Researchers sought to understand that previous research on depression and anxiety in the year before death has yielded conflicting results for a study. As a result, they set out to investigate depression and anxiety in cancer patients who had previously attended cancer clinics. Investigators looked at routine data from 4,869 deceased patients who had completed the Hospital Anxiety and Depression Scale (HADS) as part of their cancer care. The HADS data were combined with national registries’ demographic, cancer, and mortality data. They investigated the relationships between mean depression (HADS-D) and anxiety (HADS-A) scores and the percentages of high scores (≥11 on each subscale) and time to death using data from all HADS completed in the last year of life (Analysis 1). To allow for multiple HADS from the same patients, this analysis used multivariable linear regression with cubic splines and robust standard errors. Within-patient changes in scores were also investigated (Analysis 2) in a subset of patients who had completed more than 1 HADS. In Analysis 1, mean HADS-D scores increased by about 2.5, and the percentage of people with high HADS-D scores increased from 13% six months before death to 30% at 1 month before death. HADS-A changes were smaller and occurred later. Similar patterns were observed in individual patients’ HADS scores in Analysis 2. Depression should be detected and treated in cancer patients with a prognosis of 6 months or less to maximize their remaining life quality.
- Business of Medicine
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