A recently completed survey of patients battling cancer and concurrent major depression revealed an alarming result that approximately 3 out every 4 were not receiving any form of treatment for their condition. The researchers also emphasized that cancer patients are more likely to be diagnosed with major depression compared to healthy individuals. The findings are currently available online in the August 28 issue of the Lancet Psychiatry, entitled, “Prevalence, associations, and adequacy of treatment of major depression in patients with cancer: a cross-sectional analysis of routinely collected clinical data.”
The team of investigators behind this new analysis led by Jane Walker, MBChB, PhD, who is also a University of Oxford consultant psychiatrist, gathered information from 21,251 patients diagnosed with varying types of malignancies such as breast, colorectal, lung, gynecologic, or genitourinary cancer. These patients were previously assessed for depression in a number of cancer care centers in Scotland.
Data revealed occurrence of major depression was most prevalent in individuals fighting lung cancer (13.1%). Those with gynecologic cancer had the second highest prevalence at 10.9%, followed by breast cancer at 9.3%, colorectal cancer with 7.0%, and genitourinary cancer at 5.6%. When totalled, 73% of the surveyed cancer patients were recognized to have depression but were not receiving any form of treatment for it.
According to Dr. David Kissane, the head of psychiatry for Monash University in Victoria, Australia, if depression in cancer patients is proven to negatively affect their survival and quality of life, and is observed to promote suicidal ideation, there will be an urgent call for better recognition and treatment of depression.
While this hypothesized relationship between depression and survival should be alarming enough to prompt improved management protocols, Dr. Kissane explains a number of obstacles to accurately diagnose depression in cancer patients. Among these factors are time constraints, normalization of distress, similarities between depressive symptoms and the debilitating symptoms of cancer, and the patients’ own avoidance of the diagnosis of depression due to its social stigma.
To help meet the need for an improved mental health screening and management system for these patients, Dr. Kissane suggests the use of the Depression Care for People With Cancer, which is a collaborative care model featured in the SMaRT Oncology-2 and -3 experiments, in conjunction with an effective screening protocol.
In other mental health news, researchers from the Baylor College of Medicine and Texas Children’s Hospital have noted in one of their studies that there is a similar need to have improved mental health screening and management for patients with diabetes.