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Predictors of anxiety and depression in people with colorectal cancer

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Abstract

Background

People living with colorectal cancer are at risk of anxiety and depression. We investigated what factors were most highly associated with these.

Methods

Four hundred and ninety-six people with colorectal cancer completed the Hospital Anxiety and Depression Scale (HADS). Data on functioning, symptoms, illness perceptions and social difficulties were collected by questionnaire. Case-note-identified disease, treatment and co-morbidity data were recorded. Multiple logistic regression identified factors independently predictive of anxiety and depression caseness.

Results

Self-reported history of anxiety/depression predicted anxiety but not depression caseness. Depression caseness predicted anxiety caseness (p = 0.043), as did poorer self-reported cognitive functioning (p = 0.001), dyspnoea (p = 0.015) or diarrhoea (p = 0.021), reporting a high negative life and emotional impact (p < 0.001) and having difficulties with finance (p = 0.007). Having neo-adjuvant radiotherapy increased the odds of depression caseness (p = 0.007), as did poorer physical (p = 0.007), cognitive (p < 0.001) and social (p < 0.001) functioning, having constipation (p = 0.011), reporting a high negative life and emotional impact (p < 0.001), having difficulties with personal care (p = 0.022) and communicating with others (p = 0.014).

Conclusion

Levels of anxiety caseness were similar to those of non-clinical samples, but depression caseness was higher, particularly in those who had received neo-adjuvant radiotherapy. Most factors associated with possible or probable depression may be modified with appropriate intervention.

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Acknowledgments

The research team would like to thank all of the clinicians who granted access to their clinics. We are deeply grateful to those patients who gave their time to help with this research at what may have been a very difficult and distressing time. Thanks to our Steering Group members Professor Mandy Ryan (University of Aberdeen), Sue Ziebland (University of Oxford), Professor David Weller (University of Edinburgh) and Professor Sally Wyke (University of Glasgow) for their support and help with this project. The study was funded by a project grant from Cancer Research UK. The University of Aberdeen is the study sponsor.

Conflict of interest

There is no conflict of interests to declare. We (the authors) have had full control of all the primary data and are happy for the journal to review this data as required.

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Authors and Affiliations

  1. Division of Applied Health Sciences, University of Aberdeen, Polwarth Building, Aberdeen, AB25 2AY, UK

    Nicola M. Gray, Susan J. Hall, Marie Johnston, Amanda J. Lee & Neil C. Campbell

  2. General Practice and Primary Care, University of Glasgow, 1 Horselethill Road, Glasgow, G12 9LX, UK

    Susan Browne

  3. Hull York Medical School, University of Hull, Hertford Building, Hull, HU6 7RX, UK

    Una Macleod

  4. Social Dimensions of Health Institute, Universities of Dundee and St Andrews, Airlie Place, Dundee, DD1 4HJ, UK

    Elizabeth D. Mitchell

  5. Department of Clinical Oncology, Aberdeen Royal Infirmary, Foresterhill Road, Aberdeen, AB25 2ZP, UK

    Leslie Samuel

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  1. Nicola M. Gray
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  2. Susan J. Hall
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  3. Susan Browne
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  4. Marie Johnston
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Corresponding author

Correspondence to Nicola M. Gray.

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Gray, N.M., Hall, S.J., Browne, S. et al. Predictors of anxiety and depression in people with colorectal cancer. Support Care Cancer 22, 307–314 (2014). https://doi.org/10.1007/s00520-013-1963-8

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  • DOI: https://doi.org/10.1007/s00520-013-1963-8

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