Prevalence, risk factors and prognostic role of anxiety and depression in surgical gastric cancer patients

Background: The present study was conducted to explore the prevalence, risk factors and prognostic role of anxiety and depression in surgical gastric cancer patients. Methods: Totally 200 gastric cancer patients who underwent surgical resection were enrolled and their Hospital Anxiety and Depression Scale (HADS) scores were assessed before surgery. Besides, 200 healthy controls were enrolled with their HADS scores assessed at enrollment. Results: The HADS-anxiety score (7.4 +/- 3.8 vs. 4.7 +/- 2.8, P<0.001), prevalence (42.5% vs. 13.5%, P<0.001) and severity (P=0.002) of anxiety were greatly increased in gastric cancer patients compared with healthy controls. And HADS-depression score (6.9 +/- 3.5 vs. 4.2 +/- 2.6, P<0.001), prevalence (33.5% vs. 10.0%, P<0.001) and severity (P=0.001) of depression were also dramatically elevated in gastric cancer patients compared with healthy controls. Regarding the factors predicting anxiety/depression risks in gastric cancer patients, gender (female) (P=0.003), diabetes (P<0.001), higher pathological grade (P=0.005), larger tumor size (P=0.044) and higher T stage (P=0.017) were independent predictive factors for higher risk of anxiety, and age (>60 years) (P=0.025), gender (female) (P=0.004), hyperlipidemia (P=0.039), diabetes (P<0.001) and higher TNM stage (P=0.003) were independent predictive factors for higher risk of depression. Most importantly, anxiety/depression and the severity of anxiety/depression were all negatively associated with disease-free survival as well as overall survival (all P<0.05) in surgical gastric cancer patients. Conclusions: Anxiety/depression are common and severe, which predicts unfavorable prognosis in gastric cancer patients underwent surgery, suggesting the necessity of psychological care post-surgery.