title: Depression and anxiety symptoms following cancer diagnosis: a cross-sectional study.
abstract: BACKGROUND
  The aims of the present study were to assess demographic and clinical characteristics of patients after receiving a cancer diagnosis, and to determine possible risk factors for anxiety and depression.
  
  
  METHODS
  All consecutive patients aged 18 or above, were assessed before starting intravenous chemotherapy for the first time with the Hospital Anxiety and Depression Scale (HADS), the Distress Thermometer, and a Visual Analog Scale for pain. Demographic and clinical data were also collected.
  
  
  RESULTS
  The patients assessed (n = 270) had a mean age of 59.4 (SD = 11.8) years, and 50.7% were women. Tumours were more frequently colorectal (27.2%), lung (18.8%) and breast (17.6%), and 68.9% were stages 3 or 4. A HADS Anxiety score ≥8 was present in 30% of the patients, a Depression score ≥8 in 24.1%, and a Distress score ≥4 in 44.4%. Independent risk factors for HADS Depression score ≥8 were being a woman (OR = 2.45; p = 0.004), being older (OR = 1.04; p = 0.005), and cancer stage 3-4 (OR = 2.24; p = 0.023) in the multivariable analysis; for Anxiety ≥8 they were being a woman (OR = 2.47; p = 0.002), having a past psychiatric consultation (OR = 2.83; p = 0.029), and cancer stage 3-4 (OR = 1.90; p = 0.047).
  
  
  CONCLUSIONS
  These results suggest the need for greater awareness and a differentiated approach to patients at increased risk of anxiety and depression in the early stages of treatment and before starting chemotherapy.
authors.affiliation: a CEDOC and Mental Health Department, NOVA Medical School/Faculdade de Ciências Médicas , Universidade Nova de Lisboa , Lisboa , Portugal.
authors.forename: Graça
authors.initials: G
authors.lastname: Cardoso
authors.affiliation: b Department of Psychiatry , Hospital Fernando Fonseca , Amadora Portugal.
authors.forename: Joao
authors.initials: J
authors.lastname: Graca
authors.affiliation: b Department of Psychiatry , Hospital Fernando Fonseca , Amadora Portugal.
authors.forename: Catarina
authors.initials: C
authors.lastname: Klut
authors.affiliation: b Department of Psychiatry , Hospital Fernando Fonseca , Amadora Portugal.
authors.forename: Bruno
authors.initials: B
authors.lastname: Trancas
authors.affiliation: c CEAUL, NOVA Medical School/Faculdade de Ciências Médicas , Universidade Nova de Lisboa , Lisboa , Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Papoila
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology*; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology; D000072716:Cancer Pain / Q000453:epidemiology / Q000523:psychology; D015179:Colorectal Neoplasms / Q000473:pathology / Q000523:psychology; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008175:Lung Neoplasms / Q000473:pathology / Q000523:psychology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D009369:Neoplasms / Q000473:pathology / Q000523:psychology*; D012307:Risk Factors; D012737:Sex Factors; D013315:Stress, Psychological / Q000523:psychology; D055815:Young Adult
keywords: Anxiety; cancer; depression; distress; risk factors