Prevalence Of Depression And Its Determinants In Cancer Patients At Tikur Anbessa Specialized Hospital

Prevalence of depression and its determinants in cancer patients at Tikur Anbesa Specialized HospitalrnTesfalem Lukas GebreegziabherrnAddis Ababa University, 2017rnTo many patients, cancer diagnosis means a death sentence which commonly ends up psychological disturbances like depression. Depression affects cancer treatment outcome and patients’ quality of life, however; only less than a third of this case goes recognized and treated.rnThe aim of this study was to assess the prevalence and determinants of depression in cancer patients at oncology unit of Tikur Anbessa Specialized Hospital (TASH). Cross-sectional (quantitative and qualitative) survey was carried out on 325 eligible cancer patients recruited with simple random sampling technique. To determine the prevalence of depression, participants were approached and interviewed with a validated and reliable tool called Patient Health Questionnaire-9 (PHQ-9). Determinants of depression were assessed with multiple logistic regression model. A key informant interview was done to assess physicians’ knowledge and perception towards diagnosis and management of depression in cancer patients.rnTotally 325 cancer patients were approached with a complete response rate of 95.4 %. Nearly half of these patients had clinically significant depression (≥ 10 on total PHQ score). However, only 6.4% of cancer patients identified as depressed using PHQ-9 had a documented diagnosis and treatment for depression. All patients received amitriptyline prescription for treatment of depression. Multivariate analysis indicated that cancer patients with mild pain [AOR 2.86; 95% CI 1.14-7.21], moderate pain [ adjusted OR 5.21; 95% CI 1.94-14.02] and severe pain [adjusted OR 18.46; 95% CI 4.07-83.64] had significantly a higher risk of depression than cancer patients with no pain. Cancer patients with poor performance status, ECOG score of 1 [adjusted OR 4.68; 95% CI 1.46-14.97; p=0.009] and 2 [AOR 9.63; 95% CI 2.31-40.20;], had also exhibited a significantly higher risk of depression than those who were physically active and able to carry on all pre-disease performance without restriction (i.e. ECOG grade of “0”). Lack of knowledge, appropriate facility for counseling, lack of social workers and high patient load were mentioned as major challenges faced for inadequate assessment and treatment of depression in cancer patients.rnDepression is a common problem in cancer patients especially among those with pain and poor performance status. Despite this fact, almost all of the depression cases were unrecognized and left untreated. Physicians focus on cancer treatment and care solely is not enough by itself for better treatment outcome and improved quality of life.

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