Background
Anxiety and depression are common mental health related problems among patients with cancer. While many psychological variables have been proven to influence anxiety and depressive symptoms, the variables are not mutually exclusive and their integrated effects on patients with oral cancer are yet unknown. Objective To explore the prevalence of anxiety and depressive symptoms among patients with oral cancer, to find out key potentially predictive factors associated with anxiety and depressive symptoms, and to identify the sequence of their contributions.
Method
A cross-sectional study was carried out for Chinese patients with oral cancer between May 2016 and October 2017 in two Grade-A Tertiary Hospitals in Shenyang, China. 230 patients with oral cancer were interviewed with questionnaires on demographic variables, Zung Self-Rating Anxiety Scale (SAS), Center for Epidemiologic Studies Depression Scale (CES-D), Herth Hope Index (HHI), Social Impact Scale, Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R), Perceived Stress Scale-10 (PSS-10), and General Perceived Self-efficacy Scale(GSE). Chi-square test, nonparametric test, t-test, Spearman test and logistic regression analyses were conducted where appropriate to explore predictive factors of anxiety symptoms and depressive symptoms.
Results
The prevalence of anxiety symptoms and depressive symptoms in the sample population was 36.96% (85/230) and 65.21% (150/230), respectively. Age (β=0.047, OR=1.049, CI:1.013~1.086), gender (β=1.146, OR=3.147, CI:1.196~8.278), social isolation dimension of stigma (β=0.546, OR=1.726, CI:1.318~2.260), optimism (β=-0.310, OR=0.734, CI:0.594~0.906), and perceived stress (β=0.239, OR=1.270, CI:1.105~1.459) were predictors of anxiety symptoms. Marriage (β=1.158, OR=4.749, CI:1.301~17.330), positive readiness and expectancy dimension of hope (β=-0.476, OR=0.621, CI:0.401~0.961), social isolation dimension of stigma (β=0.329, OR=1.390, CI:1.060~1.823) and perceived stress (β=0.263, OR=1.300, CI:1.138~1.501) were predictors of depressive symptoms among oral cancer patients.
Conclusion
The prevalence of depressive symptoms was higher than anxiety symptoms among oral cancer patients in China. In addition to higher level of perceived stress and social isolation leading to anxiety and depressive symptoms, lower level of optimism not hope might lead to anxiety symptoms and lower level of hope, especially lower level of active action, might lead to depressive symptoms in oral cancer patients.