Depression, Anxiety and Coping Strategies in Cancer Patients: A Case Control Study

Abstract

Objectives: Psychiatric disorders frequently accompany chronic diseases especially cancer. The aim of this study was to investigate the depression and anxiety levels and the coping strategies in cancer patients. Materials and Methods: This was a case control study conducted in Karabuk University Research Hospital ( KURH) between January 2018 and December 2018. Case group constituted of patients with an established diagnosis of cancer and control group included healthy individuals. Coping Strategies Questionnaire (COPE), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were performed for all participants. Statistical analyzes were carried out using Minitab 17 Statistical Software. Case versus control comparison for continues variables was conducted using Mann Whitney U test. Degree of relationship between continues variables were measured using Spearman's rank correlation. Chi-Squared test was used to evaluate cross tabulated categorical data. Results: 94 individuals were included in the study. Both cancer and control groups consisted of 23 males and 24 females. Mean age was found 59.77±12.01 years for cancer patients and 59.06±12.36 for control group. BDI and BAI scores of the patients were significantly higher compared to healthy individuals. Considering the cut-off values; 60% (28/47) of the cancer patients were found depressed and 62% (29/47) of them were found to have anxiety while in the control group both the depression and anxiety prevalence was 28% (13/47) (p=0.004 and p=0.002 respectively). Both groups were similar regarding the coping strategies total score (p=0.779). Turning to religion, humor, mental disengagement, denial and substance use were seen more frequently in cancer patients compared to control group (p=0.004, p=0.001, p=0.005, p=0.001 and p=0.004 respectively); whereas active coping, restraint coping, acceptance and behavioral disengagement were significantly more frequent in control group (p=0.001, p=0.039, p=0.026 and p=0.055 respectively). Humor, mental disengagement, denial and substance use were positively correlated with BDI scores (r=0.30 p=0.003, r=0.38 p=0.001, r=0.29 p=0.004, r=0.22 p=0.03 respectively). Turning to religion, humor, mental disengagement and substance use were positively correlated with BAI scores (r=0.24 p=0.015, r=0.25 p=0.013, r=0.31 p=0.001, r=0.23 p=0.024 respectively). Conclusion: The results of the current study revealed that cancer patients had higher levels of depression and anxiety compared to healthy individuals and they had higher risk of being depressed or anxious. Furthermore, the patients developed different strategies in order to cope with the burden of this catastrophic disease. Therefore, cancer a multifaceted condition which must be approached in a multidimensional manner, taking psychological features of each individual into account.