The aim of the study is to assess, in advanced lung cancer patients,
the frequency of depression and the related demographic and biomedical
factors before diagnosis and after the initial treatment period.
Seventy-nine patients from among 105 advanced lung cancer patients
diagnosed between July 1994 and April 2003 in the Division of Chest
Surgery and Pulmonary at King Hussein Medical Center in Amman were
included in the study. Each patient’s demographic and biomedical
features were recorded and all patients underwent a baseline interview
by psychiatrist for assessment of a depressive state prior to diagnosis.
The evaluation was repeated after completion of initial treatment.
Symptoms of depression were assessed using the Beck Depression Inventory
Scale. The overall frequency of depression before diagnosis and after
initial treatment was 50.6% and 21.5%. Mean depression score was 16±11
and 12±9.7, respectively, before diagnosis and after initial treatment.
Patients with small cell lung cancer had significantly higher depression
scores than those with non-small cell lung cancer. Severe
breathlessness, cough, pain, tiredness, poor nutrition and performance
status were associated with an increased risk of depression. Logistic
regression analysis confirmed that pain was the most important predictor
of depression prior to diagnosis and after initial treatment. Our
results indicate that depression may be present prior to diagnosis
in-patients with advanced lung cancer and it does not necessarily
increase over time. The most important risk factor in the development of
depression was pain and its management is therefore essential during the
clinical course. Psychological screening and evaluation of subjective
physical symptoms should be part of the initial evaluation of patients
with advanced lung cancer.