Prevalence and factors associated with depression among patients with breast cancer at Moi Teaching and Referral Hospital, Eldoret.

Abstract

Background: Major Depression is the presence of sadness, empty or irritable mood, accompanied by somatic and cognitive changes. It is often unrecognized and untreated among patients with breast cancer, which causes amplification of physical symptoms, increased functional impairment, and poor treatment outcome. Factors associated with having depression among patients with breast cancer include age at diagnosis, tumor stage, surgery, and chemotherapy. There is limited data on depression among patients with breast cancer at Moi Teaching and Referral Hospital (MTRH). Objective: To determine the prevalence and factors associated with depression among patients with breast cancer at MTRH. Methods: This was a cross-sectional study, involving a total of seventy-nine patients, in which the Hamilton Depression Rating Scale (HAM-D) was used to diagnose and measure the severity of depression. A researcher-designed questionnaire was used to obtain socio-demographic and clinical information. The study was done at the breast cancer clinic, medical and surgical wards of MTRH, in which seventy-nine random consenting patients were interviewed from January to December 2017. Descriptive statistics were used for continuous data and categorical data. Chi-square and Fisher's exact tests were used to measuring for associations. Multivariate analysis by logistic regression was used to measure an independent association. Results: of all the participants 98% of them were females. The mean age was 40±7.8 years. The prevalence of depression among patients with breast cancer was 59.5%. Those who were employed were 3 times more likely to have depression compared with the unemployed (AOR=3.7, 95% CI: 1.07, 17.27; p=0.047). Patients on neoadjuvant and palliative therapy were 9 times more likely to have depression (AOR=9.43, 95% CI: 1.5, 185.32; p=0.044 and AOR =9.5, 95% CI: 1.62, 181.81; p=0.039) respectively than those on adjuvant therapy. Patients with late-stage breast cancer had 61% increased odds of having depression (AOR=1.61, 95% CI: 0.63, 4.17; p=0.319) than patients with early-stage breast cancer. Conclusion: There was a high prevalence of depression among patients with breast cancer. Being employed, the use of chemotherapy, and the late stage of cancer were significantly associated with having depression. Recommendation: Screening and interventions for depression should be initiated for all patients with breast cancer especially late stages of cancer, those on chemotherapy, and employed.