Individuals over 50 years of age and singles were more likely to develop depression [5]. This study had a lower rate of depression in lung cancer patients than Yu Lee and Pao-Yen Lin's study of 104 patients at Chang Gung Hospital in Taiwan (25%). The Yu Lee and Pao-Yen Lin study included small-cell lung cancer patients who have a worse prognosis and disease mechanism. Inflammatory cytokines increase depression risk [6]. The above factors were also demonstrated in the study of Shahedah KK et al., who showed that those who were married or had a partner had an average depression score of 9.42 lower than those who were single/widowed/never married/divorced [7].
Otherwise, our study found 26 depressed non-small cell lung cancer patients with associated factors. A total of 65.4% of individuals under 60 years of age had depression. This supported a Taiwanese study by Yu Lee and Pao-Yen Lin that found that depression was more common in young lung cancer patients [6]. The rate of depression in NSCLC patients was much higher in men than in women, which could be explained by the number of lung cancer cases predominating in men, which was consistent with many other studies [8],[9]. Otherwise, young cancer patients with little life stability may be more emotionally affected than middle-aged and elderly patients [10]. Educational level was below high school (84.6%). Due to their limited awareness and coping skills, less educated cancer patients may have more psychological issues. The study also found no statistically significant correlation between gender, age, and education and patient depression rates.
In our study, stage IV lung cancer patients had a 6.47-fold higher risk of depression (OR = 6.47; p < 0.05). Late-informed patients often have more psychological stress, more severe physical symptoms, and a greater impact on life due to illness, increasing their risk of depression. Depression may reduce cancer treatment adherence [11]. This suggested that advanced-stage NSCLC patients, whether cause or effect, may contribute to depression and low QoL. Hence, clinicians should pay attention to early screening and support mental health care of patients with non-small cell lung cancer.
The analysis showed that depressed patients had a much lower quality of life than nondepressed patients. Through the analysis, patients with depression had poor QoL in physical, emotional, and general health, especially mental health (36.94 ± 5.43), compared to the group without depression (41.78 ± 7.17), which was statistically significant in most groups. Yu Lee and Pao-Yen Lin found a similar decrease in quality of life in lung cancer patients with depression compared to those without depression [6]. This result was consistent with the fact that in the study of Prapa Paraskevi et al. and the study of Ostroff Jamie et al., the disease and therapy-related adverse effects might lead to poor quality of life (QoL) and increased psychological distress [12],[13]. Depression was independently associated with poor prognosis, treatment adherence, and QoL [14],[15]. These findings support the clinical approach and improve QoL in NSCLC patients.