Psychological symptoms in adult Saudi Arabian cancer patients: prevalence and association with self-rated oral health

Figures & data

Table 1 Characteristics of study subjects by psychological symptoms

Characteristic	Category	Total (n=375) N (%)	Depression (n=168) 44.8%		Anxiety (n=197) 52.5%		Stress (n=160) 42.7%
			n (%)	P-valuea	n (%)	P-valuea	n (%)	P-valuea
Self-rated oral health	Very good	64 (17.1)	22 (34.4)	0.0578	25 (39.1)	0.0146b	19 (29.7)	0.0070b
	Good	131 (34.9)	48 (36.6)		59 (45.0)		48 (36.6)
	Acceptable	82 (21.9)	40 (48.8)		45 (54.9)		38 (46.3)
	Bad	67 (17.9)	35 (52.2)		43 (64.2)		38 (56.7)
	Missing	31 (8.3)	23 (74.2)		25 (80.6)		17 (54.8)
Elderly (age ≥60 years)	Yes	116 (30.9)	44 (37.9)	0.0672	49 (42.2)	0.0053b	35 (30.2)	0.0007b
	No	247 (65.9)	119 (48.2)		143 (57.9)		121 (49.0)
	Missing	12 (3.2)	5 (41.7)		5 (41.7)		4 (33.3)
Gender	Female	216 (57.6)	103 (47.7)	0.1233	127 (58.8)	0.0025b	101 (46.8)	0.0339b
	Male	154 (41.1)	61 (39.6)		66 (42.9)		55 (35.7)
	Missing	5 (1.3)	4 (80.0)		4 (80.0)		4 (80.0)
Married	Yes	289 (77.1)	128 (44.3)	0.7417	145 (50.2)	0.0838	123 (42.6)	0.8591
	No	82 (21.9)	38 (46.3)		50 (61.0)		34 (41.5)
	Missing	4 (1.1)	2 (50.0)		2 (50.0)		3 (75.0)
University degree	Yes	95 (25.3)	48 (50.5)	0.1173	52 (54.7)	0.4288	45 (47.4)	0.1523
	No	262 (69.9)	108 (41.2)		131 (50.0)		102 (38.9)
	Missing	18 (4.8)	12 (66.7)		14 (77.8)		13 (72.2)
Family income	<5,000 SR	139 (37.1)	78 (56.1)	0.0010b	95 (68.3)	<0.0001b	73 (52.5)	0.0038b
	≥5,000 SR	219 (58.4)	84 (38.4)		91 (41.6)		81 (37.0)
	Missing	17 (4.5)	6 (35.3)		11 (64.7)		6 (35.3)
Smoke	Yes	98 (26.1)	49 (50.0)	0.2284	51 (52.0)	0.9096	43 (43.9)	0.7779
	No	277 (73.9)	119 (43.0)		146 (52.7)		117 (42.2)
Type of cancer	Breast	125 (33.3)	62 (49.6)	0.0063b	76 (60.8)	<0.0001b	59 (47.2)	0.2428
	Lung	35 (9.3)	23 (65.7)		28 (80.0)		18 (51.4)
	Colon	170 (45.3)	66 (38.8)		74 (43.5)		66 (38.8)
	Other	35 (9.3)	11 (31.4)		13 (37.1)		12 (34.3)
	Missing	10 (2.7)	6 (60.0)		6 (60.0)		5 (50.0)
Cancer stage	I	63 (16.8)	27 (42.9)	0.8465	32 (50.8)	0.4002	27 (42.9)	0.7333
	II	81 (21.6)	35 (43.2)		44 (54.3)		35 (43.2)
	III	63 (16.8)	26 (41.3)		30 (47.6)		22 (34.9)
	IV	88 (23.5)	40 (45.5)		42 (47.7)		40 (45.5)
	Unknown	80 (21.3)	40 (50.0)		49 (61.3)		36 (45.0)
Number of tumors	Single tumor	182 (48.5)	77 (42.3)	0.3529	89 (48.9)	0.2445	75 (41.2)	0.7314
	Two or more	165 (44.0)	78 (47.3)		91 (55.2)		71 (43.0)
	Missing	28 (7.5)	13 (46.4)		17 (60.7)		14 (50.0)
Surgical therapy	Yes	211 (56.3)	98 (46.4)	0.4274	111 (52.6)	0.9297	94 (44.5)	0.3647
	No	163 (43.5)	69 (42.3)		85 (52.1)		65 (39.9)
	Missing	1 (0.3)	1 (100.0)		1 (100.0)		1 (100.0)
Chemotherapy	Yes	310 (82.7)	138 (44.5)	0.6642	163 (52.6)	0.8282	131 (42.3)	0.5991
	No	61 (16.3)	29 (47.5)		33 (54.1)		28 (45.9)
	Missing	4 (1.1)	1 (25.0)		1 (25.0)		1 (25.0)
Radiation therapy	Yes	177 (47.2)	79 (44.6)	0.9532	96 (54.2)	0.4735	77 (43.5)	0.6591
	No	194 (51.7)	86 (44.3)		98 (50.5)		80 (41.2)
	Missing	4 (1.1)	3 (75.0)		3 (75.0)		3 (75.0)
Immunotherapy	Yes	226 (60.3)	107 (47.3)	0.2522	125 (55.3)	0.1859	100 (44.2)	0.3352
	No	143 (38.1)	59 (41.3)		69 (48.3)		56 (39.2)
	Missing	6 (1.6)	2 (33.3)		3 (50.0)		4 (66.7)
Newly diagnosed	Yes	245 (65.3)	101 (41.2)	0.0748	122 (49.8)	0.1251	99 (40.4)	0.1457
	No	111 (29.6)	57 (51.4)		65 (58.6)		54 (48.6)
	Missing	19 (5.1)	10 (52.6)		10 (52.6)		7 (36.8)
Chronic diseases other than cancer	Yes	145 (38.7)	76 (52.4)	0.0184b	83 (57.2)	0.1374	65 (44.8)	0.4984
	No	223 (59.5)	89 (39.9)		110 (49.3)		92 (41.3)
	Missing	7 (1.9)	3 (42.9)		4 (57.1)		3 (42.9)
Physical exercise	Yes	115 (30.7)	44 (38.3)	0.0904	63 (54.8)	0.5618	51 (44.3)	0.6616
	No	260 (69.3)	124 (47.7)		134 (51.5)		109 (41.9)
Health insurance coverage	Yes	179 (47.7)	70 (39.1)	0.0445b	79 (44.1)	0.0024b	68 (38.0)	0.1032
	No	192 (51.2)	95 (49.5)		115 (59.9)		89 (46.4)
	Missing	4 (1.1)	3 (75.0)		3 (75.0)		3 (75.0)
Received oral health information	Yes	148 (39.5)	66 (44.6)	0.9020	73 (49.3)	0.3513	62 (41.9)	0.8253
	No	223 (59.5)	98 (43.9)		121 (54.3)		96 (43.0)
	Missing	4 (1.1)	4 (100.0)		3 (75.0)		2 (50.0)

Notes:

a P-values for differences based on chi-squared test for proportions.

b Differences significant at P≤0.05.

Table 2 aOR and 95% confidence intervals (95% CI) for the relationship between self-rated oral health and psychological conditions, including depression, anxiety, and stress in cancer patients

Characteristic	Category	Depression			Anxiety			Stress
		aOR	95% CI	P-value	aOR	95% CI	P-value	aOR	95% CI	P-value
Self-rated oral health	Very good	1.00			1.00			1.00
	Good	1.21	(0.55–2.64)	0.6327	2.26	(1.00–5.10)	0.0494a	1.55	(0.69–3.46)	0.2847
	Acceptable	1.61	(0.68–3.81)	0.2755	2.76	(1.11–6.86)	0.0285a	2.57	(1.05–6.28)	0.0387a
	Bad	2.20	(0.86–5.66)	0.1013	6.48	(2.22–18.96)	0.0006a	4.73	(1.75–12.76)	0.0022a
Elderly (age ≥60 years)	Yes	0.65	(0.33–1.30)	0.2264	0.49	(0.23–1.02)	0.0580	0.30	(0.14–0.62)	0.0013a
	No	1.00			1.00			1.00
Gender	Female	1.56	(0.64–3.77)	0.3266	1.63	(0.64–4.12)	0.3060	2.02	(0.82–4.99)	0.1273
	Male	1.00			1.00			1.00
Married	Yes	1.57	(0.76–3.27)	0.2236	0.78	(0.37–1.65)	0.5194	2.07	(0.97–4.44)	0.0602
	No	1.00			1.00			1.00
University degree	Yes	2.06	(1.01–4.25)	0.0497a	2.71	(1.27–5.80)	0.0100a	1.64	(0.80–3.36)	0.1806
	No	1.00			1.00			1.00
Family income	<5,000 SR	2.30	(1.12–4.72)	0.0235a	2.68	(1.28–5.59)	0.0088a	1.60	(0.77–3.32)	0.2071
	≥5,000 SR	1.00			1.00			1.00
Smoke	Yes	1.24	(0.56–2.73)	0.5966	0.83	(0.36–1.92)	0.6605	1.08	(0.47–2.49)	0.8522
	No	1.00			1.00			1.00
Type of cancer	Breast	2.41	(0.68–8.53)	0.1739	5.20	(1.42–19.10)	0.0129a	1.81	(0.51–6.38)	0.3583
	Lung	5.56	(1.31–23.57)	0.0199a	16.7	(3.39–81.94)	0.0005a	1.28	(0.31–5.30)	0.7346
	Colon	1.93	(0.61–6.11)	0.2628	2.92	(0.92–9.31)	0.0700	1.61	(0.51–5.04)	0.4164
	Other	1.00			1.00			1.00
Cancer stage	I	1.00			1.00			1.00
	II	2.95	(0.92–9.49)	0.0689	1.64	(0.48–5.61)	0.4317	4.06	(1.23–13.40)	0.0213a
	III	1.70	(0.64–4.52)	0.2851	1.43	(0.52–3.95)	0.4863	1.85	(0.68–5.04)	0.2267
	IV	1.87	(0.67–5.22)	0.2294	1.53	(0.52–4.50)	0.4414	1.75	(0.62–4.95)	0.2934
	Unknown	0.90	(0.34–2.39)	0.8252	1.28	(0.46–3.58)	0.6337	1.09	(0.40–2.98)	0.8640
Number of tumors	Single tumor	1.21	(0.64–2.31)	0.5526	0.99	(0.50–1.96)	0.9873	1.02	(0.53–1.98)	0.9416
	Two or more	1.00			1.00			1.00
Surgical therapy	Yes	0.98	(0.51–1.87)	0.9533	0.41	(0.20–0.84)	0.0148a	0.85	(0.44–1.66)	0.6360
	No	1.00			1.00			1.00
Chemotherapy	Yes	1.00	(0.38–2.67)	0.9935	0.92	(0.34–2.52)	0.8744	0.66	(0.24–1.82)	0.4242
	No	1.00			1.00			1.00
Radiation therapy	Yes	0.98	(0.54–1.78)	0.9571	1.19	(0.64–2.24)	0.5842	1.19	(0.65–2.17)	0.5747
	No	1.00			1.00			1.00
Immunotherapy	Yes	1.32	(0.73–2.40)	0.3611	1.21	(0.64–2.29)	0.5478	1.44	(0.77–2.68)	0.2492
	No	1.00			1.00			1.00
Newly diagnosed	Yes	0.81	(0.44–1.49)	0.4994	0.94	(0.49–1.79)	0.8406	1.06	(0.57–1.97)	0.8503
	No	1.00			1.00			1.00
Chronic diseases other than cancer	Yes	1.81	(0.99–3.32)	0.0550	1.48	(0.77–2.85)	0.2351	1.36	(0.73–2.54)	0.3326
	No	1.00			1.00			1.00
Health insurance coverage	Yes	0.63	(0.34–1.17)	0.1422	0.56	(0.29–1.06)	0.0728	0.66	(0.35–1.22)	0.1852
	No	1.00			1.00			1.00

Note:

a P-value significant at the significance level 0.05.

Abbreviation: aOR, adjusted odds ratio.