title: Depression, anxiety, and health related quality of life among colorectal cancer survivors.
abstract: BACKGROUND
  The aim of this study was to examine the relationship between psychological distress and quality of life (QOL) dimensions in colorectal cancer (CRC) patients.
  
  
  METHODS
  This cross-sectional study was conducted in the North of Iran. A total of 157 CRC survivors were selected from the registry database and included in this study. Psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS) and QOL was estimated using the European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire C30 (EORTC QLQ C-30). The association between the patients' emotional functioning (EF) score on EORTC QLQ-C30 and their HADS scores was analysed through multiple linear regression.
  
  
  RESULTS
  In statistical terms, there were significantly negative relationships between EF and HADS-A (anxiety), and between HADS-D (depression) and HADS-T (total score). However, compared with HADS-A, the correlation between HADS-D and other QOL dimensions was significantly higher. By the same token, depression rather than anxiety was more strongly associated with reduced QOL.
  
  
  CONCLUSIONS
  The EF dimension of the EORTC QLQ-C30 predominantly assesses anxiety; however, depression has a stronger impact on the global QOL of patients than anxiety. Therefore, the use of an additional instrument is recommended for the assessment of depression in outpatients with CRC.
authors.affiliation: Epidemiology and Statistics Department, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Nayyereh
authors.initials: N
authors.lastname: Aminisani
authors.affiliation: Social Determinants of Health Research Centre, Babol University of Medical Sciences and Epidemiology Department, Faculty of Health Sciences, Shiraz University of Medical Sciences, Iran.
authors.forename: Hosseinali
authors.initials: H
authors.lastname: Nikbakht
authors.affiliation: Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Asghari Jafarabadi
authors.affiliation: Epidemiology and Statistics Department, Faculty of Health Sciences, Tabriz University of Medical Sciences, Tabriz, Iran;; Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Seyed Morteza
authors.initials: SM
authors.lastname: Shamshirgaran
keywords: Anxiety; EORTC QLQ-C30; Hospital Anxiety and Depression Scale (HADS); colorectal cancer (CRC); depression; quality of life (QOL)