Pain is associated with continuing depression in cancer survivors

ABSTRACT

Depression is common but under-diagnosed in cancer survivors. This study characterized depressive symptoms over one year in cancer survivors and examined disease-related and psychosocial predictors of depression severity. Participants (n = 122; M_age 65.33, SD = 9.17, 98.4% male) with head and neck, esophageal, gastric, or colorectal cancers were recruited through tumor registries at two regional Veterans Administration Medical Centers. Self-report measures assessing depressive symptoms (PHQ-9), combat-related PTSD symptoms (PC-PTSD), and health-related quality of life (PROMIS) were administered at six, twelve, and eighteen months after diagnosis. Symptoms consistent with major depression were endorsed by approximately one-quarter of the sample at six (24%), twelve (22%), and eighteen (26%) months post diagnosis, with 12% of participants reporting consistently significant depressive symptoms. In multivariate modeling, significant predictors of depression at eighteen months included prior depressive symptoms (β = .446, p < 0.001) and current pain interference (β = .231, p = .003). The present findings suggest that major depression is common and persistent one year following cancer diagnosis. Attention to pain management and routine monitoring of mood symptoms is critical to reducing risk of depression in cancer survivors.

KEYWORDS:

• Cancer
• colorectal
• depression
• esophageal
• head and neck
• survivor

Acknowledgments

We are indebted to the Veterans who have participated in our research studies and allow us to contribute to their healthcare.

Declaration of interest

The authors have no conflict of interest relating to this study or this manuscript.

Prior Presentations

Portions of this paper were previously presented at the 6th Biennial Cancer Survivorship Research Conference, Arlington, VA. June 2012.

Additional information

Funding

Funding was provided by the Department of Veterans Affairs Rehabilitation Research and Development Service #5I01RX000104-02. This material is the result of work supported with resources and the use of facilities at the Boston VA Medical Center and the Houston VA Health Services Research & Development Center of Excellence (HEP90-020) at the Michael E. DeBakey VA Medical Center, Houston, TX.

Notes on contributors

Patricia M. Bamonti

The authors have no conflict of interest relating to this study or this manuscript.