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.