Depression in Palliative Care Cancer Patients â€“ Prevalence and Influence of Pain
Background: Depression is an aversive emotional state which has a negative impact on the quality of life of a cancer patient. Identification of clinical depression will lead to improvement of the personâ€™s disease state by early intervention.
Methods: 200 cancer patients attending the pain and palliative care clinic were evaluated for depression using DSM-IV criteria for Major Depressive Disorder modified with Endicottâ€™s criteria. The severity of pain in the depressed and nondepressed patients was compared.
Results: 71(35.5%) out of 200 patients were found to be suffering from Major Depressive Disorder. Inpatient status (50.7%) and female sex (53.6%) were significantly more among the depressed population. There was also a significant increase in the pain experienced by the depressed compared to the nondepressed patients.
Conclusion: The prevalence of Major Depressive Disorder in terminally cancer patients is high. They also suffer from more severe pain. Early identification and intervention of the depressed state will also help in pain relief of the patients.
Derogatis LR, Morrow GR, Fetting J, Penman D, Piasetsky S, Schmale AM, et al. The prevalence of psychiatric disorders among cancer patients. JAMA 1983; 249(6):751-7.
Spiegel D. Cancer and depression. Br J Psychiatry 1996; 168(30):109-16.
Grassi L, Riba M. Clinical psycho-oncology an international perspective. Chichester UK: Wiley; 2012.
Wasteson E, Brenne E, Higginson IJ, Hotopf M, Lloyd-Williams M, Kaasa S, et al. Depression assessment and classification in palliative care patients, a systematic literature review. Palliat Med 2009; 23:739-53.
Bukberg J, Penman D, Holland JC. Depression in hospitalized cancer patients. Psychosom Med 1984; 46(3):199-212.
Mathai JP. Diagnosis of depressive disorder in patients with medical disorders. Indian Psychiatric Digest 1996; 4(1):24-34.
Ahles TA, Blanchard EB, Ruckdeschel JC. The multidimensional nature of cancer related pain. Pain 1983; 17:277-88.
Massiem J, Holland JC. Depression and cancer patients. J Clin Psychiatry1990; 51(7):12-17.
Spiegel D, Sands S, Koopman C. Pain and depression in patients with cancer. Cancer 1994; 74(9):2570-8.
Haythornwaitte JA, Sieber WJ, Kerns RD. Depression and the chronic pain experience. Pain 1991; 46:177-84.
Chaturvedi SK. Exploration of concerns and role of psychosocial intervention in palliative care â€“ A study from India. Cancer 1994; 74(7suppl):2071-8.
Endicott J. Measurement of depression in patients with cancer. Cancer 1984; 53:2243-8.
Wolff BB. Behavioral measurement of human pain. In: Sternbach RA, editor. The psychology of pain. New York: Raven Press; 1978. pp129-68.
Grassi L, Rosti G, Albieri F, Marongolo M. Depression and abnormal illness behaviour in cancer patients. Gen Hosp Psychiatry 1989; 11:404-11.
Godding PR, McAnulty RD, Witrock DA, Britt DM, Khansur T. Predictors of depression among male cancer patients. J Nerv Ment Dis 1995; 183:95-8.
Craig TJ, Abeloff MD. Psychiatric symptomatology among hospitalized cancer patients. Am J Psychiatry 1974; 131(12):1323-7.
Hart SL, Hoyt MA, Diefenbach M, Anderson DR, Kilbourn KM, Craft LL, et al. Meta-analysis of efficacy of interventions for elevated depressive symptoms in adults diagnosed with cancer. J Natl Cancer Inst 2012; 104:990-1004.