Depressive symptoms in newly diagnosed lung carcinoma : prevalence and associated risk factors

Abstract

INTRODUCTION: Depression is a recognized complication of lung cancer that is underreported in Malaysia, despite of its high prevalence in comparison with other cancer types in western country. Treating and identifying depression in cancer patients is proven to increase survival and quality of life. Therefore, we report the prevalence of depression symptoms in lung cancer as well as examining the relationship between depression and influence factors of lung cancer patient to increase awareness among physician in this country. OBJECTIVE: To study prevalence of depressive symptoms in newly diagnosed lung carcinoma and study the relationship of depressive symptoms with other socio demographic data in Malaysia. METHODOLOGY: A two year, cross sectional study from February, 2015 to February 2017, was conducted in Hospital Tengku Ampuan Afzan (HTAA), and Penang General Hospital. One hundred and three patients (103) with newly diagnosed, biopsy confirmed primary lung carcinoma were recruited. Self-rated patient’s identifications sheet, validated Centre Depression of epidemiology score (CESD) and Dukes university Religion Index (DUREL) score from three different main languages were used. RESULTS: The point 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 which may need treatment (LS,Radloff, 1977). Multivariate analysis shows those with good ECOG factor (η2 =0.24, p value<0.001) being married (η2=0.14, p <0.001) and having intrinsic religiosity (IR) (η2 =0.07, p value<0.02) are more protected against depression. CONCLUSION: High prevalence of depression symptoms in newly diagnosed lung cancer patients is demonstrated in this study and it is important that all patients be screened for depression, with more attention given to those with poor ECOG factor, being single and low intrinsic religiosity. We suggest routine screening of depressive symptoms to be conducted during ward rounds or regular clinic visits with immediate referral to a psychiatrist when indicated.