Korean J Psychosom Med.  2019 Dec;27(2):138-146. 10.22722/KJPM.2019.27.2.138.

The Effects of Depression on the Survival of Terminal Cancer Patients in a Palliative Care Unit

• Son JS
• Kim WH
• Lee JS
• Kim HY
• Kang SG
• Choi SH
• Bae JN

• KMID: 2470702
• DOI: http://doi.org/10.22722/KJPM.2019.27.2.138

Abstract

OBJECTIVES
This study examined the association between depression and survival time in terminal cancer patients admitted to the palliative care unit. Emotional problems are important for terminal cancer patients in the palliative care unit, and evaluation of patients' depression plays an important role in treatment planning.
METHODS
From October 2015 to August 2018, we conducted a retrospective study of 291 terminal cancer patients admitted to a palliative care unit at a university hospital and evaluated depression with PHQ-9 at admission. Of the 291 patients, 146 (50.2%) completed PHQ-9 but 145 (49.8%) were not evaluated due to loss of consciousness or rejection.
RESULTS
4-week survival rate in the Kaplan-Meier survival analysis were 45.4% in the non-depressed group (PHQ-9<10) and 18.7% in the depressed group (PHQ-9≥10). According to the severity of depression, in the Cox proportional hazard model, the risk of mortality in moderate, moderately sever and severe group was 2.778, 1.882 and 3.423 times higher than minimal group, respectively.
CONCLUSIONS
Of the patients with terminal cancer who were admitted to the palliative care unit, the survival time was shorter in the depressed group than in the non-depressed group. Further research is needed to determine if treatment of depression increase the survival in terminal cancer patients.

Keyword

Depression; Terminal cancer; Survival; Palliative care; Mortality

MeSH Terms

Depression*
Humans
Mortality
Palliative Care*
Proportional Hazards Models
Retrospective Studies
Survival Rate
Unconsciousness