Is nutritional status associated with the level of anxiety, depression and pain in patients with lung cancer?

Abstract

Background: Nutritional deficiencies are common in lung cancer patients, especially in those with advanced and metastatic cancers. The pathogenesis of the development of nutritional disorders in cancer patients has not been fully explained. The study was performed in order to research associations between nutritional status and mental condition and pain. The aim of the study was to assess the relationship between nutritional status and the level of anxiety, depression and perceived pain in patients with lung cancer. Methods: A total of 257 patients with lung cancer were enrolled. The Mini-Nutritional Assessment (MNA) questionnaire was used to assess their nutritional status; the Hospital Anxiety and Depression Scale (HADS) was used to assess their levels of anxiety and depression; the Visual Analog Scale (VAS) was used to assess levels of perceived pain. Results: The MNA showed that 23% of the study group was malnourished, 33% at risk of malnutrition and 44% displayed a normal nutritional status. The HADS questionnaire showed that 65% of the study group had depressive symptoms and 65% had anxiety. The mean score of the VAS was 4.35. A significant negative correlation between nutritional status and pain was observed (r=−0.65; P<0.001) as well as between nutritional status and anxiety and depression (r=−0.68; P<0.001 and r=−0.60; P<0.001, respectively). Conclusions:The prevalence of nutritional disorders and the intensity of somatic symptoms and psychological distress are high among lung cancer patients. The significant levels of depression, anxiety and pain in patients at risk of malnutrition which were highlighted in comparison to patients with a normal nutritional status indicate the need for early supportive psychotherapy or pharmacological interventions.

Association of malnutrition with geriatric assessment impairments and health‐related quality of life among older adults with gastrointestinal malignancies

“…Psychological distress, manifesting commonly as depression and/or anxiety, has also been implicated in a Chinese study of adult patients using the PG‐SGA, but the participants were younger (mean age, 50 years) 42 . Pain and/or somatization, in conjunction with depression and anxiety, in patients with lung cancer has also been reported with malnutrition, similar to our study 43 . Finally, cognitive impairment, another common age‐related concern assessed by the GA, was previously associated with malnutrition (OR 1.77 [95% CI, 1.07‐2.93]; P = .027) in one Portuguese study 44…”

Psychological distress and nutritional status in head and neck cancer patients: a pilot study

“…The results of PA measurements were less indicative, though at assessment 3, non-anxious patients had significantly higher values of PA than distressed patients. A strong and negative association between anxiety and nutritional status was observed before therapy in lung cancer patients, whereas in HNC patients Van Liew et al demonstrated that there is a dynamic reciprocal association between depressive symptoms and weight loss over the first year after diagnosis: changes in either variable were associated with concurrent, same-month changes in the other variable [30,31]. These observations underline the importance of the assessment and treatment of both psychological symptoms and weight loss.…”

Prognostic impact of prognostic nutritional index in advanced (stage IIIB/IV) non-small cell lung cancer patients

“…Due to the characteristic of cancer rapid reproduction, large quantities of nutrients are consumed and deprived from the body, causing the impairment of normal metabolism. Besides, nutritional disorders have been reported to be associated with the severity of depression, anxiety and pain, which lead to poor outcomes in cancer patients [17]. Serum albumin, synthesized by hepatocytes, is commonly used to estimate the nutritional status [18].…”