title: Is there an association between haemoglobin, depression, and anxiety in cancer patients?
abstract: OBJECTIVE
  The aim of this study was to examine the association between haemoglobin levels, anxiety disorder, and depression in cancer patients.
  
  
  METHODS
  Cancer patients attending The Norwegian Radium Hospital (NRH) rated themselves on the Hospital Anxiety and Depression Scale (HADS). Five hundred thirty-two patients also had valid measurements of haemoglobin at the same time. The associations between tertile haemoglobin levels (7.0-12.3 g/dl, 12.4-13.8 g/dl, 13.9-17.1 g/dl) and HADS-defined anxiety disorder and depression were analysed by logistic regression.
  
  
  RESULTS
  HADS-defined depression was identified in 116 cases (22%) and anxiety disorder in 149 (28%). The haemoglobin levels of the lower and middle tertiles were associated with depression (OR=3.85, 95% CI: 2.06-7.21, and OR=2.45, 95% CI: 1.25-4.81, respectively). Adjustment for covariates did not change the association significantly. No association between haemoglobin and anxiety disorder was found.
  
  
  CONCLUSIONS
  In cancer patients, the risk of depression increases with decreasing haemoglobin levels. This should be taken into account when treatment of anaemic or depressed cancer patients is decided upon.
authors.affiliation: Department of Psychosocial Oncology, Norwegian Radium Hospital, University of Oslo, Oslo, Norway.
authors.forename: Jon
authors.initials: J
authors.lastname: Skarstein
authors.forename: Ingvar
authors.initials: I
authors.lastname: Bjelland
authors.forename: Alv A
authors.initials: AA
authors.lastname: Dahl
authors.forename: Jacob
authors.initials: J
authors.lastname: Laading
authors.forename: Sophie D
authors.initials: SD
authors.lastname: Fosså
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000150:complications; D001008:Anxiety Disorders / Q000209:etiology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000209:etiology*; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000523:psychology*; D011788:Quality of Life; D012307:Risk Factors
chemical_list: D006454:Hemoglobins