title: Clinical biopsychosocial risk factors for depression in lung cancer patients: a comprehensive analysis using data from the Lung Cancer Database Project.
abstract: BACKGROUND
  Various risk factors for depression in lung cancer patients have been suggested but have been examined separately in studies with relatively small sample sizes. The present study examined the biopsychosocial risk factors of depression in lung cancer patients, focusing on psychological factors in the largest patient sample reported to date.
  
  
  METHODS
  A total of 1334 consecutively recruited lung cancer patients were selected, and data on cancer-related variables, personal characteristics, health behaviors, physical symptoms, and psychological factors were obtained. The participants were divided into groups with or without depression using the Hospital Anxiety and Depression Scale.
  
  
  RESULTS
  Among the recruited patients, 165 (12.4%) manifested depression. The results of a binary logistic regression analysis were significant (overall R2, 36.5%), and a greater risk for depression was strongly associated with psychological factors, such as personality characteristics (neuroticism) and coping style (low fighting spirit, helplessness/hopelessness, and anxious preoccupation). Although the contributions of cancer-related variables, personal characteristics, health behaviors, and clinical state were relatively low, cancer stage, cancer type, sex, and age correlated significantly with depression.
  
  
  CONCLUSIONS
  Depression was most strongly linked with personality traits and coping style, and using screening instruments to identify these factors may be useful for preventive interventions.
authors.affiliation: Psycho-Oncology Division, National Cancer Center Hospital, Tokyo. Electronic address: keshimiz@ncc.go.jp.
authors.forename: K
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Department of Nutrition and Dietetics, Faculty of Family and Consumer Sciences, Kamakura Women's University, Kamakura; Departments of Epidemiology; Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai.
authors.forename: N
authors.initials: N
authors.lastname: Nakaya
authors.affiliation: Departments of Epidemiology; Behavioral Medicine, Tohoku University Graduate School of Medicine, Sendai.
authors.forename: K
authors.initials: K
authors.lastname: Saito-Nakaya
authors.affiliation: Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya.
authors.forename: T
authors.initials: T
authors.lastname: Akechi
authors.affiliation: Psycho-Oncology Division, National Cancer Center Hospital, Tokyo.
authors.forename: Y
authors.initials: Y
authors.lastname: Yamada
authors.affiliation: Psycho-Oncology Division, National Cancer Center Hospital, Tokyo; Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa.
authors.forename: M
authors.initials: M
authors.lastname: Fujimori
authors.affiliation: Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa; Psycho-Oncology Division, National Cancer Center Hospital East, Kashiwa.
authors.forename: A
authors.initials: A
authors.lastname: Ogawa
authors.affiliation: Psycho-Oncology Division, Research Center for Innovative Oncology, National Cancer Center Hospital East, Kashiwa; Psycho-Oncology Division, National Cancer Center Hospital East, Kashiwa.
authors.forename: D
authors.initials: D
authors.lastname: Fujisawa
authors.affiliation: Division of Thoracic Oncology, National Cancer Center Hospital East, Kashiwa.
authors.forename: K
authors.initials: K
authors.lastname: Goto
authors.affiliation: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center Research Institute, Tokyo.
authors.forename: M
authors.initials: M
authors.lastname: Iwasaki
authors.affiliation: Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center Research Institute, Tokyo.
authors.forename: S
authors.initials: S
authors.lastname: Tsugane
authors.affiliation: Department of Neuropsychiatry, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Uchitomi
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008175:Lung Neoplasms / Q000453:epidemiology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012307:Risk Factors; D012923:Social Class