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Research
The relationship between depression and physical symptom burden in advanced cancer Peter Fitzgerald,1,2 Chris Lo,1,2 Madeline Li,1,2 Lucia Gagliese,1,3,4 Camilla Zimmermann,1,5 Gary Rodin1,2
1
Department of Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada 2 Department of Psychiatry, University of Toronto, Toronto, Canada 3 Department of Anesthesia and Pain Management, University Health Network, Toronto, Canada 4 School of Kinesiology and Health Science, York University, Toronto, Canada 5 Department of Medicine, University of Toronto, Toronto, Canada Correspondence to Dr Peter Fitzgerald, Department of Psychosocial Oncology & Palliative Care, The Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada; [email protected] Received 1 October 2012 Revised 22 May 2013 Accepted 2 July 2013
To cite: Fitzgerald P, Lo C, Li M, et al. BMJ Supportive & Palliative Care Published Online First: [ please include Day Month Year] doi:10.1136/bmjspcare-2012000380
ABSTRACT Background Although an association between depression and physical burden has been demonstrated in advanced cancer, it remains unclear to what extent this is limited to specific physical symptoms, such as pain and fatigue, and is mediated by disease and treatment-related factors. We therefore investigated the relationship between depression and physical burden across a multitude of physical symptoms in this population, while controlling for cancerrelated factors including disease severity and proximity to death. Patients and methods A secondary analysis was performed on cross-sectional data in 487 patients with advanced cancer. Measures included the Beck Depression Inventory II and the Memorial Symptom Assessment Scale, which measured physical burden across 24 common cancer symptoms. Disease severity was assessed by survival time and by functional status using the Karnofsky Performance Status scale. Results Depression severity significantly correlated with number of physical symptoms, symptom distress and symptom severity independent of cancer type, functional status, chemotherapy status and survival time (all p15. The depressed group was slightly younger than the nondepressed sample (mean age±SD: 58.3±10 vs 62.5 ±11 years, respectively, p
Research
The relationship between depression and physical symptom burden in advanced cancer Peter Fitzgerald,1,2 Chris Lo,1,2 Madeline Li,1,2 Lucia Gagliese,1,3,4 Camilla Zimmermann,1,5 Gary Rodin1,2
1
Department of Psychosocial Oncology and Palliative Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada 2 Department of Psychiatry, University of Toronto, Toronto, Canada 3 Department of Anesthesia and Pain Management, University Health Network, Toronto, Canada 4 School of Kinesiology and Health Science, York University, Toronto, Canada 5 Department of Medicine, University of Toronto, Toronto, Canada Correspondence to Dr Peter Fitzgerald, Department of Psychosocial Oncology & Palliative Care, The Princess Margaret Cancer Centre, 610 University Avenue, Toronto, Ontario M5G 2M9, Canada; [email protected] Received 1 October 2012 Revised 22 May 2013 Accepted 2 July 2013
To cite: Fitzgerald P, Lo C, Li M, et al. BMJ Supportive & Palliative Care Published Online First: [ please include Day Month Year] doi:10.1136/bmjspcare-2012000380
ABSTRACT Background Although an association between depression and physical burden has been demonstrated in advanced cancer, it remains unclear to what extent this is limited to specific physical symptoms, such as pain and fatigue, and is mediated by disease and treatment-related factors. We therefore investigated the relationship between depression and physical burden across a multitude of physical symptoms in this population, while controlling for cancerrelated factors including disease severity and proximity to death. Patients and methods A secondary analysis was performed on cross-sectional data in 487 patients with advanced cancer. Measures included the Beck Depression Inventory II and the Memorial Symptom Assessment Scale, which measured physical burden across 24 common cancer symptoms. Disease severity was assessed by survival time and by functional status using the Karnofsky Performance Status scale. Results Depression severity significantly correlated with number of physical symptoms, symptom distress and symptom severity independent of cancer type, functional status, chemotherapy status and survival time (all p15. The depressed group was slightly younger than the nondepressed sample (mean age±SD: 58.3±10 vs 62.5 ±11 years, respectively, p
