A cross-sectional gender-sensitive analysis of depressive symptoms in patients with advanced cancer

Abstract

Background: Patients with advanced cancer commonly report depressive symptoms. Examinations of gender differences in depressive symptoms in patients with advanced cancer have yielded inconsistent findings. Aim: The objective of this study was to investigate whether the severity and correlates of depressive symptoms differ by gender in patients with advanced cancer. Design: Participants completed measures assessing sociodemographic and medical characteristics, disease burden, and psychosocial factors. Depressive symptoms were examined using the Patient Health Questionnaire, and other measures included physical functioning, symptom burden, general anxiety, death related distress, and dimensions of demoralization. A cross-sectional analysis examined the univariate and multivariate relationships between gender and depressive symptoms, while controlling for important covariates in multivariate analyses. Setting/participants: Patients with advanced cancer ( N = 305, 40% males and 60% females) were recruited for a psychotherapy trial from outpatient oncology clinics at a comprehensive cancer center in Canada. Results: Severity of depressive symptoms was similar for males ( M = 7.09, SD = 4.59) and females ( M = 7.66, SD = 5.01), t(303) = 1.01, p = 0.314. Greater general anxiety and number of cancer symptoms were associated with depressive symptoms in both males and females. Feeling like a failure ( β = 0.192), less death anxiety ( β = –0.188), severity of cancer symptoms ( β = 0.166), and older age ( β = 0.161) were associated with depressive symptoms only in males, while disheartenment ( β = 0.216) and worse physical functioning ( β = 0.275), were associated with depressive symptoms only in females. Conclusions: Males and females report similar levels of depressive symptoms but the pathways to depression may differ by gender. These differences suggest the potential for gender-based preventive and therapeutic interventions in this population.

Understanding factors influencing demoralization among cancer patients based on the bio‐psycho‐social model: A systematic review

“…Thirty-two studies identified negative psychological factors associated with demoralization for cancer patients. [11][12][13]15,16,20,31,33,[34][35][36]39,43,45,[47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64] Absolute effect sizes ranged from 0.200 to 0.800. showed the strongest associations with demoralization: rs (across seven studies 16,20,39,53,54,56,64 ) ranged from 0.400 to 0.746 (mean = 0.633, large effect). The factor of desire for death demonstrated the second strongest association with demoralization: rs (observed across two studies 20,53 ) ranged from 0.595 to 0.645 (mean = 0.620, large effect).…”

Validation of the Death and Dying Distress Scale in patients with advanced cancer

“…Distress related to death and dying is common in patients with advanced cancer, [1][2][3] and has been associated with symptoms of depression, anxiety, and hopelessness. 4,5 However, death anxiety or death-related distress is not yet assessed routinely as a clinical or research outcome in palliative care or cancer care.…”

Death anxiety in patients with primary brain tumor: Measurement, prevalence, and determinants

“…These factors may make the experience of death anxiety robust across age, gender, tumor characteristics, treatment received, and time since diagnosis. A similar effect has been noted in metastatic cancer, in which the typical female preponderance of depression is eliminated by the effects of the disease (Miller et al, 2011; Shapiro et al, 2020).…”