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

Abstract

Background Cancer survivors (CS) 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 CS’ anxiety and depression. Methods A cross‐sectional study was conducted among 1,546 CS 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 CS were 28.2 % and 48.2%, respectively. 74.9% CS had one or more comorbidities. Almost all CCDs examined showed associations with anxiety, except for CS with diabetes. CS with hyperlipidemia, diabetes, heart and cardiovascular diseases, and musculoskeletal diseases had significantly greater depression scores. When compared with those without CCD, CS with 1‐2 CCDs and ≥3 CCDs had higher risks of anxiety and depression. Conclusions Anxiety and depression were more prevalent among CS who also had CCDs. CCD have significantly negative association with CS’ anxiety and depression. Further cohort research will help deduce the causal relationships between CCDs, and anxiety and depression.