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The prevalence of anxiety and depression among cervical cancer patients seen in a tertiary government hospital using the hospital anxiety and depression scale-english/ Filipino version (HADS/HADS-P)

Kristine I. Alvaro, MD and Ireene G. Cacas-David, MD, FPOGS, FPSMFM, FPSUOG
Department of Obstetrics and Gynecology, Philippine General Hospital, University of the Philippines-Manila

Background: Due to improving survival longevity among cervical cancer patients, ensuring the quality of life becomes important to the gynecologist. Cancer, as a chronic disease, afflicts the patient both physically and psychologically. Anxiety and depression have been the two most common psychopathologic conditions affecting the cancer patient. Hence, recognizing their presence is important for holistic management.

Objective: The objective of this study is to determine the prevalence of anxiety and depression among cervical cancer patients seen in a tertiary government hospital.

Methods: This is a cross-sectional study performed on 384 cervical cancer patients from a tertiary government hospital. The Hospital Anxiety and Depression Scale-Pilipino (HADS-P) was the screening tool used to determine the presence of anxiety and depression. A score of 8 and above was used to detect depression and anxiety. Data were analyzed using Stata 15. Multivariate analysis was also utilized. Pearson chi square and Fisher’s Exact tests were used. Variables that were significant were subjected to logistic regression analysis.

Conclusion: The prevalence rates of anxiety, depression, and anxiety and depression among cervical cancer patients in our setting are 8.6%, 35.7%, and 6.5% respectively. Factors related to anxiety included receiving psychological support from family and friends, stage III/IV cancer, and being at 4 to 6 months from time of diagnosis. Depression had significant relationships with age, employment status, chemoradiation, and stage II cancer. Although rates in general were lower compared to other countries, the mere presence of anxiety and/or depression among cervical cancer patients implies the need for the gynecologist to give attention not only to the physical aspects of cervical cancer but to the psychological effects as well. Psychological screening could be performed even if by means of a simple validated tool in order to detect psychopathology early on.