Psychological influence of cancer diagnosis in patients attending a tertiary care hospital in Eastern India

Abstract

Cancer is one of the leading causes of psychiatric morbidity. Psychological aspect of cancer patients is often neglected, especially in places with high case load. We undertook this study from Eastern India to examine the prevalence and grades of anxiety and depression in cancer patients. This was an interview based cross sectional study. The Hospital Anxiety and depression Scale (HADS) was used to score the anxiety and depression in the patients. The demographic data of patients were analyzed for any correlation with HADS scores. Although some patients in our study were ignorant of the diagnosis, the relatives were fully informed and the subsequent treatment of malignancy was according to standard protocol. Thus, ignorance of the patients for the study period did not hamper their treatment.Of the 142 patients we studied, 48% knew their diagnosis and its prognosis. Altogether, the average scores for anxiety and depression were 8.7± 3.8 and 7.6±4.5 respectively. Considering 8 as the cut off of “high” score, 47.2% and 57% of patients scored high on anxiety and depression subsets respectively. Knowledge of cancer was associated with significantly high scores for both anxiety (9.1 ±4.2 vs. 6.3±4.4, P < 0.001) and depression (9.1±4.1 vs.7.9±3.6, P = 0.05). Performing regression analysis with the
demographical data, only 'knowledge of cancer' was the variable with any significant association. Also, performing stratified age based analysis, anxiety scores were found to be more in the age group 3039 years.The patients with the knowledge of cancer diagnosis had significantly high psychiatric morbidity compared with cancer patients who were ignorant. However, in our country this is often because of the social stigmata associated with the disease and lack of proper information. Treatment of anxiety and depression in cancer patients is a vital part of their management and goes a long way in alleviating their suffering. A larger, multi center study is needed to find the actual prevalence of these co morbidities in cancer patients.