Prevalence of depression and associated risk factors in newly diagnosed breast cancer patients treated at ocean road cancer institute

Abstract

ABSTRACT Background: Depression is a common condition that affects patients with cancer. However, compared to other cancers, breast cancer is associated with higher rates of depression. The prevalence of depression has detrimental effects on patients’ quality of life, adherence to treatment, and survival. Known risk factors for depression include: a lower level of education, more invasive surgery, a higher stage of the disease, and decreases in social support. Very few studies have evaluated the prevalence, severity, and risk factors for depression among breast cancer patients in Africa, and even fewer studies in Tanzania. Therefore, this study aimed at helping clinicians’ assessment and treatment of depression in patients with breast cancer. Objective: The study aimed to determine the prevalence of depression and associated factors among newly diagnosed breast cancer patients receiving treatment at the Ocean Road Cancer Institute in Dar es Salaam. Methodology: This was a hospital-based cross-sectional study involving women diagnosed with breast cancer in the year 2023. The study was conducted from December 2023 to March 2024 and collected information on independent variables including socio-demographic, clinical, and treatment factors. The dependent variables were the prevalence and severity of depression which were assessed using the Patient Health Questionnaire (PHQ-9). The Statistical Package for the Social Sciences (SPSS, version 26) was used for data entry and analysis. Both univariate and multivariate analyses were used to determine the relationship between independent and dependent variables. Results: A total of 197 breast cancer patients were recruited. The mean age of participants was 50.4 years and all participants were females. Depression was found in (108 cases) that is 54.8% of the study participants. Among 108 patients with depression, 40% had mild depression, 11% had moderate depression, and 4% had moderately severe depression. Depression was significantly associated with younger age <45years (OR= 2.65 P=0.021 95% CI (1.16-6.06)), advanced stage of the disease (OR=3.44 P=0.001 95% CI (1.17-10.10), not having received surgery (OR=6.11 P=0.001 95% CI (2.76-13.56)), not having received vi radiation (OR=2.35 P=0.044 CI (1.50-6.77)), being HIV positive (OR=10.17 P=0.001 95% CI (2.49-41.63)) and presence of pain (OR=2.81 P=0.004 95% CI (1.40-5.65)). Conclusion: This study has demonstrated that the prevalence of depression is high in newly diagnosed breast cancer patients. Factors that were significantly associated with depression were the younger age of patients, advanced stage of disease, not receiving surgery, not receiving radiotherapy, being HIV positive, and the presence of pain. It is, therefore, essential to emphasize the multidisciplinary management of cancer patients and to build strong collaboration with psychiatrists and the palliative care team. This will allow ease of consultation, referral, and timely and efficient management of these patients. Keywords: Breast cancer, Depression, Prevalence, Risk factors, Patient Health Questionnaire (PHQ-9), Tanzania.