Key result
Task dependency is associated with ~24-fold higher depression risk in palliative care men versus women.
Why the study?
The usual gender differences in depression prevalence are less strong, absent, or reversed in palliative care settings, and reasons for excess depression among men were unclear.
Does dependency on others for basic tasks explain the higher prevalence of depression among men receiving palliative care?
Cross-Sectional (n=300)
No
Does dependency on others for basic tasks explain the higher prevalence of depression among men receiving palliative care?
Odds Ratio: 24.3 (95% CI 3.1–193.2)
Absolute Event Rate: 37.8% vs 2.4%
p-value: p=0.003
Dependency on others for basic tasks is a significant risk factor for depression in men receiving palliative care, which may explain the gender differences in depression prevalence in this setting.
May warrant gender-specific depression screening in palliative care; hypothesis-generating and requires prospective validation.
BACKGROUND: in community studies the prevalence of depression is higher in women than men; however, in palliative care settings this relationship is usually less strong, absent or reversed. AIM: to identify reasons for excess depression among men receiving palliative care. DESIGN: cross-sectional study. SETTING/PARTICIPANTS: we interviewed 300 patients recruited from a large hospice in South East London. Depression was measured using the Primary Care Evaluation of Mental Disorder. RESULTS: the higher prevalence of depression among men was not explained by a higher prevalence of particular types of cancer nor confounding by other covariates. Possible effect modifiers were examined. Depending on others for help with basic tasks (eating, dressing, washing or using the toilet) was a risk factor for depression in men only, with 37.8% of dependent men being depressed compared to 2.4% of similarly affected women (OR = 24.3, 3.1-193.2, p = 0.003). We observed a dose-response effect between the level of dependency and depression in men (p for trend = 0.01). CONCLUSION: depending on others for help with basic tasks appears to contribute to the burden of depression among men with terminal illness. This gender-specific association may explain why the usual gender differences in depression prevalence are not observed in palliative care.
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Hayes et al. (2011) conducted a cross-sectional in Terminal illness receiving palliative care (n=300). Dependency on others for basic tasks in men vs. Dependency on others for basic tasks in women was evaluated on Depression (OR 24.3, 95% CI 3.1-193.2, p=0.003). Dependency on others for basic tasks was a strong risk factor for depression in men receiving palliative care compared to similarly affected women (37.8% vs 2.4%; OR 24.3; 95% CI 3.1-193.2; p=0.003).
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