Depression hastens decline in cancer patients

Depression causes patients with advanced cancer to die sooner than they should, say scientists at the University of Liverpool.

In a six-month study patients who were found to be depressed had a 7% increased chance of dying and this percentage increased depending on the severity of the depression. Depression is common in patients with advanced cancer and in a significant number of patients it is persistent.

The researchers examined symptoms and mood in patients using a screening method originally devised for postnatal mothers, containing questions on worthlessness, subjective sadness and suicidal thoughts as well as questions about symptoms and pain. Depression affected 29% of patients at the initial screening and 54.5% of surviving patients remained depressed eight weeks later.

Professor Mari Lloyd-Williams from the School of Population, Community and Behavioural Sciences said: "Previous research has shown that stroke patients who were depressed did not regain function as well as other patients and they had a higher risk of dying - all patients who have suffered a stroke are now screened for depression but this is not the case for patients at any stage of cancer.

"We know that a patient's mental state affects their physical state but not enough is known about why this happens. We believe that when someone is depressed they lose motivation and therefore the will to live.

"Depression affects 25% of patients with advanced cancer but at this stage it is difficult to diagnose. Whilst patients with advanced cancer are clearly very ill they can still be effectively treated for depression but the first step in the treatment is the recognition that the patient is depressed."

Professor Lloyd-Williams and her team have been awarded £2.5 million to carry out further research in palliative care. They are currently working on a larger study of more than 400 patients to identify what emotional and psychological health problems cancer patients experiencing in order to better understand their mental health needs and how to improve their primary care.