title: Patterns and predictors of antidepressant use in ambulatory cancer patients with common solid tumors.
abstract: OBJECTIVE
  Depressive symptoms and antidepressant use are prevalent among cancer patients. We sought to identify determinants of prescribing commonly used antidepressants.
  
  
  METHODS
  This multi-institutional study enrolled 3106 ambulatory patients with cancer of the breast, prostate, colon/rectum, or lung. Five case-finding methods were used to identify patients with depressive symptoms. Logistic models were used to examine factors that impact antidepressant use.
  
  
  RESULTS
  Approximately, 47% of patients were defined as having depressive symptoms. Clinicians rated being sad/depressed as one of the top three priority problems for 10.5% of patients. Antidepressants were prescribed in 19% of all patients, 25% with depressive symptoms and 14% nondepressed patients. After adjusting for other covariates, these variable categories were significantly associated with greater use of antidepressants: depressive symptoms, family history of depression, concurrent medication use, cancer treatment status, and certain other clinical and demographic variables. The strongest individual predictors were concurrent use of more than 10 medications (odds ratio [OR] = 3.3), a family history of depression (OR = 2.2), sedative use (OR = 2.1), non-Hispanic white race (OR = 2.0), and anxiolytics use (OR = 2.0).
  
  
  CONCLUSIONS
  Depressive symptoms are found in nearly half of outpatients with cancer, and one-fourth of patients with depressive symptoms are taking an antidepressant. Patients receiving antidepressants are more often those taking multiple medications, those with a depression diathesis, and those with more extensive cancer treatment. Patients who were younger, white, and female were also more likely to be taking antidepressants.
authors.affiliation: The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Fisch
authors.forename: Fengmin
authors.initials: F
authors.lastname: Zhao
authors.forename: Judith
authors.initials: J
authors.lastname: Manola
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Miller
authors.forename: William F
authors.initials: WF
authors.lastname: Pirl
authors.forename: Lynne I
authors.initials: LI
authors.lastname: Wagner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001007:Anxiety / Q000453:epidemiology; D001943:Breast Neoplasms / Q000523:psychology; D015179:Colorectal Neoplasms / Q000523:psychology; D003863:Depression / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology / Q000523:psychology; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D016015:Logistic Models; D008175:Lung Neoplasms / Q000523:psychology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D016017:Odds Ratio; D010045:Outpatients; D015995:Prevalence; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000523:psychology; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
chemical_list: D014151:Anti-Anxiety Agents; D000928:Antidepressive Agents; D006993:Hypnotics and Sedatives
keywords: antidepressants; cancer; depression; prescribing; symptoms