Cancer Pain, Anxiety, and Depression in Admitted Patients at a Tertiary Care Hospital: A Prospective Observational Study

Anshika Arora; Sunil K Saini; Vipul Nautiyal; S K Verma; Meenu Gupta; B P Kalra; Mushtaq Ahmad

doi:10.4103/IJPC.IJPC_4_19

Cancer Pain, Anxiety, and Depression in Admitted Patients at a Tertiary Care Hospital: A Prospective Observational Study

Indian J Palliat Care. 2019 Oct-Dec;25(4):562-566. doi: 10.4103/IJPC.IJPC_4_19.

Authors

Anshika Arora¹, Sunil K Saini¹, Vipul Nautiyal², S K Verma³, Meenu Gupta², B P Kalra⁴, Mushtaq Ahmad²

Affiliations

¹ Department of Surgery, Cancer Research Institute, SRHU, Dehradun, Uttarakhand, India.
² Department of Radiotherapy, Cancer Research Institute, SRHU, Dehradun, Uttarakhand, India.
³ Department of Medicine, Cancer Research Institute, SRHU, Dehradun, Uttarakhand, India.
⁴ Department of Paediatrics, Cancer Research Institute, SRHU, Dehradun, Uttarakhand, India.

Abstract

Context: Pain is the most common symptom in admitted cancer patients. The association between the severity of cancer pain and distress symptoms such as depression and anxiety is a subject of research.

Aims: The aim is to study the prevalence of pain, anxiety, and depression in admitted cancer patients and determine the association between pain and anxiety and depression at a tertiary cancer care institute.

Settings and design: This was prospective observational study.

Subjects and methods: We enrolled 393 cancer inpatients prospectively after written informed consent. Their disease details, presence, severity, and character of pain were recorded. Numerical Pain Scale was used for pain scores, self-reporting Hospital Anxiety and Depression Scale for anxiety and depression.

Statistical analysis used: Normal data were analyzed with parametric, nonnormal with nonparametric methods, and categorical with the Chi-square test.

Results: The prevalence of moderate-to-severe pain was 41.5%, anxiety 20.3%, and depression 24.8%. Proportion of patients with anxiety and depression was 9.2% and 17.7% in patients with no pain; about 32.8% and 36.7% with severe pain, respectively (P < 0.000). In patients with no depression 6% had anxiety; with depression 44.9% had anxiety (P < 0.000). Odd's ratio to have anxiety and depression was 4.44 (95% confidence interval [CI] 2.0318-9.7024) and 2.92 (95% CI 1.5739-5.4186), respectively, in patients with pain as compared to no pain (P < 0.00). There was a positive correlation between pain, anxiety, and depression scores.

Conclusions: There is strong association between the presence and severity of pain and distress symptoms such as anxiety and depression in admitted cancer patients.

Keywords: Association of cancer pain and distress; cancer pain; hospital anxiety and depression score; numerical pain scale; prevalence of anxiety; prevalence of depression.