title: Anxiety in terminally ill cancer patients.
abstract: BACKGROUND
  Anxiety in terminal cancer is linked to diminished quality of life, yet overall it is poorly understood with regard to prevalence and relationship to other aspects of psychological distress.
  
  
  OBJECTIVE
  This study examines anxiety in terminally ill cancer patients, including the prevalence of anxiety symptoms, the relationship between anxiety and depression, differences in anxiety between participants receiving inpatient palliative care and those receiving outpatient care, and characteristics that distinguish highly anxious from less anxious patients.
  
  
  METHODS
  Participants were 194 patients with terminal cancer. Approximately half (n=103) were receiving inpatient care in a palliative care facility and half (n=91) were receiving outpatient care in a tertiary care cancer center. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression, and was administered along with measures of hopelessness, desire for hastened death, and social support.
  
  
  RESULTS
  Moderately elevated anxiety symptoms were found in 18.6% of participants (n=36) and 12.4% (n=24) had clinically significant anxiety symptoms. Level of anxiety did not differ between the two treatment settings. However, participants receiving palliative care reported significantly higher levels of depression and desire for hastened death. A multivariate prediction model indicated that belief in an afterlife, social support, and anxiolytic and antidepressant use were unique, significant predictors of anxiety.
  
  
  CONCLUSIONS
  Severity of anxiety symptoms did not differ between the study sites, suggesting that anxiety may differ from depression and desire for hastened death in the course that it takes over the duration of terminal cancer.
authors.affiliation: Department of Psychology, Fordham University, Bronx, NY, USA. kolvae@mskcc.org
authors.forename: Elissa
authors.initials: E
authors.lastname: Kolva
authors.forename: Barry
authors.initials: B
authors.lastname: Rosenfeld
authors.forename: Hayley
authors.initials: H
authors.lastname: Pessin
authors.forename: William
authors.initials: W
authors.lastname: Breitbart
authors.forename: Robert
authors.initials: R
authors.lastname: Brescia
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology*; D001293:Attitude to Death; D003643:Death; D003863:Depression / Q000523:psychology; D005260:Female; D005544:Forecasting; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D010045:Outpatients; D010166:Palliative Care; D011569:Psychiatric Status Rating Scales; D012067:Religion; D012944:Social Support; D012959:Socioeconomic Factors; D013727:Terminal Care; D019452:Terminally Ill / Q000523:psychology*