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Frequency of depression among oncology outpatients and association with other symptoms

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Abstract

Purpose

Depression occurs among an estimated 15% of cancer patients (range, 1–77.5%). Our main objective was to identify the frequency of reported depression by using the Brief Edinburgh Depression Scale (BEDS) among cancer outpatients. Our secondary objective was to identify associated symptoms of cancer using the Edmonton Symptom Assessment System (ESAS) and to evaluate the screening performance of depression between ESAS and BEDS.

Methods

In this multicenter prospective study conducted, we used the ESAS to collect information on nine symptoms: pain, fatigue, nausea, depression, anxiety, drowsiness, shortness of breath, lack of appetite, and feeling of well-being (each rated from 0 to 10). The BEDS was used to assess for “probable depression” (score >6). Data were analyzed using a parametric and nonparametric test.

Results

A total of 146 patients completed the study. The prevalence of probable depression was 43/146 (29%). Probable depression was associated with increased fatigue (p = 0.008), depression (p < 0.0001), anxiety (p < 0.0001), shortness of breath (p = 0.01), and decreased feeling of well-being (p < 0.001). Among patients with probable depression, 42 (98%) patients were not using antidepressants. Regarding the sensitivity and the specificity, we determined that the optimal cutoff for using the ESAS as a depression screening tool was ≥2.

Conclusion

We found significant associations between probable depression as determined with the BEDS and five symptoms as detected with the ESAS. The vast majority of patients with probable depression were not receiving pharmacological treatment. Depression should be suspected in patients with higher symptom distress as for any one of these 5 ESAS items.

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Acknowledgment

This research is supported by a grant from the Apicil Foundation.

Conflicts of interest

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Authors and Affiliations

  1. Department of Palliative Care and Rehabilitation Medicine, Unit 1414, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, TX, 77030, USA

    Wadih Rhondali & Eduardo Bruera

  2. Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Lyon, France

    Wadih Rhondali, Elise Perceau, Veronique Trillet-Lenoir & Marilene Filbet

  3. Pole Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon, France

    Julien Berthiller

  4. Centre Léon Bérard, Lyon, France

    Pierre Saltel & Olivier Tredan

  5. Clinique Francois Chenieux, Limoges, France

    Jean-Pierre Coulon

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  1. Wadih Rhondali
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  2. Elise Perceau
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  4. Pierre Saltel
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Correspondence to Wadih Rhondali.

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Rhondali, W., Perceau, E., Berthiller, J. et al. Frequency of depression among oncology outpatients and association with other symptoms. Support Care Cancer 20, 2795–2802 (2012). https://doi.org/10.1007/s00520-012-1401-3

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  • DOI: https://doi.org/10.1007/s00520-012-1401-3

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