Stress, anxiety, depression, and resilience in cancer patients on chemotherapy

Abstract

Background: Cancer chemotherapy is an intense and cyclic treatment that is associated with a number of distressing side effects that may affect the person's psyche. Aim: The aim of the study is to evaluate stress, anxiety, depression, and resilience in cancer patients undergoing chemotherapy. Materials and Methods: Consecutive cancer patients undergoing chemotherapy at a tertiary care rural medical college hospital were included in the study with their consent. Patients having comorbid medical or psychiatric disorders were excluded. Demographic and clinical characteristics of the patients were recorded. The Depression Anxiety Stress Scale and Abbreviated Connor-Davidson Resilience Scale were administered and scored as per the test manual. The data were analyzed using the SPSS software with t-test, Chi-square test, Mann–Whitney U-test, Spearman's correlation, and multiple regression analysis. Results: The study included 32 male and 68 female cancer patients on chemotherapy. Depression was found in 33 patients, anxiety was observed in ten patients while stress was present in three patients. Stress was positively correlated to anxiety and depression, while resilience was negatively correlated to depression. There were no gender differences in stress, anxiety, depression, or resilience. A multiple regression was run to predict depression from stress, anxiety, and resilience. These variables statistically significantly predicted depression, F (3,96) =55.075, P < 0.0001, R2 = 0.632. All three variables added statistically significantly to the prediction (P < 0.05). Conclusion: One-third of cancer patients on chemotherapy suffer from depression which is negatively correlated with resilience. Significant predictors of depression in these patients were stress, anxiety, and resilience. Psychiatric management in addition to reducing depression, stress, and anxiety should also aim to increase resilience in these patients.