Depressive symptom patterns and their consequences for diagnosis of affective disorders in cancer patients.
OBJECTIVE
In order to obtain references for adequate diagnostic procedures of depressive syndromes in cancer patients, the present study analyzes first the prevalence of somatic, emotional, and cognitive symptoms of depression. In a second part, the ability of diagnostic procedures to discriminate between patients with and without comorbid affective disorder is investigated.


METHODS
From a cross-sectional survey investigating comorbid mental disorders in cancer patients with standardized clinical assessment, a subsample of 71 patients with current affective disorders and depressive symptoms according to the Diagnostic and Statistic Manual of Mental Disorders, 4th edition (DSM-IV) were analyzed. In addition to patients' symptom patterns, a discriminant analysis including all depressive symptoms was conducted.


RESULTS
Cognitive symptoms are less prevalent in cancer patients than somatic and emotional symptoms. Loss of interest discriminated best between patients with and without diagnosis of comorbid affective disorder. Additionally, decreased energy and fatigue proved to have discriminatory value.


CONCLUSIONS
Cognitive symptoms should receive special attention in diagnostic procedures for affective disorders in cancer patients. In spite of possible symptom overlap with the cancer disease and its treatment, fatigue proves to be a useful criteria for diagnosis of depression.
Department of Psychiatry and Psychotherapy, Freiburg University Medical Center, Hauptstrasse 5, 79104, Freiburg, Germany. Katrin_Reuter@psyallg.ukl.uni-freiburg.de
Katrin
K
Reuter
Simone
S
Raugust
Jürgen
J
Bengel
Martin
M
Härter
D000328:Adult; D000368:Aged; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis* / Q000453:epidemiology; D009369:Neoplasms / Q000523:psychology*; D015995:Prevalence; D018709:Statistics, Nonparametric