title: Prevalence and predictive factors of depression and anxiety in patients with pancreatic cancer: a longitudinal study.
abstract: OBJECTIVE
  It is known that depression and anxiety occur more frequently in pancreatic cancer patients than in those with other malignancies. However, few studies have assessed depression and anxiety using reliable psychiatric diagnostic tools. The purpose of this study was to determine the prevalence of depression and anxiety among pancreatic cancer patients before and 1 month after the start of anticancer treatment using reliable psychiatric diagnostic tools, and to identify factors that predict their occurrence.
  
  
  METHODS
  Pancreatic cancer patients were consecutively recruited. Structured clinical interviews were used to determine the presence of affective disorders, anxiety disorders and adjustment disorders. Baseline interviews were performed prior to initiation of anticancer treatment, while follow-up interviews were performed 1 month after treatment was started. Medical, demographic and psychosocial backgrounds were also assessed as predictive factors.
  
  
  RESULTS
  One hundred and ten patients participated in the baseline interview and 91 in the follow-up interview. Depression and anxiety were observed in 15 patients (13.6%) at the baseline, and 15 patients (16.5%) at the follow-up. Lack of confidants was associated with depression and anxiety at the baseline. At the baseline, sadness, lower Karnofsky Performance Status and prior experience with the death of a family member due to cancer predicted newly diagnosed depression and anxiety at the follow-up.
  
  
  CONCLUSIONS
  A considerable percentage of pancreatic cancer patients experienced depression and anxiety. Multidimensional psychosocial predictive factors were found and optimal psychological care should incorporate early detection of sadness.
authors.affiliation: Psycho-Oncology Division, Chiba Cancer Center, Chiba.
authors.forename: Nobuya
authors.initials: N
authors.lastname: Akizuki
authors.affiliation: Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo keshimiz@ncc.go.jp.
authors.forename: Ken
authors.initials: K
authors.lastname: Shimizu
authors.affiliation: Graduate School of Clinical Psychology, Teikyo Heisei University, Chiba.
authors.forename: Mariko
authors.initials: M
authors.lastname: Asai
authors.affiliation: Psychiatry Division, Kitasato University Kitasato Institute Hospital, Tokyo.
authors.forename: Tomohito
authors.initials: T
authors.lastname: Nakano
authors.affiliation: Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo.
authors.forename: Takuji
authors.initials: T
authors.lastname: Okusaka
authors.affiliation: Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, Tokyo.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Shimada
authors.affiliation: Department of Psycho-Oncology, National Cancer Center Hospital, Tokyo.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Inoguchi
authors.affiliation: Department of Neuropsychiatry, Okayama University Hospital, Okayama.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Inagaki
authors.affiliation: Section of Medical Research for Suicide, Center for Suicide Prevention, National Institute of Mental Health, National Center for Neurology & Psychiatry, Tokyo.
authors.forename: Maiko
authors.initials: M
authors.lastname: Fujimori
authors.affiliation: Division of Palliative Care and Psycho-oncology, Nagoya City University Hospital, Aichi Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Aichi.
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Akechi
authors.affiliation: Innovation Center for Supportive, Palliative and Psychosocial Care, National Cancer Center, Tokyo, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Uchitomi
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000453:epidemiology* / Q000209:etiology; D003863:Depression / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000523:psychology*; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors
keywords: anxiety; depression; pancreatic neoplasms; prevalence