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dc.contributor.authorHopwood, Penelope
dc.contributor.authorStephens, Richard J
dc.date.accessioned2009-11-19T15:21:30Z
dc.date.available2009-11-19T15:21:30Z
dc.date.issued2000-02
dc.identifier.citationDepression in patients with lung cancer: prevalence and risk factors derived from quality-of-life data. 2000, 18 (4):893-903 J. Clin. Oncol.en
dc.identifier.issn0732-183X
dc.identifier.pmid10673533
dc.identifier.urihttp://hdl.handle.net/10541/86499
dc.description.abstractPURPOSE: To evaluate self-reported depression rates in patients with inoperable lung cancer and to explore demographic, clinical, and quality-of-life (QOL) factors associated with depression and thus identify patients at risk. PATIENTS AND METHODS: Nine hundred eighty-seven patients from three palliative treatment trials conducted by the Medical Research Council Lung Cancer Working Party formed the study sample. 526 patients (53%) had poor prognosis small-cell lung cancer (SCLC) and 461 patients (47%) had good prognosis non-small-cell lung cancer (NSCLC). Hospital Anxiety and Depression Scale data and QOL items from the Rotterdam Symptom Checklist were analyzed, together with relevant demographic and clinical factors. RESULTS: Depression was self-rated in 322 patients (33%) before treatment and persisted in more than 50% of patients. SCLC patients had a three-fold greater prevalence of case depression than those with NSCLC (25% v 9%; P <.0001). An increased rate for women was found for good performance status (PS) patients (PS of 0 or 1) but the sex difference reduced for poor PS patients (PS of 3 or 4) because of increased depression rates for men (chi(2) for trend, P <.0001). Multivariate analysis showed that functional impairment was the most important risk factor; depression increased by 41% for each increment on the impairment scale. Pretreatment physical symptom burden, fatigue, and clinician-rated PS were also independent predictors, but cell type was not. CONCLUSION: Depression is common and persistent in lung cancer patients, especially those with more severe symptoms or functional limitations. Psychologic screening and appropriate intervention is an essential part of palliative care.
dc.language.isoenen
dc.subjectLung Canceren
dc.subject.meshActivities of Daily Living
dc.subject.meshAdult
dc.subject.meshAged
dc.subject.meshAged, 80 and over
dc.subject.meshAnalysis of Variance
dc.subject.meshAnxiety
dc.subject.meshCarcinoma, Non-Small-Cell Lung
dc.subject.meshCarcinoma, Small Cell
dc.subject.meshChi-Square Distribution
dc.subject.meshDepression
dc.subject.meshFatigue
dc.subject.meshFemale
dc.subject.meshFollow-Up Studies
dc.subject.meshForecasting
dc.subject.meshHumans
dc.subject.meshLung Neoplasms
dc.subject.meshMale
dc.subject.meshMiddle Aged
dc.subject.meshMulticenter Studies as Topic
dc.subject.meshMultivariate Analysis
dc.subject.meshPalliative Care
dc.subject.meshPrevalence
dc.subject.meshPrognosis
dc.subject.meshQuality of Life
dc.subject.meshRandomized Controlled Trials as Topic
dc.subject.meshRisk Factors
dc.subject.meshSex Factors
dc.titleDepression in patients with lung cancer: prevalence and risk factors derived from quality-of-life data.en
dc.typeArticleen
dc.contributor.departmentCancer Research Campaign Psychological Medicine Group, Christie Hospital National Health Service Trust, Withington, Manchester, UK. penelope.hopwood@man.ac.uken
dc.identifier.journalJournal of Clinical Oncologyen
html.description.abstractPURPOSE: To evaluate self-reported depression rates in patients with inoperable lung cancer and to explore demographic, clinical, and quality-of-life (QOL) factors associated with depression and thus identify patients at risk. PATIENTS AND METHODS: Nine hundred eighty-seven patients from three palliative treatment trials conducted by the Medical Research Council Lung Cancer Working Party formed the study sample. 526 patients (53%) had poor prognosis small-cell lung cancer (SCLC) and 461 patients (47%) had good prognosis non-small-cell lung cancer (NSCLC). Hospital Anxiety and Depression Scale data and QOL items from the Rotterdam Symptom Checklist were analyzed, together with relevant demographic and clinical factors. RESULTS: Depression was self-rated in 322 patients (33%) before treatment and persisted in more than 50% of patients. SCLC patients had a three-fold greater prevalence of case depression than those with NSCLC (25% v 9%; P <.0001). An increased rate for women was found for good performance status (PS) patients (PS of 0 or 1) but the sex difference reduced for poor PS patients (PS of 3 or 4) because of increased depression rates for men (chi(2) for trend, P <.0001). Multivariate analysis showed that functional impairment was the most important risk factor; depression increased by 41% for each increment on the impairment scale. Pretreatment physical symptom burden, fatigue, and clinician-rated PS were also independent predictors, but cell type was not. CONCLUSION: Depression is common and persistent in lung cancer patients, especially those with more severe symptoms or functional limitations. Psychologic screening and appropriate intervention is an essential part of palliative care.


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