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      Depression and anxiety in patients with hematological malignancies, prevalence, and associated factors

      research-article
      , MBBS, MD, , MBBS, MPH, , BSN, , BSN, , MD, FRCP, , MBBS, MD
      Saudi Medical Journal
      Saudi Medical Journal

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          Abstract

          Objectives:

          To study the prevalence and associated factors of depression and anxiety in hematological cancers (HC) patients.

          Methods:

          We conducted a cross-sectional survey in all HC patients at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia between March 2014 and June 2015. We excluded patients with depression, or generalized anxiety disorder. We conducted a structured face to face interview using an internally developed and validated questionnaire (Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 patient’s questionnaire with all participants).

          Results:

          Among 211 participants, depression was detected in 98 (46.5%) and anxiety was detected in 47 (22.3%). Thirty-eight (18.1%) had concurrent anxiety and depression. Multiple co-morbidities and tense home atmosphere were predictive for anxiety and depression. We found no association between gender, smoking, income, or being on active therapy and depression or anxiety.

          Conclusions:

          Depression and anxiety are highly prevalent in HC patients in KAMC. Health care providers should screen HC cancers for depression and anxiety; as early intervention possibly improve their disease outcome and will likely enhance their psychological wellbeing.

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          Most cited references27

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          Diagnostic and statistical manual of mental disorders.

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            Anxiety and depression after cancer diagnosis: prevalence rates by cancer type, gender, and age.

            Reported prevalence of emotional distress in cancer patients varies widely across studies. The present study determined prevalence of anxiety and depression (separated for presence of symptoms versus clinical levels) in a large, representative sample of cancer patients after diagnosis. During the years 2004-2009, 10,153 consecutive patients were routinely screened with the Psychosocial Screen for Cancer questionnaire at two major cancer centers. Patients' mean age was 59 years and 45% were men. Across cancer types, 19.0% of patients showed clinical levels of anxiety and another 22.6% had subclinical symptoms. Further, 12.9% of patients reported clinical symptoms of depression and an additional 16.5% described subclinical symptoms. Analyses by cancer type revealed significant differences such that patients with lung, gynecological, or hematological cancer reported the highest levels of distress at the time point of cancer diagnosis. As expected, women showed higher rates of anxiety and depression, and for some cancer types the prevalence was two to three times higher than that seen for men. In some cancer types emotional distress was inversely related to age. Patients younger than 50 and women across all cancer types revealed either subclinical or clinical levels of anxiety in over 50% of cases. Findings describe levels of emotional distress after diagnosis but cannot inform about trajectories of anxiety and depression over time. Given that levels of anxiety and depression varied widely by cancer type, gender, and age, these results inform which cancer patients are most likely in need of psychosocial support. Copyright © 2012 Elsevier B.V. All rights reserved.
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              Prevalence of depression in patients with cancer.

              Depression is the psychiatric syndrome that has received the most attention in individuals with cancer. The study of depression has been a challenge because symptoms occur on a broad spectrum that ranges from sadness to major affective disorder and because mood change is often difficult to evaluate when a patient is confronted by repeated threats to life, is receiving cancer treatments, is fatigued, or is experiencing pain. Although many research groups have assessed depression in cancer patients since the 1960s, the reported prevalence (major depression, 0%-38%; depression spectrum syndromes, 0%-58%) varies significantly because of varying conceptualizations of depression, different criteria used to define depression, differences in methodological approaches to the measurement of depression, and different populations studied. Depression is highly associated with oropharyngeal (22%-57%), pancreatic (33%-50%), breast (1.5%-46%), and lung (11%-44%) cancers. A less high prevalence of depression is reported in patients with other cancers, such as colon (13%-25%), gynecological (12%-23%), and lymphoma (8%-19%). This report reviews the prevalence of depression in cancer patients throughout the course of cancer.
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                Author and article information

                Journal
                Saudi Med J
                Saudi Med J
                Saudi Medical Journal
                Saudi Medical Journal (Saudi Arabia )
                0379-5284
                August 2016
                : 37
                : 8
                : 877-881
                Affiliations
                [1] From the Department of Oncology (Abuelgasim, Ahmed, Alaskar), King Abdulaziz Medical City National Guard Health Affairs, the King Abdullah International Medical Research Center (Alqahtani), Alhasa, the King Saud bin Abdulaziz University for Health Sciences (Abuelgasim, Alayed), College of Nursing, the King Abdullah International Medical Research Center (Alaskar), Riyadh, Kingdom of Saudi Arabia, and the Department of Psychiatry (Malik), Howard University Hospital, Washington, DC, USA
                Author notes
                Address correspondence and reprint request to: Dr. Khadega A. Abuelgasim, Department of Oncology, King Abdulaziz Medical City National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia. E-mail: khadega444@ 123456yahoo.com
                Article
                SaudiMedJ-37-877
                10.15537/smj.2016.8.14597
                5018705
                27464865
                e188f24e-53cf-49bd-b6b1-afff62c1d1a1
                Copyright: © Saudi Medical Journal

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 09 February 2016
                : 10 July 2016
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