Depressive symptoms in cancer patients and healthy controls: differences and similarities

Abstract

Literature on depressive symptoms prevalence among cancer patients is diverse. Several studies report higher levels compared to healthy controls, whereas others report only minimal differences or even similar levels. This diversity may be explained by the complex construct of depression and associated psychosocial factors. Instead of merely focusing on prevalence, it may be beneficial to investigate if depression among cancer patients is caused by similar mechanisms compared to healthy individuals. This way, psychological treatment can be more tailored. 249 curative treated patients were matched to 249 healthy controls on age, gender and education. Both samples received questionnaires, measuring depressive symptoms (CES-D), positive and negative affect, stress and coping. Conducted analyses involved t-tests for means and regression analyses for predictors. Patients scored higher on depressive symptoms (p=0.002) compared to healthy controls, with a prevalence of 21.7% and for healthy controls 12.6% (p=0.008). Positive (p=0.024) and negative affect (p=0.018) were significantly higher among cancer patients. Highest positive affect was reported by non-depressed cancer patients. Predictors of depressive symptoms including stress and coping were comparable between the groups. Higher levels of depressive symptoms were found among cancer patients compared to healthy controls, but predictors were comparable, with the exception of positive affect. This suggests that not diagnosis of cancer is indicative for depressed mood, but more the impact and coping with the disease. Future research may investigate the relationship between depressive symptoms and positive affect, with respect to a potential role of positive affect as a buffer for depressive symptoms in this population.