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Cited by 103Cancer survivorship and careMental Health Treatment and AccessCOVID-19 and Mental Health

The DOI matches its Crossref record; 63 of the 63 references it cites were found in a registry or an index.

Depression, Anxiety, and Other Mental Disorders in Patients With Cancer in Low- and Lower-Middle–Income Countries: A Systematic Review and Meta-Analysis

Open access
Walker, Zoe J., Xue, Siqi, Jones, Michael P., Ravindran, Arun V.·2021·JCO Global Oncology
DOI 10.1200/go.21.00056PMC PMC8457869
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Abstract

PURPOSE: Cancer is a growing public health issue in low- and lower-middle–income countries (LLMICs), but the mental health consequences in this setting have not been well-characterized. We aimed to systematically evaluate the available literature on the prevalence, associates, and treatment of mental disorders in patients with cancer in LLMICs. METHODS: We systematically searched Medline, PsycINFO, EMBASE, and CINAHL. We performed a random effects meta-analysis to determine the pooled prevalence of major depression or anxiety disorders in this population, defined by Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases criteria. We qualitatively reviewed studies that examined the prevalence of depressive or anxiety disorders defined by self-report tools, the prevalence of other mental disorders, associated factors of depressive and anxiety symptoms, and the treatment of mental disorders in this population. RESULTS: Forty studies spanning a 15-year period were included in the review. The pooled prevalence defined by Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases criteria was 21% for major depression (95% CI, 15 to 28) and 18% for anxiety disorders (95% CI, 8 to 30). Depressive and anxiety symptoms were most frequently associated with advanced disease and low levels of education. Among the four studies evaluating treatment, three evaluated the effectiveness of psychotherapy and one evaluated a yoga program. CONCLUSION: The prevalence of depression and anxiety in patients with cancer generally appears higher in LLMICs than in upper-income countries. Our findings demonstrate the existence of a significant and underappreciated disease burden. We suggest that clinicians remain vigilant to psychiatric symptoms. Improved screening and treatment are likely to improve quality of life and reduce both morbidity and mortality.

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FIG 1 Preferred reporting items for systematic reviews and meta-analyses flowchart.
FIG 1 Preferred reporting items for systematic reviews and meta-analyses flowchart.CC BY · PubMed Central
FIG 2 Prevalence of major depression (interview-based tools). ES, estimate.
FIG 2 Prevalence of major depression (interview-based tools). ES, estimate.CC BY · PubMed Central
FIG 3 Prevalence of anxiety disorders (interview-based tools). ES, estimate.
FIG 3 Prevalence of anxiety disorders (interview-based tools). ES, estimate.CC BY · PubMed Central

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Metadata

Authors
Walker, Z. J., Xue, S., Jones, M. P., & Ravindran, A. V.
Affiliations
  • Centre for Addiction and Mental Health (CA)
  • University of Toronto (CA)
Corresponding author
Ravindran, Arun V.
ORCID
Venue
JCO Global Oncology
Publisher
American Society of Clinical Oncology (ASCO)
Published
2021-12
Volume
7
Issue
7
Pages
1233-1250
ISSN
2687-8941 (ISSN-L)
DOI
10.1200/go.21.00056
PMC
PMC8457869
OpenAlex
W3192811719
Cited by
103
References
59
Citations by year
2026: 18 · 2025: 19 · 2024: 24 · 2023: 25 · 2022: 16 · 2021: 1
FWCI
2.00
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • JCO Global Oncology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
  • Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Keywords
cancer, depression, anxiety disorders, mental illness, low- and lower-middle-income countries, prevalence, risk factors, advanced disease, educational attainment, psychotherapy, yoga, mental health screening, mental health services
MeSH terms
Anxiety, Anxiety Disorders, Depression, Major Depressive Disorder, Developing Countries, Humans, Neoplasms, Quality of Life

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