Psychological impact of hospital admission in cancer patients.

PURPOSE: Analyze the prevalence of anxiety and depression in hospitalized cancer patients and associated clinical and psychosocial factors. METHODS: A single-center, prospective, observational study was conducted in the Oncology Department of Miguel Servet Hospital (HUMS). Patients completed Hospital Anxiety and Depression Scale (HADS), Duke-UNC Functional Social Support Questionnaire (DUKE), and Consumer Assessment of Healthcare Providers and Systems (CAHPS). Clinical and psychosocial variables were collected. RESULTS: 166 patients were included. Prevalence of anxiety at admission was 47% (95% CI: 39-55%) and depression 43% (95% CI: 35-51%), decreasing at discharge to 40% (95% CI:32-48%) and 39% (95% CI:31-47%), respectively. Baseline anxiety was associated with anxiolytics (29.5% vs 13.6%; p = 0.012) and antidepressants use (25.6% vs 11.4%; p = 0.017); baseline depression with Eastern Cooperative Oncology Group Performance Status (ECOG) ≥ 2 (64.7% vs 42.1%; p = 0.022) and opioid (62% vs 41.1%; p = 0.008). At discharge, higher anxiety was associated with poorer patient-oncologist relationship (26.7% vs 12.1%; p = 0.022), and higher anxiety (r = -0.15, p = 0.01) and depression (r = -0.3, p = 0.001) with lower social support. At discharge, fatigue was associated with increased anxiety (36.7% vs 18.7%; p = 0.013) and depression (35.6% vs 19.6%; p = 0.028); pre-admission anxiolytics use, to greater anxiety (28.3% vs 14.3%; p = 0.034) and depression (27.1% vs 15.2%; p = 0.074); pre-admission antidepressants use (30.5% vs 9.8%; p = 0.001) and opioids (57.6% vs 39.1%; p = 0.026) with greater depression. CONCLUSIONS: Hospitalized cancer patients show high prevalence of anxiety and depression. Poorer doctor-patient relationship, less social support, fatigue, and pre-admission anxiolytics use were associated with greater anxiety and depression; pre-admission antidepressants and opioids were associated with depression.