title: The prevalence and predictors of subsyndromal anxiety and depression in adult Asian cancer patients across the first year of diagnosis.
abstract: OBJECTIVE
  There is an increased prevalence of anxiety and depression in Asian patients diagnosed with cancers; these are known to interfere with treatment, treatment adherence and mortality. This study sought to investigate the prevalence and predictors of subsyndromal anxiety and depression in first-year Asian cancer patients.
  
  
  METHODS
  A total of 206 patients newly diagnosed with cancer in Singapore completed the Hospital Anxiety and Depression Scale (HADS) at T1 (baseline; on average 2 months post-diagnosis), T2 (3 months post-baseline) and T3 (6 months post-baseline). Subsyndromal anxiety and depression were identified using locally validated cut-offs (HADS-A ≥5 and HADS-D ≥7). Adjusted odds ratios were calculated using baseline predictors.
  
  
  RESULTS
  Across the three time points, 68-69% of participants were identified as having subsyndromal anxiety and close to 27-38% participants were identified as having subsyndromal depression. Multivariate logistic regressions revealed a lack of predictors for T1 subsyndromal anxiety and depression. Participants with late/metastatic stages of cancer were almost four times as likely to suffer from subsyndromal anxiety at T2. Single participants had a 75% lowered odds, but those living in three to four room public housing were close to four times as likely to suffer from subsyndromal depression at T2. Older patients and those who had undergone surgery were found to significantly suffer from subsyndromal depression at T3.
  
  
  CONCLUSIONS
  The significant levels of depression and anxiety coupled with the lack of consistent predictors across the first year following cancer diagnosis further underscore the importance of careful assessment and clinician-vigilance in recognizing and identifying Asian patients who may express these emotional sequelae following the cancer diagnosis. A better understanding of patients' pathophysiological and psychological responses and individual strengths and coping skills are thus essential.
authors.affiliation: Department of Psychological Medicine, National University of Singapore, Singapore.|Duke-NUS Medical School, Singapore.|Department of Psychological Medicine, National University Hospital, Singapore.
authors.forename: Rathi
authors.initials: R
authors.lastname: Mahendran
authors.affiliation: Department of Psychological Medicine, National University of Singapore, Singapore.|Duke-NUS Medical School, Singapore.
authors.forename: Haikel A
authors.initials: HA
authors.lastname: Lim
authors.affiliation: Department of Psychological Medicine, National University of Singapore, Singapore.
authors.forename: Joyce Ys
authors.initials: JY
authors.lastname: Tan
authors.affiliation: Department of Psychological Medicine, National University of Singapore, Singapore.|Department of Psychological Medicine, National University Hospital, Singapore.
authors.forename: Ee Heok
authors.initials: EH
authors.lastname: Kua
authors.affiliation: Department of Psychology, National University of Singapore, Singapore.
authors.forename: Konstadina
authors.initials: K
authors.lastname: Griva
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000367:Age Factors; D001007:Anxiety / Q000453:epidemiology*; D044466:Asian People / Q000523:psychology*; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000473:pathology* / Q000523:psychology* / Q000601:surgery; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012111:Residence Characteristics; D012307:Risk Factors; D012846:Singapore / Q000453:epidemiology; D013997:Time Factors
keywords: Asia; anxiety; depression; oncology; predictors