Physical complaints may suggest depression in cancer patients
Published by University of Leicester Press Office for University of Leicester in Education and also in Health
New study in cancer shows physical symptoms are amplified by depression and should not be ignored
New research from the University of Leicester demonstrates that physical symptoms may be indicative of depression in cancer patients.
Bodily complaints such as fatigue, insomnia and poor appetite are known to be symptoms of depression in primary care but traditional teaching suggested that these so called somatic symptoms of depression should be ignored in medical settings where they are assumed to be contaminants of physical illness.
Researchers from the University Department of Cancer Studies and Molecular Medicine examined somatic and non-somatic symptoms in 279 patients seen up to three times following their cancer diagnosis. 31% were in a palliative stage. Their research has been published on line ahead of print in the Journal of Affective Disorders.
Depression was diagnosed by self-report PHQ9 and HADS-D scales and using DSMIV criteria. The researchers found that when looking for broadly defined depression the most accurate diagnostic symptoms were all somatic (namely trouble sleeping or sleeping too much; feeling tired or having little energy; poor appetite or overeating; trouble concentrating on things such as reading). When looking for more severe major depressive disorder (MDD) both somatic and non-somatic symptoms were valuable although one symptom “low energy” was poorly discriminating. In a subset of palliative patients, the symptom “moving or speaking slowly” was less influential but other somatic symptoms such as poor appetite/overeating and feeling tired or having little energy were valuable.
Dr Alex Mitchell, a consultant psychiatrist with the Leicestershire Partnership NHS Trust and a researcher at the University of Leicester, said: “Cancer clinicians should therefore be careful about attributing somatic symptoms of depression to cancer itself. This even applies in the later stages of cancer. Depression scales that exclude all physical symptoms may not be the optimal choice in cancer patients.”