Depression, anxiety and their associated factors among patients with cancer receiving treatment at oncology units in Amhara Region, Ethiopia: a cross-sectional study

Abstract

ObjectiveTo assess the prevalence of anxiety and depression symptoms, and their associated factors among patients with cancer receiving cancer treatment in Amhara region oncology centres in Northwest, Ethiopia.DesignInstitution-based cross-sectional study was conducted.SettingThree oncology units at comprehensive hospitals in the Amhara region, Ethiopia.ParticipantsAdult patients who had a pathologically confirmed cancer diagnosis and received cancer therapy were our study participants.Main outcome measuresThe Hospital Anxiety and Depression Scale was used to assess anxiety and depression symptoms.ResultA total of 392 patients with cancer participated in this study, of which 57.1% (95% CI 52.1% to 62.1%) and 60.2% (95% CI 55.2% to 65.1%) had anxiety and depression, respectively.Poor social support (adjusted OR, AOR=4.43, 95% CI (1.70 to 11.50)), poor performance status (AOR=1.97, 95% CI (1.02 to 3.79)) and increased pain severity (AOR=1.30, 95% CI (1.14 to 1.48)) were factors associated with anxiety. Furthermore, poor performance status (AOR=2.77, 95% CI: (1.42, 5.39)) and pain severity (AOR=1.25, 95% CI: (1.11 to 1.42)) were significantly associated with depression.Conclusion and recommendationAnxiety and depression were common among patients with cancer. Social support, performance status and pain were determinant factors of anxiety in patients with cancer. Moreover, performance status and pain were associated with depressive symptoms. Therefore, patients with low social support, poor performance status and severe pain should get special emphasis.

Anxiety and depression among cancer patients in Ethiopia: a systematic review and meta-analysis

“…Generally, nine studies assessed the association between age and depression. Of these, five studies indicated that age was not significantly associated with depression ( 16 , 18 , 20 , 29 , 34 ), whereas four studies reported a statistically significant association between age and depression, out of which three of them showed higher risk of depression among younger patients ( 22 , 31 , 33 ), while one study showed higher risk of depression among older cancer patients ( 6 ). This variation between studies might be due to the difference in age categorization and/or sample size across the primary studies.…”

“…Among the 17 studies included in this analysis, one study reported anxiety alone ( 28 ), five studies reported depression alone ( 15 , 16 , 29 – 31 ), while the remaining 11 studies reported both depression and anxiety ( 6 , 17 , 18 , 20 , 22 , 32 – 37 ). Correspondingly, the magnitudes of anxiety and depression were determined by pooling findings of 12 ( 6 , 17 , 18 , 20 , 22 , 28 , 32 – 37 ) and 16 ( 6 , 15 – 18 , 20 , 22 , 29 – 37 ) studies respectively. All included studies utilized institutional based cross-sectional study design with a sample size ranging from 77 ( 34 ), to 428 ( 31 ).…”

“…All included studies utilized institutional based cross-sectional study design with a sample size ranging from 77 ( 34 ), to 428 ( 31 ). Two studies included breast cancer patients only ( 31 , 33 ), while others included all malignancies ( 6 , 15 – 18 , 20 , 22 , 28 – 30 , 32 , 34 – 37 ). All included primary studies involved cancer patients who were receiving care.…”

“…All included primary studies involved cancer patients who were receiving care. Regarding the methods of diagnosis, 12 studies utilized the hospital anxiety and depression scale ( 6 , 17 , 18 , 20 , 22 , 28 , 32 – 37 ), while five studies used the patient health questionnaire ( 15 , 16 , 29 – 31 ). Nine of the studies were conducted in the national capital, Addis Ababa ( 15 , 18 , 22 , 28 – 33 ), whereas eight of the included studies were conducted in different regions of the country ( 6 , 16 , 17 , 20 , 34 – 37 ) ( Table 1 ).…”

“…On the other hand, pooling the effect size of some variables deemed meaningless because of the marked variation in categories between the primary studies. For instance, six studies investigated the association between age and occurrence of anxiety; five of them found no significant association between age and anxiety, even if some of the studies treated age as continuous variable while others categorized it ( 6 , 20 , 28 , 33 , 34 ). In contrast, one study showed a statistically significant association between age and anxiety, where older patients had higher risk of anxiety ( 18 ).…”