Depression, anxiety and related factors among Syrian breast cancer patients: a cross-sectional study

Abstract

Introduction Breast cancer represents a traumatic experience with a psychological burden. The prevalence of psychological distress (which include depression and anxiety) among breast cancer patients is estimated to be 15 to 54%, but studies have shown that applying some psychological treatments has contributed to decreasing depression and anxiety. So, it is crucial to diagnose and treat patients with the appropriate means. After reviewing the literature, no studies discussed depression and anxiety among Syrian breast cancer patients. Methods A cross-sectional study in Al-Bairouni hospital in Damascus, Syria carried out using face-to-face interviews based on a structured questionnaire. All breast cancer patients were included, except who refused to participate, and responses with missing data were excluded. The questionnaire consisted of 2 sections: the first included Socio-demographic characteristics, and the other evaluated patients' depression using PHQ-2 and GAD-2 scales. Data were gathered using the Kobo toolbox app and then entered into an Excel sheet. Results Five hundred patients were interviewed. 35.6% of the patients had a GAD-2 score greater than or equal to 3.00, while 35% had a PHQ-2 score greater than or equal to 3.00. There is a significant negative relationship between the age of the patient and the GAD-2 score and PHQ-2 score, which means the older the patient is, the lower the GAD-2 and PHQ-2 scores are. A multivariable regression model showed that younger (age ≤ 45 years) and being widowed were associated with being positive for further evaluation for generalized anxiety disorder. Similarly, patients younger than 45 are significantly associated with the need for further evaluation for major depressive disorder (MDD). Social status had a stronger association with the need for further assessment for MDD, with divorced women showing the strongest association, followed by widowed and married women compared to single women. Conclusion This study showed high anxiety and depression among breast cancer patients. The patient’s age and social status were significant factors in determining the need for further psychological assessment. In General, Younger patients showed higher levels of depression and anxiety, the size of the tumor did not show significant association with psychological distress.

Prevalence of psychological distress and associated factors among Omani women diagnosed with breast cancer: a single-centre, cross-sectional study

“…We also observed that older patients were significantly more likely to exhibit depressive symptoms compared with younger patients. This contradicts findings from a study conducted in Syria which showed that younger women with BC suffered more frequently from anxiety and depressive symptoms compared with older women 35. Indeed, younger women in Oman are reportedly more likely to exhibit anxiety symptoms because of their fear of adverse effects affecting their perceived attractiveness and femininity as a result of the side effects of cancer treatment 36.…”

“…However, older people with BC in Germany were found to be 1.2-times more likely to experience both depressive and anxiety symptoms compared with younger patients 37. In general, older individuals with BC may be more likely to report depressive symptoms compared with younger individuals because of lack of energy, increased sleep disturbances, decreased interest in activity and the coexistence of other conditions, such as cardiovascular disease, stroke, diabetes and hearing or visual impairments, all of which are more frequent in older age 31 35…”

Burnout levels and correlates among healthcare providers in Syria following the 2023 Turkish–Syrian earthquakes: A cross‐sectional study

“…While this discrepancy could partly be attributed to the differential impact of the earthquake on these cities-with Aleppo experiencing more severe effects. 10,23 it is also necessary to consider other contributing factors. These may include, but are not limited to, pre-existing infrastructure, availability of resources, and the level of social support systems in place.…”

“…These may include, but are not limited to, pre-existing infrastructure, availability of resources, and the level of social support systems in place. 23 Such factors could influence the mental health outcomes of healthcare providers and highlight the need for interventions tailored to the unique challenges faced in each location.…”

Prevalence and associated factors of depression among breast cancer patients in Sub-Saharan Africa: A systematic review and meta-analysis

“…It was also higher than primary studies conducted in India, 18 Malaysia, 40 Jordan, 41 and Syria. 42 The discrepancy might mainly be due to the difference in the countries’ income level. The present review was mainly on the SSA countries where there is low healthcare expenditure, poor health care infrastructure, high cost of medication, transportation and accommodation.…”