Irene Teo1, Semra Ozdemir2, Chetna Malhotra2, Grace Meijuan Yang3, Remee R Ocampo4, Sushma Bhatnagar5, Thushari Hapuarachchi6, Anjum Khan Joad7, Lubna Mariam8, Gayatri Palat9, Rubayat Rahman10, Eric A Finkelstein2. 1. Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Programme for Health Services & Systems Research, Duke-NUS Medical School, Singapore; Division of Palliative and Supportive Care, National Cancer Centre Singapore, Singapore. Electronic address: irene.teo@duke-nus.edu.sg. 2. Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Programme for Health Services & Systems Research, Duke-NUS Medical School, Singapore. 3. Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore; Division of Palliative and Supportive Care, National Cancer Centre Singapore, Singapore. 4. Department of Psychology, Singapore Management University, Singapore. 5. Department of Oncology-Anaesthesiology and Palliative Medicine, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India. 6. National Cancer Institute (Apeksha Hospital), Maharagama, Sri Lanka. 7. Department of Anaesthesia and Palliative Care Medicine, Bhagwan Mahaveer Cancer Hospital and Research Centre, Jaipur, India. 8. Department of Radiation Oncology, National Institute of Cancer Research & Hospital, Dhaka, Bangladesh. 9. Department of Pain and Palliative Medicine, MNJ Institute of Oncology and Regional Cancer Centre, Hyderabad, India. 10. Centre for Palliative Care, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.
Abstract
CONTEXT: Addressing symptoms of anxiety and depression is important in cancer palliative care. However, little information exists on the prevalence of high anxiety and depression scores and mental health service use among advanced cancer patients in South Asia. OBJECTIVES: To examine among South Asian advanced cancer patients, the 1) prevalence of high anxiety and depression scores, 2) factors associated with high anxiety and depression scores, and 3) mental health service use. METHODS: This cross-sectional, multi-site study recruited patients receiving oncology care across six major public hospitals in India, Bangladesh and Sri Lanka. Participants were adults, diagnosed with stage IV metastatic solid cancer and aware they had cancer. Participants' high anxiety and depression scores (using clinically-relevant Hospital Anxiety and Depression Scale threshold of >10), sociodemographic characteristics, patient-perceived cancer stigma and mental health service use were assessed. RESULTS: In the overall sample (N=1140), 54% met threshold scores for high anxiety and/or depression scores: 32% reported high anxiety scores and 47% reported high depression scores. Symptom burden (OR's [95% CI's] = 1.09-1.13 [1.05-1.09, 1.12-1.17]) and perceived stigma (1.11-1.16 [1.06-1.11, 1.16-1.22]) were statistically significantly associated with high anxiety and depression scores. Of the patients with high anxiety and/or depression scores (n=617), 97% had not received mental health services, and 38% of them indicated they were open to a referral. CONCLUSION: High, clinically-relevant anxiety and depression scores are common among South Asian advanced cancer patients. Efforts should be made to alleviate psychological morbidity, including providing greater access to supportive/palliative medicine teams or mental health services.
CONTEXT: Addressing symptoms of anxiety and depression is important in cancer palliative care. However, little information exists on the prevalence of high anxiety and depression scores and mental health service use among advanced cancerpatients in South Asia. OBJECTIVES: To examine among South Asian advanced cancerpatients, the 1) prevalence of high anxiety and depression scores, 2) factors associated with high anxiety and depression scores, and 3) mental health service use. METHODS: This cross-sectional, multi-site study recruited patients receiving oncology care across six major public hospitals in India, Bangladesh and Sri Lanka. Participants were adults, diagnosed with stage IV metastatic solid cancer and aware they had cancer. Participants' high anxiety and depression scores (using clinically-relevant Hospital Anxiety and Depression Scale threshold of >10), sociodemographic characteristics, patient-perceived cancer stigma and mental health service use were assessed. RESULTS: In the overall sample (N=1140), 54% met threshold scores for high anxiety and/or depression scores: 32% reported high anxiety scores and 47% reported high depression scores. Symptom burden (OR's [95% CI's] = 1.09-1.13 [1.05-1.09, 1.12-1.17]) and perceived stigma (1.11-1.16 [1.06-1.11, 1.16-1.22]) were statistically significantly associated with high anxiety and depression scores. Of the patients with high anxiety and/or depression scores (n=617), 97% had not received mental health services, and 38% of them indicated they were open to a referral. CONCLUSION: High, clinically-relevant anxiety and depression scores are common among South Asian advanced cancerpatients. Efforts should be made to alleviate psychological morbidity, including providing greater access to supportive/palliative medicine teams or mental health services.
Authors: Katarina Wang; Carmen Ma; Feng Ming Li; Angeline Truong; Salma Shariff-Marco; Janet N Chu; Debora L Oh; Laura Allen; Mei-Chin Kuo; Ching Wong; Hoan Bui; Junlin Chen; Scarlett L Gomez; Tung T Nguyen; Janice Y Tsoh Journal: Support Care Cancer Date: 2022-08-30 Impact factor: 3.359