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

Kanser Hastalarında Depresyon, Anksiyete ve Başa Çıkma Stratejileri: Vaka Kontrol Çalışması

Fatih İNCİ, Suleyman ERSOY, Habibe İNCİ, Velittin Selcuk ENGİN, Didem ADAHAN

Abstract

Objectives: Psychiatric disorders frequently accompany chronic diseases especially cancer. The aim ofthis 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 ResearchHospital (KURH) between January 2018 and December 2018. Case group constituted of patients with anestablished diagnosis of cancer and control group included healthy individuals. Coping StrategiesQuestionnaire (COPE), Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) wereperformed 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 malesand 24 females. Mean age was found 59.77±12.01 years for cancer patients and 59.06±12.36 for controlgroup. 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 prevalencewas 28% (13/47) (p=0.004 and p=0.002 respectively). Both groups were similar regarding the copingstrategies total score (p=0.779). Turning to religion, humor, mental disengagement, denial and substanceuse 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 behavioraldisengagement were significantly more frequent in control group (p=0.001, p=0.039, p=0.026 and p=0.055respectively).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 depressionand 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 thiscatastrophic disease. Therefore, cancer is a multifaceted condition which must be approached in amultidimensional manner, by taking psychological features of each individual into account

Özet

Amaç: Psikiyatrik rahatsızlıklar, kanser başta olmak üzere kronik hastalıklara sıklıkla eşlik eder. Bu çalışmada kanser hastalarındaki depresyon ve anksiyete düzeylerini ve başa çıkma yöntemlerini araştırmayı amaçladık. Materyal ve Metot: Vaka kontrol çalışmamızı Karabük Üniversitesi Eğitim ve Araştırma Hastanesinde Ocak 2018 ile Aralık 2018 tarihleri arasında gerçekleştirdik. Vaka grubunu kanser tanısı almış hastalar oluştururken, kontrol grubu olarak da sağlıklı bireyler çalışmaya dahil edildi. Cope başa çıkma ölçeği (COPE), Beck Depresyon Ölçeği (BDI) ve Beck Anksiyete Ölçeği (BAI)tüm katılımcılara uygulandı. Çalışmanın istatistik analizleri Minitab 17 programı ile yapıldı. Vaka grubu ile kontrol grubunun karşılaştırılmasında Mann Whitney U test kullanıldı. Sürekli değişkenler arasındaki korelasyon Spearman's rank korelasyon testi kullanılarak araştırıldı. Kategorik değişkenlerin karşılaştırılmasında Kikare testi kullanıldı. Bulgular: Çalışmaya 94 kişi dahil edildi. Hem hastalar hem de kontrol grubu 23 erkek ve 24 kadından oluşmaktaydı. Yaş ortalaması kanser hastalarında 59,77± 12,01, kontrol grubunda 59,06 ±12,36 yıldı. Hastaların BDI ve BAI skorları sağlıklı bireylere kıyasla anlamlı derecede yüksek bulundu (p