title: Factors Associated with Depression Assessed by the Patient Health Questionnaire-2 in Long-Term Cancer Survivors.
abstract: BACKGROUND
  This cross-sectional study aimed to evaluate the prevalence of depressive disorders and factors associated in long-term cancer survivors.
  
  
  METHODS
  A total of 702 long-term cancer survivors over 5-years in remission were recruited in a university-affiliated tertiary hospital in Korea. Self-report using the Patient Health Questionnaire-2 and the Fatigue Severity Scale assessed depression and fatigue, respectively. Demographic characteristics, cancer-related clinical characteristics, comorbidity, health behaviors, and physical symptoms were assessed through the review of medical records or a structured self-administered questionnaire.
  
  
  RESULTS
  We identified 26.1% of patients who had a depressed mood or displayed a loss of interest. The most prevalent primary site of cancer was the stomach (65.2%), followed by lung, breast, colorectal, and thyroid cancer. We also found that 5.7% of subjects experienced double or triple primary cancers. Larger proportion among depressive group (89.1%) complained at least one physical problem than among non-depressive group (53.2%). Physical symptoms including sleep problems, dry mouth, indigestion, pain, decreased appetite, and febrile sense were more frequent in the depressive group than in the non-depressive group. The Fatigue Severity Scale scores were higher in the depressive group than in the non-depressive group (P<0.001). Multiple logistic regression analysis showed that the highest tertile level of fatigue (odds ratio, 7.31; 95% confidence interval, 3.81-14.02) was associated with the increased risk of depression.
  
  
  CONCLUSIONS
  These findings suggest that careful concern about depression is necessary in long-term cancer survivors. Fatigue may be a surrogate sign for depression, and warrants further evaluation.
authors.affiliation: Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Ae-Jin
authors.initials: AJ
authors.lastname: Goo
authors.affiliation: Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Yun-Mi
authors.initials: YM
authors.lastname: Song
authors.affiliation: Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jinyoung
authors.initials: J
authors.lastname: Shin
authors.affiliation: Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hyeonyoung
authors.initials: H
authors.lastname: Ko
keywords: Depression; Fatigue; Koreans; Survivors