Depression and anxiety in cancer patients in a Tertiary General Hospital in Singapore.

Background: Past research has indicated that distress, anxiety and depression may occur in cancer patients during the course of their illness and treatment.

Aims: This study aims to establish the prevalence of anxiety and depression in cancer patients in a Singapore hospital. It also describes the clinical characteristics of these patients, and examines if cancer patients with a psychiatric diagnosis differ from those without.

Methods: Cross-sectional anxiety and depression symptom data were collected using the MINI International Neuropsychiatric Interview generating DSM IV diagnoses from inpatients of an oncology ward in the tertiary hospital.

Results: In all, 315 patients were interviewed. Fifty three (16.8%) were diagnosed with major depression, while 30 (9.5%) were found to have generalized anxiety disorder, three to ten times higher than their corresponding prevalence rates in the general population. Patients with depression or anxiety tend to be unemployed, in stage 4 cancer, who can develop these symptoms at any time from the onset of cancer diagnosis, even when perceived social support is strong. Oncology patients with depression were more likely to be in terminal stages of cancer and to correctly identify themselves to have mental health issues, than those without (p<0.01).

Conclusions: The psychological impact of cancer is appreciable. The lack of identifiable risk factors makes the task of diagnosing psychiatric conditions in cancer patients an onerous one. The psychiatrist involved may want to look beyond socio-demographic variables and consider biological factors in cancer to better help detect psychiatric morbidity in this group of patients.