Association between anxiety, depression, and comorbid chronic diseases among cancer survivors

OBJECTIVE: Cancer survivors (CSs) often face the dual physical burden of cancer and other comorbid chronic disease (CCD) and have a great deal of psychological distress, such as anxiety and depression. However, the association between CCD and psychological problems remain less clear in CS. This study was performed to investigate the prevalence of anxiety and depression in Chinese CS, and whether CCD have impact on CSs' anxiety and depression. METHODS: A cross-sectional study was conducted among 1546 CSs in Shanghai, China. All participants were asked to complete a questionnaire containing Zung self-rating anxiety scale (SAS), Zung self-rating depression scale (SDS), and questions on sociodemographic characteristics and CCD. Associations between CCDs, and anxiety and depression, were evaluated by using logistic regression, adjusted for confounding factors. RESULTS: The prevalence of anxiety and depression in CSs were 28.2 % and 48.2%, respectively. 74.9% CSs had one or more comorbidities. Almost all CCDs examined showed associations with anxiety, except for CSs with diabetes. CSs with hyperlipidemia, diabetes, heart and cardiovascular diseases, and musculoskeletal diseases had significantly greater depression scores. When compared with those without CCD, CSs with one to two CCDs and greater than or equal to three CCDs had higher risks of anxiety and depression. CONCLUSIONS: Anxiety and depression were more prevalent among CSs who also had CCDs. CCD have significantly negative association with CSs' anxiety and depression. Further cohort research will help deduce the causal relationships between CCDs, and anxiety and depression.