Med.  2018 May;33(3):585-594. 10.3904/kjim.2016.108.

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

Affiliations
  • 1Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea. sook3529@hanmail.net
  • 2Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea.
  • 3Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.

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.

Keyword

Anxiety; Neoplasms; Depression; Gastrointestinal

MeSH Terms

Anxiety*
Appetite
Depression*
Drug Therapy
Fatigue
Gastrointestinal Neoplasms*
Global Health
Humans
Multivariate Analysis
Prevalence*
Prospective Studies
Quality of Life
Stomach Neoplasms
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