title: The use of antidepressants in patients with advanced cancer--results from an international multicentre study.
abstract: OBJECTIVE
  Depression is common in patients with advanced cancer; however, it is not often recognized and therefore not treated. The aims of this study were to examine the prevalence of the use of antidepressants (ADs) in an international cross-sectional study sample and to identify sociodemographic and medical variables associated with their use.
  
  
  METHODS
  The study was conducted in patients with advanced cancer from 17 centres across eight countries. Healthcare professionals registered patient and disease-related characteristics. A dichotomous score (no/yes) was used to assess the use of ADs other than as adjuvant for pain. Self-report questionnaires from patients were used for the assessment of functioning and symptom intensity.
  
  
  RESULTS
  Of 1051 patient records with complete data on ADs, 1048 were included (M:540/F:508, mean age 62 years, standard deviation [SD] 12). The majority were inpatients, and 85% had metastatic disease. The prevalence of AD use was 14%. Multivariate logistic regression analyses showed that younger age (odds ratio [OR] 2.46; confidence interval [CI] 1.32-4.55), female gender (OR 1.59; CI 1.09-2.33), current medication for pain (OR 2.68; CI 1.65-4.33) and presence of three or more co-morbidities (OR 4.74; CI 2.27-9.91) were associated with AD use for reasons other than pain. Disease-related variables (diagnoses, stage, Karnofsky Performance Status and survival) were not associated with the use of ADs.
  
  
  CONCLUSIONS
  Female gender, younger age, analgesic use and multiple co-morbidities were associated with the use of ADs. However, information is still limited on which variables guide physicians in prescribing AD medication. Further longitudinal studies including details on psychiatric and medication history are needed to improve the identification of patients in need of ADs.
authors.affiliation: European Palliative Care Research Centre, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway; Department of Oncology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
authors.forename: Elene
authors.initials: E
authors.lastname: Janberidze
authors.forename: Marianne Jensen
authors.initials: MJ
authors.lastname: Hjermstad
authors.forename: Cinzia
authors.initials: C
authors.lastname: Brunelli
authors.forename: Jon Håvard
authors.initials: JH
authors.lastname: Loge
authors.forename: Hanne Cathrine
authors.initials: HC
authors.lastname: Lie
authors.forename: Stein
authors.initials: S
authors.lastname: Kaasa
authors.forename: Anne Kari
authors.initials: AK
authors.lastname: Knudsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D003863:Depression / Q000188:drug therapy* / Q000209:etiology; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005060:Europe; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000523:psychology*; D016017:Odds Ratio; D015995:Prevalence; D017678:Sex Distribution; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires
chemical_list: D000928:Antidepressive Agents
keywords: advanced cancer; antidepressants; clinical characteristics; depression; oncology; palliative care