title: Depression and functional impairment independently contribute to decreased quality of life in cancer patients prior to chemotherapy.
abstract: BACKGROUND
  An inverse association either between depression or impaired functional status and quality of life (QoL) has been reported for cancer patients, but the independent effect of depression or depressive symptoms and of functional impairment on QoL is unclear.
  
  
  METHODS
  We investigated the prevalence of depression or depressive symptoms with the Beck Depression Inventory (BDI), the functional impairment with the ECOG-Performance-Status (ECOG-PS) and the QoL with the EORTC-QLQ-C30 questionnaire in a sample of 175 hospitalised cancer patients prior to the start of chemotherapy.
  
  
  RESULTS
  Sixteen of 175 patients (9.1%) screened positive for major depression, 29 (16.6%) had mild to moderate depressive symptoms. In 11 of 15 scales of the EORTC-QLQ-C30 questionnaire depression or depressive symptoms were significantly associated with worse QoL in univariate analysis and in 12 of 15 scales poor ECOG-PS was significantly associated with worse QoL. In multivariate analysis including ECOG-PS and BDI, the effect of depression and/ or depressive symptoms on QoL was persistent in seven scales: global QoL, physical- and role functioning, fatigue, nausea & vomiting, pain, and constipation, that of ECOG-PS in five scales: global QoL, emotional functioning, nausea & vomiting, pain, and appetite loss.
  
  
  CONCLUSIONS
  Signs of major depression or depressive symptoms and impaired functional status contribute independently to poorer QoL in cancer patients prior to chemotherapy.
authors: Internal Medicine Clinic II, Department of Haematology and Medical Oncology, Friedrich-Schiller-University, Erlanger Allee 101, D-07747 Jena, Germany. ulrich.wedding@med.uni-jena.de
authors: Ulrich
authors: U
authors: Wedding
authors: Anja
authors: A
authors: Koch
authors: Bernd
authors: B
authors: Röhrig
authors: Ludger
authors: L
authors: Pientka
authors: Heinrich
authors: H
authors: Sauer
authors: Klaus
authors: K
authors: Höffken
authors: Iris
authors: I
authors: Maurer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003863:Depression / Q000150:complications* / Q000209:etiology / Q000523:psychology; D003865:Major Depressive Disorder / Q000150:complications* / Q000523:psychology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006304:Health Status; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D017567:Karnofsky Performance Status; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy / Q000523:psychology*; D015995:Prevalence; D011446:Prospective Studies; D011581:Psychological Tests; D011594:Psychometrics; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors