Depression - An independent predictor of early death in patients with advanced Cancer

Objective: Depression is common in patients with late stage cancer. This study was carried out to investigate whether depression is associated with survival, measuring physical symptoms as a potential confounding variable. Patients and methods: One hundred and thirty two patients formed the study sample and eighty-seven patients participated in the study. The Edinburgh Depression Scale (EDS) and self-rated symptoms list were completed three times over an eight-week period and analyzed, together with relevant demographic and clinical factors. Results: Depression was self-rated in 29% (25/87) of patients at the initial screen and 54.5% of surviving patients remained depressed at eight-week follow-up. No significant associations were found between baseline EDS 'caseness' and demographic factors or tumour type. However EDS scores were significantly correlated with four symptoms measures. Sixty two percent (54/87) of patients died during the 12 month period of the study. The EDS score had a significant independent effect upon risk of death in study period - a one-point increase in EDS score raises risk of outcome (death) by 7%. Conclusions: Depression is an independent predictor of poor survival in patients with advanced cancer. It is important that patients with advanced cancer are screened for depression and appropriate interventions offered. (C) 2008 Elsevier B.V. All rights reserved.