Depression Rates Before Diagnosis and After Treatment in Patients With Advanced Lung Cancer

The aim of the study was to assess, in advanced lung cancer pati­ents, the frequency of depression and the related demographic and biomedical factors before diagnosis and after the initial treatment period. Seventy nine patients from among 105 advanced lung can­cer patients diagnosed between July 2001 and April 2002 in the Di­vision of Chest Disease, Oncology Education and Research Hospi­tal in Ankara, were included in the study. Each patient’s demograp­hic and biomedicals features were recorded and all patients under­went a baseline interview by consultant psychologists for assess­ment of a depressive state prior to diagnosis. The evaluation was re­peated after completion of initial treatment. Symptoms of depressi­on were assessed using the Beck Depression Inventory adapted for Turkey. The overall frequency of depression before diagnosis and after initi­al treatment was 50.6% and 21.5%. Mean depression score was 16±11 and 12±9.7, respectively, before diagnosis and after initial treatment. Patients with small-cell lung cancer had significantly higher depression scores than those with non-small-cell lung can­cer. Severe breathlesness, cough, pain, tiredness, poor malnutrition and performance status were associated with an increased risk of depression. Logistic regression analysis confirmed that pain was the most important predictor of depression prior to diagnosis and after initial treatment. Our results indicate that depression may be present prior to diagno­sis in patients with advanced lung cancer and it does not necessa­rily increase over time. The most important risk factor in the deve­lopment of depression was pain and its management is therefore es­sential during the clinical course. Psychological screening and eva­luation of subjective physical symptoms should be part of the initi­al evaluation of patients with advanced lung cancer.