Is there an association between haemoglobin, depression, and anxiety in cancer patients?

Objective: The aim of this study was to examine the association between haemoglobin levels, anxiety disorder, and depression in cancer patients. Methods: Cancer patients attending The Norwegian Radium Hospital (NRH) rated themselves on the Hospital Anxiety and Depression Scale (HADS). Five hundred thirty-two patients also had valid measurements of haemoglobin at the same time. The associations between tertile baemoglobin levels (7.0-12.3 g/dl, 12.4-13.8 g/dl, 13.9-17.1 g/dl) and HADS-defined anxiety disorder and depression were analysed by logistic regression. Results: HADS-defined depression was identified in 116 cases (22%) and anxiety disorder in 149 (28%). The haemoglobin levels of the lower and middle tertiles were associated with depression (OR=3.85, 95% CI: 2.06-7.21, and OR=2.45, 95% CI: 1.25-4.81, respectively). Adjustment for covariates did not change the association significantly. No association between haemoglobin and anxiety disorder was found. Conclusion: In cancer patients, the risk of depression increases with decreasing haemoglobin levels. This should be taken into account when treatment of anaemic or depressed cancer patients is decided upon. (c) 2005 Elsevier Inc. All rights reserved.