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Cited by 9Cancer survivorship and carePalliative and Oncologic CarePalliative Care and End-of-Life Issues

Depression and anxiety during the year before death from cancer

Open access
Magill, Nicholas, Walker, Jane, Symeonides, Stefan, Gourley, Charlie, Hobbs, Harriet, Rosenstein, Donald, Frost, Chris, Sharpe, Michael·2022·Journal of Psychosomatic Research
DOI 10.1016/j.jpsychores.2022.110922
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Abstract

OBJECTIVE: Previous studies of depression and anxiety during the year before death have reported different findings. We therefore aimed to study depression and anxiety in patients who had died from cancer and had previously attended cancer clinics. METHODS: We analysed routine data on 4869 deceased patients who had completed the Hospital Anxiety and Depression Scale (HADS) as part of their routine cancer care. The HADS data were linked with demographic, cancer and mortality data from national registries. We used data from all HADS completed in the last year of life to investigate 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 (Analysis 1). This analysis used multivariable linear regression with cubic splines and robust standard errors to allow for multiple HADS from the same patients. We also investigated within-patient changes in scores (Analysis 2) in a subset of patients who had completed more than one HADS. RESULTS: In Analysis 1, modelled mean HADS-D scores increased by around 2.5 and the percentage of high HADS-D scores increased from 13% at six months before death to 30% at one month before death. Changes in HADS-A were smaller and occurred later. In Analysis 2, similar patterns were observed in individual patients' HADS scores. CONCLUSION: Depression should be looked for and treated in patients with cancer and a prognosis of six months or less, in order to maximise the quality of patients' remaining life.

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  • People with an advanced progressive illness and their caregivers frequently experience anxiety, uncertainty and anticipatory grief.

    “People with an advanced progressive illness and their caregivers frequently experience anxiety, uncertainty and anticipatory grief.”

    From Acceptance and Commitment Therapy (ACT) for people with advanced progressive illness, their caregivers and staff involved in their care: A scoping review. (2023) · cites this paper as [3]

    The Introduction (page unavailable) says anxiety is common in patients with cancer, and the Discussion (page unavailable) describes patients anticipating future losses. The paper does not establish that caregivers frequently experience these feelings, does not assess uncertainty or anticipatory grief as such, and does not extend its findings beyond cancer to advanced progressive illness generally. (LLM, conf=0.87)

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  • Anxiety, worry, uncertainty, loss of control and social role are common in people with advanced progressive illness.

    “Anxiety, worry, uncertainty, loss of control and social role are common.2–5”

    From Acceptance and Commitment Therapy (ACT) for people with advanced progressive illness, their caregivers and staff involved in their care: A scoping review. (2023) · cites this paper as [3]

    The Introduction says anxiety is common in patients with cancer, and the Discussion describes possible worries about dying and future losses. The paper does not establish that uncertainty, loss of control, or loss of social role are common, and its evidence concerns patients with cancer rather than advanced progressive illness generally. The supplied copy does not give page numbers for these sections. (LLM, conf=0.87)

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Authors
Magill, N., Walker, J., Symeonides, S., Gourley, C., Hobbs, H., Rosenstein, D., Frost, C., & Sharpe, M.
Affiliations
  • London School of Hygiene & Tropical Medicine (GB)
  • Warneford Hospital (GB)
  • Edinburgh Cancer Research (GB)
  • University of North Carolina at Chapel Hill (US)
Corresponding author
Sharpe, Michael
ORCID
Venue
Journal of Psychosomatic Research
Publisher
Elsevier BV
Published
2022-07
Volume
158
Pages
110922
ISSN
0022-3999 (ISSN-L)
DOI
10.1016/j.jpsychores.2022.110922
OpenAlex
W4224294290
Cited by
9
References
34
Citations by year
2026: 1 · 2025: 1 · 2024: 3 · 2023: 4
FWCI
0.84
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Psychosomatic Research (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • Edinburgh Research Explorer (University of Edinburgh) (submittedVersion, cc-by)
Funders
Cancer Research UK
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
Keywords
depression, anxiety, cancer, last year of life, time to death, Hospital Anxiety and Depression Scale, quality of life, palliative care, terminal illness, psychosocial care
MeSH terms
Anxiety, Anxiety Disorders, Depression, Humans, Neoplasms, Quality of Life

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