Citation

Brintzenhofe-Szoc KM, Levin TT, Li Y, Kissane DW, Zabora JR. Psychosomatics 2009; 50(4): 383-391.

Copyright

(Copyright © 2009, Academy of Psychosomatic Medicine, Publisher Elsevier Publishing)

DOI

10.1176/appi.psy.50.4.383

PMID

19687179

Abstract

BACKGROUND: Mixed anxiety/depression is associated with poorer psychosocial and treatment outcomes, worse quality of life, pooreradherence to treatment, slower recovery, greater suicide risk, and highercost-utilization.
OBJECTIVE: This study aimed to examine the cancer-specific prevalence of these symptoms.
METHOD: Cross-sectional anxiety and depression symptom data were collected with the Brief Symptom Inventory from adult outpatients presenting to a tertiary cancer center (N=8,265).
RESULTS: Mixed anxiety/depression symptoms were seen in 12.4% of patients; overall depression symptoms in 18.3%, overall anxiety symptoms in 24.0%, pure anxiety symptoms in 11.7%, and pure depression symptoms in 6.0%; 70% had neither. Higher rates of mixed anxiety/depression symptoms were seen with stomach, pancreatic, head and neck, and lung cancers, but lower rates were seen in those with breast cancers. The mixed anxiety/depression phenotype occurs in two-thirds of depressed cancer patients.
DISCUSSION: The fact that 70% of patients did not meet thresholds for depression or anxiety symptoms can be interpreted as a reflection of the resistance to developing a significant level of these symptoms. However, because stomach, pancreatic, head and neck, and lung cancers have higher levels of mixed anxiety/depression symptoms, the question can be raised as to whether these are associated with a more biological type of anxiety/depression (e.g., due to cytokine release) and whether this phenotype should be actively targeted because of its frequent occurrence in these cancers.

Language: en

Keywords

Anxiety Disorders; Cohort Studies; Cross-Sectional Studies; Depressive Disorder; Female; Humans; Logistic Models; Male; Middle Aged; Neoplasms; Prevalence; Psychiatric Status Rating Scales; Quality of Life; ROC Curve