Investigation on depression in hospitalized patients in the Department of Oncology_West China Medical Journal

Authors：

WANG Yu ¹ , YU Jianying ¹ , DONG Zaiquan ¹ , WANG Jian ¹ , LIU Yang ¹ , LUO Shanxia ¹ , CHEN Liang ¹ , HUANG Mingjin ¹ , MO Liling ¹ , GUO WanJun ¹ , HE Ning ¹ , CHEN Ran ¹ , JIANG Yu ² , YIN Wenrong ² ,  ZHANG Lan ¹

1. Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China;
2. Department of Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R.China;

Corresponding?author：

ZHANG Lan, Email: zhangzilan102@126.com

Keywords：

Oncology; Inpatients; Depression; Risk factors

DOI：

10.7507/1002-0179.201508017

Video：

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Objective To investigate the estimated prevalence of depression and its associated factors among inpatients in the Department of Oncology in general hospitals. Methods On October 29th, 2013, we surveyed all hospitalized patients from the Department of Oncology in West China Hospital, Sichuan University. The questionnaire on patients’ demographic characteristics and the Patient Health Questionnaire-9 (PHQ-9) were combined to form one questionnaire to investigate the incidence of depression in hospitalized patients in general hospitals and its influencing factors. Results We gave out 546 questionnaires and retrieved 528 with a retrieval rate of 96.6%. Seven questionnaires had 15 or more empty items and were deleted. The final number of valid questionnaires was 521, with a validity rate of 95.4%. The estimated prevalence of depression among inpatients from the Department of Oncology was 32.8% (171/521). Risk factors for depression in patients in the Department of Oncology included female gender [OR=1.550, 95%CI (1.034, 2.325), P=0.034] illiterate and primary school education [OR=2.534, 95%CI (1.329, 4.832), P=0.005] and annual household income lower than 10 000 RMB [OR=1.850, 95%CI (1.056, 3.243), P=0.032]. A total of 135 patients had suicidal risks, among whom 90 (52.6%) had depression, and Spearman correlation analysis showed that suicidal risk was moderately and positively correlated with PHQ-9 scores (r=0.558, P<0.001). Conclusions The estimated total prevalence of depression is high in hospitalized patients in the Department of Oncology, especially in female, low educational level and low family income patients. We must pay more attention to the mental health of cancer patients, evaluate depression and suicidal tendency carefully and provide psychological service timely.

Citation： WANGYu, YUJianying, DONGZaiquan, WANGJian, LIUYang, LUOShanxia, CHENLiang, HUANGMingjin, MOLiling, GUOWanJun, HENing, CHENRan, JIANGYu, YINWenrong, ZHANGLan. Investigation on depression in hospitalized patients in the Department of Oncology. West China Medical Journal, 2017, 32(2): 200-203. doi: 10.7507/1002-0179.201508017 Copy

1.	?Brintzenhofe-Szoc KM, Levin TT, Li Y, et al. Mixed anxiety/depression symptoms in a large cancer cohort: prevalence by cancer type. Psychosomatics, 2009, 50(4): 383-391.
2.	Bultz D, Groff L, Fitch Margaret, et al. Implementing screening for distress, the 6th vital sign: a Canadian strategy for changing practice. Psychooncology, 2011, 20(5): 463-469.
3.	Carlson E, Waller A, Mitchell J. Screening for distress and unmet needs in patients with cancer: review and recommendations. J Clin Oncol, 2012, 30(11): 1160-1177.
4.	So WK, Marsh G, Ling WM, et al. Anxiety, depression and quality of life among Chinese breast cancer patients during adjuvant therapy. Eur J Oncol Nurs, 2010, 14(1): 17-22.
5.	Cole G, Mccusker J, Ciampi A, et al. The prognosis of major and minor depression in older medical inpatients. Am J Geriatr Psychiatry, 2006, 14(11): 966-975.
6.	L?we B, Spitzer L, Williams B, et al. Depression, anxiety and somatization in primary care: syndrome overlap and functional impairment. Gen Hosp Psychiatry, 2008, 30(3): 191-199.
7.	Vyssoki B, Gleiss A, Rockett IR, et al. Suicide among 915 303 Austrian cancer patients: who is at risk?. J Affect Disord, 2015, 175: 287-291.
8.	Yang L, Liu L, Wang X, et al. Prevalence and associated positive psychological variables of depression and anxiety among Chinese cervical cancer patients: a cross-sectional study. PLoS One, 2014, 9(4): e94804.
9.	Wang Y, Zou L, Jiang M, et al. Measurement of distress in Chinese inpatients with lymphoma. Psychooncology, 2013, 22(7): 1581-1586.
10.	Wang C, Guo B, Peng X, et al. Psychological morbidity and health-related quality of life in patients with differing awareness of cancer diagnosis: a cross-sectional study. Psychooncology, 2014, 23(9): 975-980.
11.	李娟, 劉偉, 徐琳. 老年惡性腫瘤住院患者抑郁狀況調查. 臨床精神醫學雜志, 2007, 17(4): 270-271.
12.	Hosaka T, Aoki T, Watanabe T, et al. Comorbidity of depression among physically ill patients and its effect on the length of hospital stay. Psychiatry Clin Neurosci, 1999, 53(4): 491-495.
13.	Horowitz M, Snyder D, Ludi E, et al. Ask suicide-screening questions to everyone in medical settings: the asQ'em Quality Improvement Project. Psychosomatics, 2013, 54(3): 239-247.
14.	Tang ST, Li CY, Chen CC. Trajectory and determinants of the quality of life of family caregivers of terminally ill cancer patients in Taiwan. Qual Life Res, 2008, 17(3):387-395.
15.	Spitzer R, Kroenke K, Williams J. Validation and utility of a self-report Version of PRIME-MD: the PHQ Primary Care Study. J Am Med Assoc, 1999, 282(18): 1737-1744.
16.	Kroenke K, Spitzer L, Williams B, et al. The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry, 2010, 32(4): 345-359.
17.	Martin A, Rief W, Klaiberg A, et al. Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population. Gen Hosp Psychiatry, 2005, 28(1): 71-77.
18.	卞崔冬, 李春波, 錢潔, 等. 患者健康問卷抑郁癥狀群量表在綜合性醫院中的應用研究. 同濟大學學報: 醫學版, 2009, 30(5): 136-140.
19.	Manea L, Gilbody S, Mcmillan D. Optimal cut-off score for diagnosing depression with the patient health questionnaire(PHQ-9): a meta-analysis. CMAJ, 2012, 184(3): e191-e196.
20.	Maneeton B, Maneeton N, Mahathep P. Prevalence of depression and its correlations: a cross-sectional study in Thai cancer patients. Asian Pac J Cancer Prev, 2012, 13(5): 2039-2043.
21.	Phillips MR, Zhang J, Shi Q, et al. Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001-05: an epidemiological survey. Lancet, 2009, 373(9680): 2041-2053.
22.	李建明, 李妲, 張素英. 綜合醫院內科住院病人焦慮抑郁狀況研究. 中國健康心理學雜志, 2010, 18(3): 3-6.
23.	Valdes-Stauber J, Vietz E, Kilian R. The impact of clinical conditions and social factors on the psychological distress of cancer patients: an explorative study at a consultation and liaison service in a rural general hospital. BMC Psychiatry, 2013, 13(13): 226.
24.	Qiu J, Yang M, Chen W, et al. Prevalence and correlates of major depressive disorder in breast cancer survivors in Shanghai, China. Psychooncology, 2012, 21(12): 1331-1337.
25.	Hong JS, Tian J. Prevalence of anxiety and depression and their risk factors in Chinese cancer patients. Support Care Cancer, 2014, 22(2): 453-459.
26.	楊冬林, 張婧, 賈秀珍, 等. 抑郁癥患者的首診途徑及疾病經濟負擔. 衛生經濟研究, 2016(1): 35-37.
27.	婁元菊, 宋西俊, 薛志敏. 自殺現象與干預措施的研究. 國際精神病學雜志, 2010, 37(2): 72-75.

1. ?Brintzenhofe-Szoc KM, Levin TT, Li Y, et al. Mixed anxiety/depression symptoms in a large cancer cohort: prevalence by cancer type. Psychosomatics, 2009, 50(4): 383-391.
2. Bultz D, Groff L, Fitch Margaret, et al. Implementing screening for distress, the 6th vital sign: a Canadian strategy for changing practice. Psychooncology, 2011, 20(5): 463-469.
3. Carlson E, Waller A, Mitchell J. Screening for distress and unmet needs in patients with cancer: review and recommendations. J Clin Oncol, 2012, 30(11): 1160-1177.
4. So WK, Marsh G, Ling WM, et al. Anxiety, depression and quality of life among Chinese breast cancer patients during adjuvant therapy. Eur J Oncol Nurs, 2010, 14(1): 17-22.
5. Cole G, Mccusker J, Ciampi A, et al. The prognosis of major and minor depression in older medical inpatients. Am J Geriatr Psychiatry, 2006, 14(11): 966-975.
6. L?we B, Spitzer L, Williams B, et al. Depression, anxiety and somatization in primary care: syndrome overlap and functional impairment. Gen Hosp Psychiatry, 2008, 30(3): 191-199.
7. Vyssoki B, Gleiss A, Rockett IR, et al. Suicide among 915 303 Austrian cancer patients: who is at risk?. J Affect Disord, 2015, 175: 287-291.
8. Yang L, Liu L, Wang X, et al. Prevalence and associated positive psychological variables of depression and anxiety among Chinese cervical cancer patients: a cross-sectional study. PLoS One, 2014, 9(4): e94804.
9. Wang Y, Zou L, Jiang M, et al. Measurement of distress in Chinese inpatients with lymphoma. Psychooncology, 2013, 22(7): 1581-1586.
10. Wang C, Guo B, Peng X, et al. Psychological morbidity and health-related quality of life in patients with differing awareness of cancer diagnosis: a cross-sectional study. Psychooncology, 2014, 23(9): 975-980.
11. 李娟, 劉偉, 徐琳. 老年惡性腫瘤住院患者抑郁狀況調查. 臨床精神醫學雜志, 2007, 17(4): 270-271.
12. Hosaka T, Aoki T, Watanabe T, et al. Comorbidity of depression among physically ill patients and its effect on the length of hospital stay. Psychiatry Clin Neurosci, 1999, 53(4): 491-495.
13. Horowitz M, Snyder D, Ludi E, et al. Ask suicide-screening questions to everyone in medical settings: the asQ'em Quality Improvement Project. Psychosomatics, 2013, 54(3): 239-247.
14. Tang ST, Li CY, Chen CC. Trajectory and determinants of the quality of life of family caregivers of terminally ill cancer patients in Taiwan. Qual Life Res, 2008, 17(3):387-395.
15. Spitzer R, Kroenke K, Williams J. Validation and utility of a self-report Version of PRIME-MD: the PHQ Primary Care Study. J Am Med Assoc, 1999, 282(18): 1737-1744.
16. Kroenke K, Spitzer L, Williams B, et al. The patient health questionnaire somatic, anxiety, and depressive symptom scales: a systematic review. Gen Hosp Psychiatry, 2010, 32(4): 345-359.
17. Martin A, Rief W, Klaiberg A, et al. Validity of the brief patient health questionnaire mood scale (PHQ-9) in the general population. Gen Hosp Psychiatry, 2005, 28(1): 71-77.
18. 卞崔冬, 李春波, 錢潔, 等. 患者健康問卷抑郁癥狀群量表在綜合性醫院中的應用研究. 同濟大學學報: 醫學版, 2009, 30(5): 136-140.
19. Manea L, Gilbody S, Mcmillan D. Optimal cut-off score for diagnosing depression with the patient health questionnaire(PHQ-9): a meta-analysis. CMAJ, 2012, 184(3): e191-e196.
20. Maneeton B, Maneeton N, Mahathep P. Prevalence of depression and its correlations: a cross-sectional study in Thai cancer patients. Asian Pac J Cancer Prev, 2012, 13(5): 2039-2043.
21. Phillips MR, Zhang J, Shi Q, et al. Prevalence, treatment, and associated disability of mental disorders in four provinces in China during 2001-05: an epidemiological survey. Lancet, 2009, 373(9680): 2041-2053.
22. 李建明, 李妲, 張素英. 綜合醫院內科住院病人焦慮抑郁狀況研究. 中國健康心理學雜志, 2010, 18(3): 3-6.
23. Valdes-Stauber J, Vietz E, Kilian R. The impact of clinical conditions and social factors on the psychological distress of cancer patients: an explorative study at a consultation and liaison service in a rural general hospital. BMC Psychiatry, 2013, 13(13): 226.
24. Qiu J, Yang M, Chen W, et al. Prevalence and correlates of major depressive disorder in breast cancer survivors in Shanghai, China. Psychooncology, 2012, 21(12): 1331-1337.
25. Hong JS, Tian J. Prevalence of anxiety and depression and their risk factors in Chinese cancer patients. Support Care Cancer, 2014, 22(2): 453-459.
26. 楊冬林, 張婧, 賈秀珍, 等. 抑郁癥患者的首診途徑及疾病經濟負擔. 衛生經濟研究, 2016(1): 35-37.
27. 婁元菊, 宋西俊, 薛志敏. 自殺現象與干預措施的研究. 國際精神病學雜志, 2010, 37(2): 72-75.

West China Medical Journal

Investigation on depression in hospitalized patients in the Department of Oncology

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