Skip to main content

Advertisement

Log in

Prevalence of anxiety and depression and their risk factors in Chinese cancer patients

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

This paper aimed to obtain information on the levels of anxiety and depression among cancer patients in China. The factors influencing these psychological problems were also analyzed.

Methods

A total of 1,217 cancer patients were interviewed, and each participant was asked to complete a self-administered questionnaire. The anxiety status, depression status, disease stage, tumor site, pain status, and performance status of the patients during the week prior to the interview were assessed.

Results

The anxiety and depression prevalence rates were 6.49 and 66.72 %, respectively. The prevalence rates of depression were 60.62 % for head and neck cancer, 77.19 % for lung cancer, 57.9 % for breast cancer, 75.81 % for esophagus cancer, 63.40 % for stomach cancer, 68.42 % for liver cancer, 54.37 % for colorectal cancer, and 71.13 % for cervix cancer. The factors influencing depression of patients were performance status (P < 0.0001), pain (P = 0.0003), age (P < 0.0001), and education level (P < 0.0001). The risk factors of anxiety were performance status (P = 0.0007), age (P < 0.0001), and gender (P < 0.0001).

Conclusions

Depression was a more important psychological problem than anxiety in cancer patients. Compared with 3.8 % of the prevalence of depression in normal population, depression level was high among Chinese cancer patients. Patients with lung, esophagus, and cervix cancers were the high-risk groups for depression. Poor performance status, pain, old age, and low-level education were the predicting factors for depression.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Zhang YN, Zhang HW, Song LL, Tang LL (2010) Application of the NCCN Distress Thermometer in Chinese cancer patients. Chin Ment Health 24(12):897–901

    CAS  Google Scholar 

  2. Al-Shakhli H, Harcourt D, Kenealy J (2006) Psychological distress surrounding diagnosis of malignant and nonmalignant skin lesions at a pigmented lesion clinic. J Plast Reconstr Aesthet Surg 59:479–486. doi:10.1016/j.bjps.2005.01.010

    Article  CAS  PubMed  Google Scholar 

  3. Montazeri A, Milroy R, Hole D et al (1998) Anxiety and depression in patients with lung cancer before and after diagnosis: findings from a population in Glasgow, Scotland. J Epidemiol Community Health 52:203–204

    Article  CAS  PubMed  Google Scholar 

  4. Penelope H, Richard J (2000) Depression in patients with lung cancer: prevalence and risk factors derived from quality-of-life data. J Clin Oncol 18(4):893–903

    Google Scholar 

  5. Stoudemire A, Thompson TL (1983) Medication non-compliance: systematic approaches to evaluation and intervention. Gen Hosp Psychiatry 5:233–239

    Article  CAS  PubMed  Google Scholar 

  6. Tian J, Chen ZC, Hang LF (2009) The effects of psychological status of the patients with digestive system cancers on prognosis of the disease. Cancer Nurs 32(3):230–235

    Article  PubMed  Google Scholar 

  7. Gramignano G, Lusso MR, Madeddu C et al (2006) Efficacy of l-carnitine administration on fatigue, nutritional status, oxidative stress, and related quality of life in 12 advanced cancer patients undergoing anticancer therapy. Nutrition 2:136–145

    Article  Google Scholar 

  8. Van CE, Arends J (2005) The causes and consequences of cancer-associated malnutrition. Eur J Oncol Nurs 2:S51–S63

    Google Scholar 

  9. Greer S (1983) Cancer and the mind. Br J Psychiatry 143:535–543

    Article  CAS  PubMed  Google Scholar 

  10. Miller AH (1998) Neuroendocrine and immune system interactions in stress and depression. Psychiatr Clin N Am 21:454–456

    Article  Google Scholar 

  11. Massie MJ (2004) Prevalence of depression in patients with cancer. J Natl Cancer Inst Monogr 32:57–71

    Article  PubMed  Google Scholar 

  12. Chapman CR (1979) Psychological and behavioral aspects of cancer pain. Adv Pain Res Ther 2:45–56

    Google Scholar 

  13. Takahashi T, Hondo M, Nishimura K et al (2008) Evaluation of quality of life and psychological response in cancer patients treated with radiotherapy. Radiat Med 26:39–401

    Article  Google Scholar 

  14. So WK, Marsh G, Ling WM et al (2009) Anxiety, depression and quality of life among Chinese breast cancer patients during adjuvant therapy. Eur J Oncol Nurs 14:17–22. doi:10.1016/j.ejon. 2009.07.005

    Article  PubMed  Google Scholar 

  15. Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S (2001) The prevalence of psychological distress by cancer site. Psychooncology 10:19–28

    Article  CAS  PubMed  Google Scholar 

  16. Strong V, Waters R, Hibberd C, Rush R, Cargill A, Storey D, Walker J, Wall L, Fallon M, Sharpe M (2007) Emotional distress in cancer patients: the Edinburgh Cancer Centre symptom study. Br J Cancer 96:868–874. doi:10.1038/sj.bjc.6603626

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  17. Pascoe S, Edelman S, Kidman A (2000) Prevalence of psychological distress and use of support services by cancer patients at Sydney hospitals. J Psychiatry 34:785–791

    CAS  Google Scholar 

  18. Ashraff S, Gupta SLA, Chaudhury LCS et al (2004) Effect of short-term psychiatric intervention in cancer patients. MJAFI 60:109–112

    Google Scholar 

  19. Korfage IJ, Essink-Bot ML, Janssens AC, Schröder FH, Koning HJ (2006) Anxiety and depression after prostate cancer diagnosis and treatment: 5-year follow-up. Br J Cancer 94:1093–1098

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  20. Tagay S, Herpertz S, Langkafel M et al (2006) Health-related quality of life, depression and anxiety in thyroid cancer patients. Care Rehab 15:695–703

    Google Scholar 

  21. Chen ML, Zhang HK, Yeh CH (2000) Anxiety and depression in Taiwanese cancer patients with and without pain. J Adv Nurs 32:944–951

    CAS  PubMed  Google Scholar 

  22. Zabora J, BrintzenhofeSzoc K, Curbow B, Hooker C, Piantadosi S (2001) The prevalence of psychological distress by cancer site. Psych Oncol 10(1):19–28

    Article  CAS  Google Scholar 

  23. Medeiros M, Oshima CT, Forones NM (2010) Depression and anxiety in colorectal cancer patients. J Gastrointest Cancer 41(3):179–184

    Article  PubMed  Google Scholar 

  24. Evans DL, McCartney CF, Nemeroff CB, Raft D, Quade D, Golden RN et al (1986) Depression in women treated for gynecological cancer: clinical and neuroendocrine assessment. Am J Psychiatry 143:447–451

    CAS  PubMed  Google Scholar 

  25. Mashhadi MA, Mansoor S, Zahra Z (2013) Evaluation of depression in patients with cancer in South of Iran (Zahedan). Iran J Cancer Prev 6:112–116

    Google Scholar 

  26. Vukojević M, Perić I, Kordić M (2012) Anxiety and depression in oncology patients in the Mostar University Clinical Hospital. Lijec Vjesn 134(7–8):208–214

    PubMed  Google Scholar 

  27. Tel H, Sari A, Aydin HT (2013) Social support and depression among the cancer patients. Glob J Med Res K: Interdiscip 13(3) Version 1.0 (online ISSN: 2249–4618)

    Google Scholar 

  28. Laird BJ, Boyd AC, Colvin LA, Fallon MT (2009) Are cancer pain and depression interdependent? A systematic review. Psychooncology 18(5):459–464

    Article  PubMed  Google Scholar 

  29. Jack L, Scott A, Colvin L, Laird B, Fallon M (2011) Pain and depression in cancer patients: a longitudinal study. BMJ Support Palliat Care 1:A11. doi:10.1136/bmjspcare-2011-000020.30

    Article  Google Scholar 

  30. Jehn CF, Flath B, Strux A, Krebs M, Possinger K, Pezzutto A, Lüftner D (2012) Influence of age, performance status, cancer activity, and IL-6 on anxiety and depression in patients with metastatic breast cancer. Breast Cancer Res Treat 136(3):789–794

    Article  CAS  PubMed  Google Scholar 

  31. Lin CC, Lai YL (2003) Effect of cancer pain on performance status, mood states, and level of hope among Taiwanese cancer patients. J Pain Symptom Manag 25(1):29–37

    Article  Google Scholar 

  32. Lansky SB, List MA, Hermann CA (1985) Absence of major depressive disorder in female cancer patients. J Clin Oncol 3:1553–1560

    CAS  PubMed  Google Scholar 

  33. Vodermaier A, Linden W, MacKenzie R, Greig D, Marshall C (2011) Disease stage predicts post-diagnosis anxiety and depression only in some types of cancer. Br J Cancer 105(12):1814–1817. doi:10.1038/bjc.2011.503

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  34. Lueboonthavatchai P (2007) Prevalence and psychosocial factors of anxiety and depression in breast cancer patients. J Med Assoc Thail 90(10):2164–2174

    Google Scholar 

  35. Wang XD, Wang XL, Ma H (1999) Rating scales for mental health. Zhongguo Xingli Weisheng Zazhi, Beijing

    Google Scholar 

  36. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370

    Article  CAS  PubMed  Google Scholar 

  37. Leung CM, Ho S, Kan CS, Hung CH, Chen CN (1990) Evaluation of the Chinese version of the Hospital Anxiety and Depression Scale. A cross-cultural perspective. Int J Psychsom 40(4):29–34

    Google Scholar 

  38. Gao LP, Weng CS (2008) Influencing factors of quality of life in cancer patients of initial stages receiving radio- and chemotherapy and its countermeasures. Nurs J Chin People's Liberation Army 8:10–12

    Google Scholar 

  39. Spijker AV, Trijsberg RW, Duivenvoorden HJ (1997) Psychological sequelae of cancer diagnosis: a meta-analytical review of 58 studies after 1980. Psychosom Med 59:280–293

    Google Scholar 

  40. Zang YJ, Zao Z, Meng JX (2004) The clinical analysis for anxiety and depression of hypertension patients. Med J Chin People Health 116(111):675–676

    Google Scholar 

  41. Cancer Institute of China (2001) The incidences and mortalities of malignant tumors in some regions of China, vol 1. China Medical Technology, Beijing, pp 1–39

    Google Scholar 

  42. Liu Y, Wang YF, Shong LQ et al (2007) The progress in the study on depression of cancer patients. Chin J of Beh Med Sci l16(11):1054–1056

    Google Scholar 

  43. Wan CH, Luo JH, Yang Z, Meng Q (2007) Measurements and applications of quality of life in patients with cancers. Kexue, Beijing

    Google Scholar 

  44. Fernandes WC, Kimura M (2010) Health related quality of life of women with cervical cancer. Rev Latino-Am Enfermagem 18(3):360–367

    Article  Google Scholar 

  45. Burns M, Costello J, Ryan-Woolley B, Davidson S (2007) Assessing the impact of late treatment effects in cervical cancer: an exploratory study of women's sexuality. Eur J Cancer Care 16:364–372

    Article  CAS  Google Scholar 

  46. Wei RC (2010) The sex life and its influencing factors in cervical cancer patients after surgery. Chin J Nurs 45(9):843–844

    Google Scholar 

  47. Chen X, Lu W, Zheng Y et al (2010) Exercise, tea consumption, and depression among breast cancer survivors. J Clin Oncol 28:991–998

    Article  PubMed  Google Scholar 

  48. Grav S, Hellzèn O, Romild U, Stordal E (2012) Association between social support and depression in the general population: the HUNT study, a cross-sectional survey. J Clin Nurs 21(1–2):111–120

    Article  PubMed  Google Scholar 

  49. Mohr DC, Classen C, Barrera M Jr (2004) The relationship between social support, depression and treatment for depression in people with multiple sclerosis. Psychol Med 34(3):533–541

    Article  CAS  PubMed  Google Scholar 

Download references

Conflict of interest

The authors have no conflicts of interest to declare. This study has no financial relationship with any organization that sponsored the research and authorship. The corresponding author has full control of all primary data and will allow the journal to review the data if requested.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jun Tian.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hong, J.S., Tian, J. Prevalence of anxiety and depression and their risk factors in Chinese cancer patients. Support Care Cancer 22, 453–459 (2014). https://doi.org/10.1007/s00520-013-1997-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-013-1997-y

Keywords

Navigation