Analysis the incidence and related risk factors of depression in patients with esophageal cancer combined with bone metastasis.

BACKGROUND

Esophageal cancer is highly malignant and frequently metastasizes to bones. Concomitant depression worsens prognosis; however, its incidence and determinants in this specific population remain poorly defined.

AIM: To determine the incidence of depression and its independent risk factors in patients with esophageal cancer and bone metastasis.

METHODS

A total of 100 consecutive eligible patients admitted between March 2022 and March 2025 were recruited. Depression was assessed with the Beck Depression Inventory-II; scores > 4 defined the depression group (n = 42) and scores ≤ 4 the non-depression group (n = 58). Demographic, clinical, and laboratory variables were compared between the groups. Multivariate logistic regression was used to identify independent risk factors.

RESULTS

Depression prevalence was 42.0% (42/100). Univariate analysis demonstrated significant differences in monthly per-capita household income, education level, social support, sleep disorders, and serum high-sensitivity C-reactive protein (all P < 0.05); no differences were observed in sex, age, tumor characteristics, or other laboratory indices (all P > 0.05). Multivariable analysis revealed the following independent risk factors for depression: Low income [odds ratio (OR) = 2.66, 95% confidence interval (CI): 1.17-6.03], low education (OR = 2.46, 95%CI: 1.08-5.61), low social support (OR = 5.10, 95%CI: 1.81-14.39), sleep disorders (OR = 2.79, 95%CI: 1.23-6.35), and elevated high-sensitivity C-reactive protein (OR = 1.31 per unit increase, 95%CI: 1.18-1.46).

CONCLUSION

Depression is common among patients with esophageal cancer and bone metastasis. Low socioeconomic status, limited education, insufficient social support, sleep disturbances, and systemic inflammation were independent predictors. Interventions that address these modifiable factors may reduce depression risk in this population.