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High Frequency of Depression in Advanced Cancer with Concomitant Comorbidities: A Registry Study
Peter Strang1,2, Torbjörn Schultz2
1Department of Oncology-Pathology, Karolinska Institutet, Stockholms Sjukhem Foundation, Mariebergsgatan 22, SE 112 19 Stockholm, Sweden.
Cancers
|April 14, 2025
Summary
Depression is common in advanced cancer, particularly in women and frail individuals. Early identification and management are crucial, as depression impacts healthcare needs and cancer prognosis.
Area of Science:
- Oncology
- Geriatrics
- Psychiatry
Background:
- Depression is a frequent complication in cancer patients, linked to distress and reduced treatment adherence.
- The exact prevalence of depression in advanced cancer remains unclear due to methodological challenges.
Purpose of the Study:
- To investigate the prevalence of depression in the final year of life among cancer patients.
- To identify variables associated with depression in this population, including age, sex, socioeconomic status, and frailty.
Main Methods:
- Analysis of an administrative database of clinically verified depression diagnoses in 27,343 individuals during their last year of life.
- Data were correlated with age, area-level socioeconomic status (Mosaic system), and Hospital Frailty Risk Score (HFRS).
- Statistical methods included t-tests, chi-2 tests, and binary logistic regression.
Main Results:
- A clinical diagnosis of depression was identified in 4.3% of patients.
- Depression was more prevalent in women (4.8% vs. 3.8%) and the elderly (≥80 years).
- A significant association was found between depression risk and frailty, with higher rates in intermediate (5.3%) and high-risk (7.8%) HFRS groups compared to low-risk (3.3%). No socioeconomic differences were observed.
Conclusions:
- Depression is more common in women and individuals with multimorbidity.
- Frailty, assessed by HFRS, is a strong predictor of depression in the last year of life.
- Clinical decision-making in cancer care should incorporate depression assessment due to its impact on healthcare needs and prognosis.
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