Psychological impact of hospital admission in cancer patients.

PURPOSE: Analyze the prevalence of anxiety and depression in hospitalized cancer patients and associated clinical and psychosocial factors.

METHODS

A single-center, prospective, observational study was conducted in the Oncology Department of Miguel Servet Hospital (HUMS). Patients completed Hospital Anxiety and Depression Scale (HADS), Duke-UNC Functional Social Support Questionnaire (DUKE), and Consumer Assessment of Healthcare Providers and Systems (CAHPS). Clinical and psychosocial variables were collected.

RESULTS

166 patients were included. Prevalence of anxiety at admission was 47% (95% CI: 39-55%) and depression 43% (95% CI: 35-51%), decreasing at discharge to 40% (95% CI:32-48%) and 39% (95% CI:31-47%), respectively. Baseline anxiety was associated with anxiolytics (29.5% vs 13.6%; p = 0.012) and antidepressants use (25.6% vs 11.4%; p = 0.017); baseline depression with Eastern Cooperative Oncology Group Performance Status (ECOG) ≥ 2 (64.7% vs 42.1%; p = 0.022) and opioid (62% vs 41.1%; p = 0.008). At discharge, higher anxiety was associated with poorer patient-oncologist relationship (26.7% vs 12.1%; p = 0.022), and higher anxiety (r = -0.15, p = 0.01) and depression (r = -0.3, p = 0.001) with lower social support. At discharge, fatigue was associated with increased anxiety (36.7% vs 18.7%; p = 0.013) and depression (35.6% vs 19.6%; p = 0.028); pre-admission anxiolytics use, to greater anxiety (28.3% vs 14.3%; p = 0.034) and depression (27.1% vs 15.2%; p = 0.074); pre-admission antidepressants use (30.5% vs 9.8%; p = 0.001) and opioids (57.6% vs 39.1%; p = 0.026) with greater depression.

CONCLUSIONS

Hospitalized cancer patients show high prevalence of anxiety and depression. Poorer doctor-patient relationship, less social support, fatigue, and pre-admission anxiolytics use were associated with greater anxiety and depression; pre-admission antidepressants and opioids were associated with depression.