Depression as comorbid diagnosis among cancer patients hospitalized in a general hospital in Puerto Rico

B68

Background: Cancer is the second leading cause of death in Puerto Rico. Moreover the incidence of cancer, particularly in women, is increasing annually by 1.5%. Some reports have suggested an association between increased morbidity and depression in cancer patients A high prevalence of major depressive episodes has been found in cancer patients, ranging from a minimum of 5% to more than 40%, and 25% in hospitalized patients. The purpose of this study is to explore the incidence of depression in oncology patients hospitalized in a short term general hospital. This study was conducted as part of a needs assessment which will serve in the development of a cancer control and prevention program in Puerto Rico.
 Methods: This exploratory study collected sociodemographic data and information about depression symptoms and mental disorder diagnoses of 206 patients registered in the clinical psychology service program of a general hospital in the southwest area of Puerto Rico. Subjects were hospitalized in a general hospital between January 2003 and June 2007. Mental illness indicators were assessed using a semi-structured interview based on the American Psychiatric Association diagnostic system (DSM-IV-TR). Descriptive statistics (median, frequency, and cross-tabs) were used for data analysis.
 Results: Subjects were equally distributed in gender (50% female, 50% male.) Mean age was 62 years old (SD=15.5). The majority of the sample (87.1%) had high school education or less. Most participants were cared for in the Intensive Care Unit (40.8%), followed by the Oncology Department (14.1%), Internal Medicine (12.1%), Coronary Intensive Care Unit (9.7%), whereas 23% of the participants were cared for in the remaining hospital departments. Of the cancer patients, 65.5% presented a psychological diagnosis. Most patients met criteria for a mood disorder (43.9%), followed by adjustment disorders (26.7%), and disorders due to medical condition (12.1%). Within mood disorders, 40.4% of the patients met criteria for a major depressive disorder, single episode, while 30.7% met criteria for a major depressive disorder, recurrent. As for adjustment disorders, 53.3% met criteria for an adjustment disorder with depressed mood.
 Conclusion: Results indicate a high incidence of depressive symptoms in hospitalized cancer patients. Bearing in mind that major depression was the most common mental disorder in this population, it is necessary to explore in future studies, its comorbidity with cancer outpatients. These findings suggest the importance to incorporate psychological interventions when designing and implementing cancer control and prevention programs, considering the negative impact that mental illness may have upon adjustment and recovery of cancer patients.