A survey on symptom frequency and intensity in hospitalized advanced cancer patients with depressive dis-order

YU Yang; LIU Yong; LI Qing; JIN Xin; LIU Fei

Abstract：Objective To investigate the frequency and intensity of symptoms in hospitalized advanced cancer patients with de?pressive disorder, then the relationship between these symptoms and depression was analyzed. Methods One hundred ninety?six patients were surveyed by Edmonton Symptom Assessment System ( ESAS) and Self?Rating Depression Scale ( SDS). Chi?Square test and Wilcoxon rank?sum test were used respectively to compare the incidence and intensity of the patients with and without depressive symp?toms, and Spearman correlation coefficients was used for the analysis of correlation between depression and symptoms. Results In 196 patients, 76(38?? 8%) patients had depressive disorder (SDS≥53). Compared with the patients without depressive symptoms, the high frequent symptoms expressed by patients with depressive disorder were worse well?being (98?? 7% vs.86?? 7%,P = 0?? 029), worse appetite (97?? 3% vs.74?? 2%,P = 0?? 002), pain (94?? 7% vs.63?? 3%,P<0?? 001), anxiety (84?? 2% vs.49?? 2%,P<0?? 001), dyspnea (84?? 2% vs. 71?? 7%,P= 0?? 021), drowsiness (73?? 7% vs. 55?? 8%;P= 0?? 006) and nausea (61?? 8% vs.38?? 3%,P<0?? 001), respectively. However, these patients with depressive disorder expressed higher intensity of symptoms (ESAS≥1)[median (P25?P75 )]including worse well?being[7 (5?8), P<0?? 001], fatigue[7(5?8), P<0?? 001], worse appetite[6(4?8), P= 0?? 010], anxiety[5(3?7), P<0?? 001], and dyspnea[5(3?7), P= 0?? 019]. Spearman??s correlation analysis showed that there was a significant association between SDS and other symptoms in the ESAS. Correlation coefficients of SDS with depression, fatigue and anxiety were 0?? 57, 0?? 52 and 0?? 51, respectively (P<0?? 001). Conclu?sion Expression of symptom burdens may be higher and more severe in hospitalized advanced cancer patients with depression. The awareness of symptom frequency and intensity not only help us to identify depression and make some interventions, but also help us to take more concern about the severe symptoms, so as to improve the quality of life of cancer patients.