Prevalence of Depression, Anxiety, and Suicidality Among Breast Cancer Patients at Kenyatta National Hospital, Kenya

Abstract

Background: Breast cancer cases are increasing worldwide. Females with BC accounted for 2.1 million (11.6 percent) of the 18.1 million cancer cases reported worldwide in the year, 2018. Many studies indicate low quality of life among patients diagnosed with cancer. Increased risk of depression as well as anxiety in such patients has been associated with higher rate of mor-tality. In the long run, this may add to the burden on families, communities and might also increase healthcare consumption and costs. Resulting psychiatric morbidities in such patients negatively impact patient well-being and adversely affect prognosis and treatment outcome. Broad Objective: The over-all objective of the study was to outline the prevalence of Depression, Anxiety, and Suicidality in patients of BC attending CTC at Kenyatta National Hospital. Methodology: This cross-sectional descriptive study utilized purposive sampling to enroll 100 patients of breast cancer. Data was collected at the KNH, Cancer Treatment Centre (CTC) utilizing questionnaires. The Hospital Anxiety Depression Scale used to determine whether or not a patient is depressed and/or anxious. Suicidality assessed using Beck’s scale for Suicidal Ideation. A re-searcher-designed Socio-Demographic Questionnaire was used to capture other crucial data. SPSS version 22.0 was used for analysis of the data. Frequency tables, charts, and bar graphs used to depict and demonstrate the discrete variables, mean and standard deviation used for analyz-ing continuous variables. Bivariate analysis employed to analyze links between dependent, inde-pendent and moderating variables comprising of correlation and chi-square tests. Multivariate analysis will be performed for correlates, if and where applicable. To obtain adjusted odds ratios for multivariate analysis, regression analysis will be used. Results: Depression was prevalent in 33% of patients. 7% had mild, 18% had moderate and 8% had severe depression respectively. Overall anxiety noted in 39% patients of which 9% had mild, 17% moderate and 13% had severe anxiety according to HADS scale. Suicidal ideation was seen in 14% of patients. Additional findings from the study showed significant association of socio-demographic factors like, living alone (p-0.019), use of chemotherapy (0.039) with prevalence of depression; surgery (p-0.027), duration of diagnosis (0.047) and recurrence (0.009) of cancer with prevalence of anxiety; chemotherapy (p-0.020) and recurrence (0.005) with suicidal ideation in BC patients. 11 Conclusion: The prevalence of depression, anxiety and suicidality was substantial in BC patients attending CTC, KNH. This upholds the importance of need for timely psychological interventions and early psychiatric screening, assessment and treatment to equip patients with better mental health and outcome. These measures will enhance treatment adherence in patients and possibly lower healthcare costs.