Depressive Symptoms in Newly Diagnosed Lung Carcinoma: Prevalence and Associated Risk Factors / 결핵

BACKGROUND: Depression is a recognized complication of lung cancer underreported in developing countries such as Malaysia. Treating and identifying depression in cancer patients increases survival and quality of life. Our objectives are to study prevalence of depressive symptoms in newly diagnosed lung carcinoma, and examine the relationship of depressive symptoms with other influencing risk factors. METHODS: A 2-year, cross sectional study February 2015–February 2017, was conducted at Hospital Tengku Ampuan Afzan, and Penang General Hospital. One hundred and three patients with newly diagnosed, biopsy confirmed primary lung carcinoma were recruited. Self-rated patient's identification sheet, validated Center for Epidemiologic Studies Depression (CES-D), and Dukes University Religion Index score from three different main languages were used. RESULTS: Prevalence of current depressive symptoms (CES-D total score ≥16) is 37.9%. The result suggests prevalence of those at high risk of moderate to major depression, may need treatment. Multivariate analysis reveals those with good Eastern Cooperation Oncology Group factor (η2=0.24, p<0.001) married (η2=0.14, p<0.001) with intrinsic religiosity (IR) (η2=0.07, p<0.02) are more resistant to depression. CONCLUSION: One in three of lung carcinoma patients, are at increased risk for depression. Clinicians should be aware that risk is highest in those with poor performance status, single, and with poor IR. We suggest routine screening of depression symptoms as it is feasible, to be performed during a regular clinic visit with immediate referral to psychiatrist when indicated.

Defaulters among lung cancer patients in a suburban district in a developing country

This study was carried out to determine the prevalence, patient's characteristic and reasons for defaulting follow-up and treatment among patients with lung cancer. Patients with histologically confirmed lung cancer were recruited. Patient's detailed demographic data, occupation, socioeconomic status, and educational level of both the patients and their children were recorded. Defaulters were classified as either intermittent or persistent defaulters. By using Chi-square test, defaulter status was compared with various demographic and disease characteristic factors. The reasons for default were determined. Ninety five patients were recruited. Among them, 81.1% patients were males; 66.3% were Malays. The mean age [SD] was 60 +/- 10.5 years. About 46.3% of the patients had Eastern Cooperation Oncology Group [ECOG] functional status 0/1 and 96.8% of the patients presented with advanced stage [Stage 3b or 4]. Overall, 20 patients [21.1%] were defaulters [35.0% intermittent defaulters; 65.0% persistent defaulters]. Among the intermittent defaulters, 8 patients defaulted once and one patient defaulted 3 times. Among the 20 defaulters, only 2 [10%] patients turned up for the second follow-up appointment after telephone reminder. Two main reasons for default were 'too ill to come' [38.5.5%] and logistic difficulties [23.1%]. No correlation was found between patient education, children education, income, ECOG status, stage of the disease, race, and gender with the defaulter rate. Defaulter rate among lung cancer patients was 21.1%. Children education level is the only significant factor associated with the defaulter rate