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Association of Depression and Anxiety on Quality of Life, Treatment Adherence, and Prognosis in Patients with Advanced Non-small Cell Lung Cancer

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Symptoms of depression and anxiety are common in patients with lung cancer and may produce an impact on both health-related quality of life (HRQL) and survival. The aim of the present study was to evaluate the association of depression and anxiety on HRQL, treatment adherence, and prognosis in patients with non-small cell lung cancer (NSCLC).

Methods

This is a prospective study of patients with stage IIIB or IV NSCLC. Depression and anxiety were measured using the hospital anxiety and depression scale, the International Neuropsychiatric Interview, and the HRQL with the EORTC QLQ-C30 and QLQ-LC13 questionnaires. Instruments were applied before treatment and repeated at 3 and 6 months. Lack of treatment adherence was considered as patients who stopped going to their consultation appointments.

Results

A total of 82 patients were included. At the initial evaluation, depression and anxiety were found in 32.9 and 34.1 % of patients, respectively. Depression was associated with feminine gender (p = 0.034) and poor performance status (p = 0.048). Depression and anxiety showed an association with HRQL. Patients with depression showed median overall survival of 6.8 months, whereas that for nondepressed patients was 14 months (hazard ratio [HR], 1.9; 95 % confidence interval (95 % CI), 1.03–3.7; p = 0.042). The 58 % of patients with depression had poor treatment adherence versus 42 % of patients without depression (p = 0.004).

Conclusions

Depression and anxiety were present in one-third of patients with recently diagnosed NSCLC. Depression and anxiety were associated with decreased HRQL scales, and depression was independently associated with treatment adherence and with poor prognosis.

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Acknowledgment

This project was supported partially by Instituto Nacional de Cancerología (INCan) and CONACYT (115574).

Conflict of interest

The authors have nothing to disclose.

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Authors and Affiliations

  1. Thoracic Oncology Clinic, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico

    Óscar Arrieta MD, Laura P. Angulo MD, Carolina Núñez-Valencia RP, Yuzmiren Dorantes-Gallareta MD & Eleazar O. Macedo MD

  2. Faculty of Medicine, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico

    Óscar Arrieta MD

  3. Psychiatry Department, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico

    Laura P. Angulo MD & Dulce Martínez-López MD

  4. Psycho-Oncology Department, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico

    Carolina Núñez-Valencia RP & Salvador Alvarado RP

  5. Thoracic Surgery Department, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico

    José-Francisco Corona-Cruz MD

  6. Clinical Research Division, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico

    Luis F. Oñate-Ocaña MD

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  1. Óscar Arrieta MD
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Correspondence to Óscar Arrieta MD.

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Arrieta, Ó., Angulo, L.P., Núñez-Valencia, C. et al. Association of Depression and Anxiety on Quality of Life, Treatment Adherence, and Prognosis in Patients with Advanced Non-small Cell Lung Cancer. Ann Surg Oncol 20, 1941–1948 (2013). https://doi.org/10.1245/s10434-012-2793-5

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  • DOI: https://doi.org/10.1245/s10434-012-2793-5

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