A recent study confirmed that patients with cancer are at a high risk of depression in their final 6 months. The researchers reported their results in the Journal of Psychosomatic Research.
The final 6 months of life is presumed to be a high-risk period for depression and anxiety in patients with cancer. However, few studies have examined whether depression and anxiety do occur in the last year of life and to what extent.
Using 2 analytical approaches, the researchers evaluated data on patients who had attended the National Health Service (NHS) cancer center clinics in Edinburgh, Glasgow, and Dundee Scotland between May 2008 and August 2011. Hospital Anxiety and Depression Scale (HADS) results were used to assess depression severity. The first analysis included 4869 patients and the second analysis included 978 patients.
At 12 months before death, the mean HADS depression score was 5.37 and the anxiety score was 5.62. Depression scores started to increase at 6 months before death, and anxiety increased at 3 months before death. At 6 months, 13% of patients reported high depression scores. At 1 month before death, that number climbed to 30%.
“Although this finding is arguably the one of most relevance from a cancer clinic perspective, it may not necessarily reflect changes in individual patients,” the researchers noted. “This is because depression and/or anxiety may influence clinic attendance. However, the similarity of the findings of analyses 1a and 2 make this explanation unlikely.”
Although most patients with cancer in the UK attend NHS clinics, the researchers’ findings may not generalize to the UK population at large, as some patients may receive care in other settings. It also doesn’t take into account newer, more effective therapies made available over the past 10 years.
The researchers conclude, “the findings of this study confirm that the last months of life are a ‘high risk’ period for depression and emphasize the need to screen for depression in patients judged to be in the last 6 months of their life, when this prognosis can be estimated.”
Magill N, Walker J, Symeonides S, et al. Depression and anxiety during the year before death from cancer. J Psychosom Res. 2022;158:110922. doi:10.1016/j.jpsychores.2022.110922