Araştırma Makalesi
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Kanser hastalarında anksiyete, depresyon ve yaşam kalitesinin kapsamlı değerlendirilmesi: klinik, sosyodemografik ve psikososyal etkenler

Yıl 2025, Cilt: 6 Sayı: 5, 575 - 581, 24.10.2025

Öz

Özet
Amaç:
Kanser hastalarında anksiyete ve depresyon prevalansını değerlendirmek, sosyodemografik ve klinik belirleyicileri ortaya koymak ve yaşam kalitesi (YK) ile ilişkilerini incelemek.

Yöntemler:
Üçüncü basamak bir onkoloji kliniğinde 750 yetişkin kanser hastası üzerinde kesitsel bir çalışma yürütüldü. Anksiyete ve depresyon sırasıyla Beck Anksiyete Envanteri (BAE) ve Beck Depresyon Envanteri (BDE) ile ölçüldü; yaşam kalitesi ise EORTC QLQ-C30 ile değerlendirildi. Sosyodemografik ve klinik veriler yapılandırılmış formlar aracılığıyla toplandı. Karşılaştırmalı, korelasyon ve alt grup analizleri yapıldı; p < 0,05 istatistiksel olarak anlamlı kabul edildi.

Bulgular:
Anksiyete ve depresyon prevalansı sırasıyla %46,5 ve %42,4 olup, iki durum arasında anlamlı komorbidite görüldü. Anksiyete, kadınlarda, dul bireylerde ve geleneksel olmayan yaşam düzenine sahip olanlarda daha sık gözlendi ve en yüksek oran jinekolojik kanserli hastalarda saptandı. Depresyon ise demografik veya klinik faktörlerle anlamlı bir ilişki göstermedi. Anksiyete; duygusal, bilişsel ve sosyal işlevsellik ile negatif korelasyon gösterirken, depresyon yalnızca duygusal işlevsellik ile ilişkili bulundu. Eşzamanlı anksiyete–depresyonu olan hastalar, duygusal işlevsellikte en belirgin bozulmayı gösterdi.

Sonuç:
Anksiyete ve depresyon kanser hastalarında yüksek prevalansa sahiptir ve yaşam kalitesi üzerinde farklı ancak kısmen örtüşen etkilere sahiptir. Anksiyete birden fazla işlevsel alanı etkilerken, depresyon daha çok duygusal boyutta sınırlı kalmıştır. Kadın cinsiyet, dul olma ve sınırlı sosyal destek başlıca risk faktörleri olarak öne çıkmıştır; kanser tipi, metastaz ve diğer komorbiditelerin etkisi ise sınırlı bulunmuştur. Bulgular, rutin onkoloji bakımında evrensel distres taramasının ve bütünleşik psikososyal desteğin gerekliliğini vurgulamaktadır.

Anahtar Kelimeler: Anksiyete; Depresyon; Yaşam Kalitesi; Kanser; Psikososyal Komorbidite; Kesitsel Çalışma; Beck Anksiyete Envanteri; Beck Depresyon Envanteri; EORTC QLQ-C30; Sosyodemografik Faktörler; Klinik Belirleyiciler; Prevalans; Duygusal İşlevsellik; Bilişsel İşlevsellik; Sosyal İşlevsellik; Psikososyal Müdahaleler; Distres Taraması

Kaynakça

  • Mitchell AJ, Chan M, Bhatti H, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12(2):160-174. doi:10.1016/S1470-2045(11)70002-X
  • Walker J, Hansen CH, Martin P, et al. Prevalence, associations, and adequacy of treatment of major depression in patients with cancer: a cross-sectional analysis of routinely collected clinical data. Lancet Psychiatry. 2014;1(5):343-350. doi:10.1016/S2215-0366(14)70313-X
  • Wang X, Wang N, Zhong L, et al. Prognostic value of depression and anxiety on breast cancer recurrence and mortality: a systematic review and meta-analysis of 282,203 patients. Mol Psychiatry. 2020;25(12):3186-3197. doi:10.1038/s41380-020-00865-6
  • Warth M, Zöller J, Köhler F, Aguilar-Raab C, Kessler J, Ditzen B. Psychosocial interventions for pain management in advanced cancer patients: a systematic review and meta-analysis. Curr Oncol Rep. 2020; 22(1):3. doi:10.1007/s11912-020-0870-7
  • Tarhani M, Goudarzi F, Hasanvand S, Ebrahimzadeh F, Rassouli M. Uncertainty, anxiety, depression, and the quality of life in patients with cancer. Oncol Radiotherapy. 2020;1(46):20-27.
  • Walker J, Mulick A, Magill N, et al. Major depression and survival in people with cancer. Psychosom. Med. 2021:83(5):410-416. doi:10.1097/PSY.0000000000000942
  • Andersen BL, DeRubeis RJ, Berman BS, et al. Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation. J Clin Oncol. 2014;32(15):1605-1619. doi:10.1200/JCO.2013.52.4611
  • Kangas M, Henry JL, Bryant RA. Correlates of acute stress disorder in cancer patients. J Trauma Stress. 2007;20(3):325-334. doi:10.1002/jts. 20253
  • Vella SL, Pai NB. A theoretical review of psychological resilience: defining resilience and resilience research over the decades. Arch Med Health Sci. 2019;7(2):233-239. doi:10.4103/amhs.amhs_119_19
  • Ngan TT, Tien TH, Donnelly M, O'Neill C. Financial toxicity among cancer patients, survivors and their families in the United Kingdom: a scoping review. J Public Health (Oxf). 2023;45(4):e702-e713. doi:10.1093/pubmed/fdad143
  • Wang YH, Li JQ, Shi JF, et al. Depression and anxiety in relation to cancer incidence and mortality: a systematic review and meta-analysis of cohort studies. Mol Psychiatry. 2020;25(7):1487-1499. doi:10.1038/s41380-019-0595-x
  • Crist JV, Grunfeld EA. Factors reported to influence fear of recurrence in cancer patients: a systematic review. Psycho-Oncology. 2013;22(5):978-986. doi:10.1002/pon.3114
  • Vitale E, Halemani K, Shetty A, et al. Sex differences in anxiety and depression conditions among cancer patients: a systematic review and meta-analysis. Cancers 2024:16(11);1969. doi:10.3390/cancers16111969
  • Hopwood P, Sumo G, Mills J, Haviland J, Bliss JM; START Trials Management Group. The course of anxiety and depression over 5 years of follow-up and risk factors in women with early breast cancer: results from the UK Standardisation of Radiotherapy Trials (START). Breast. 2010;19(2):84-91. doi:10.1016/j.breast.2009.11.007
  • Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988; 56:893-897. doi:10.1037/0022-006X.56.6.893
  • Hong Y, Yuhan L, Youhui G, et al. Death anxiety among advanced cancer patients: a cross-sectional survey. Support Care Cancer. 2022;30(4):3531-3539. doi:10.1007/s00520-022-06795-z
  • Arch JJ, Bright EE, Finkelstein LB, et al. Anxiety and depression in metastatic cancer: a critical review of negative impacts on advanced care planning and end-of-life decision making with practical recommendations. JCO Oncol Pract. 2023;19(12):1097-1108. doi:10.1200/OP.23.00287
  • Laporte-Estela G, Rivera-Vélez M, Ayala-Rodríguez P, et al. The impact of employment and economic perception on nutrition and depression among cancer survivors. Healthcare (Basel). 2025;13(16):2075. doi:10. 3390/healthcare13162075
  • Riedl D, Schüßler G. Factors associated with and risk factors for depression in cancer patients-a systematic literature review. Transl Oncol. 2022;16:101328. doi:10.1016/j.tranon.2021.101328
  • Marzorati C, Voskanyan V, Sala D, et al.; EUonQoL Consortium. Psychosocial factors associated with quality of life in cancer patients undergoing treatment: an umbrella review. Health Qual Life Outcomes. 2025;23(1):31. doi:10.1186/s12955-025-02357-z
  • Lopes C, Severo M, Fontes F, et al. Trajectories of anxiety and depression symptoms over five years since breast cancer diagnosis: results of the NEON-BC prospective study. Healthcare. 2022;10(4):661. doi:10.3390/healthcare10040661
  • Chen F, Deng Y, Li S, et al. Fear of cancer recurrence and perceived pain in patients with breast cancer: a network analysis approach. Asia Pac J Oncol Nurs. 2025;12:100763. doi:10.1016/j.apjon.2025.100763
  • Finck C, Barradas S, Zenger M, Hinz A. Quality of life in breast cancer patients: associations with optimism and social support. Int J Clin Health Psychol. 2018;18(1):27-34. doi:10.1016/j.ijchp.2017.11.002
  • Arrieta O, Angulo LP, Núñez-Valencia C, et al. Association of depression and anxiety on quality of life, treatment adherence, and prognosis in patients with advanced non-small cell lung cancer. Ann Surg Oncol. 2013;20(6):1941-1948. doi:10.1245/s10434-012-2793-5
  • Price SN, Palmer AM, Fucito LM, et al. Tobacco use and cancer-related symptom burden: analysis of the US Population Assessment of Tobacco and Health Study. Cancer. 2023;129(15):2385-2394. doi:10.1002/cncr. 34746
  • Riba MB, Donovan KA, Ahmed K, et al. NCCN Guidelines® insights: distress management, version 2.2023. J Natl Compr Canc Netw. 2023; 21(5):450-457. doi:10.6004/jnccn.2023.0026

Comprehensive evaluation of anxiety, depression, and quality of life in cancer patients: clinical, sociodemographic, and psychosocial influences

Yıl 2025, Cilt: 6 Sayı: 5, 575 - 581, 24.10.2025

Öz

Aims: It was aimed to evaluate the prevalence of anxiety and depression among cancer patients, and examine their association with quality of life (QoL).
Methods: A cross-sectional study was conducted, including 750 adult cancer patients at a tertiary oncology outpatient clinic. Anxiety and depression status were measured using the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI), respectively, while QoL was assessed with the EORTC QLQ-C30. Sociodemographic and clinical data were collected through structured forms. Comparative, correlation, and subgroup analyses were performed, with p<0.05 considered statistically significant.
Results: The prevalence of anxiety and depression was 46.5% and 42.4%, respectively, Anxiety was more common among females, widowed individuals, and those living in non-traditional arrangements, and was highest in patients with gynecological cancers. Depression showed no significant association with demographic or clinical factors. Anxiety was negatively correlated with emotional, cognitive, and social functioning, whereas depression was selectively linked to emotional functioning. Patients with comorbid anxiety–depression demonstrated the most significant impairment in emotional functioning.
Conclusion: Anxiety and depression are highly prevalent in cancer patients and exert distinct but overlapping effects on QoL, with anxiety impacting multiple functional domains. Female sex, widowhood, and limited social support emerged as key risk factors, whereas cancer type, metastasis, and comorbidity had a minor influence. These findings underscore the need for universal distress screening and integrated psychosocial support in routine oncology care.

Kaynakça

  • Mitchell AJ, Chan M, Bhatti H, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: a meta-analysis of 94 interview-based studies. Lancet Oncol. 2011;12(2):160-174. doi:10.1016/S1470-2045(11)70002-X
  • Walker J, Hansen CH, Martin P, et al. Prevalence, associations, and adequacy of treatment of major depression in patients with cancer: a cross-sectional analysis of routinely collected clinical data. Lancet Psychiatry. 2014;1(5):343-350. doi:10.1016/S2215-0366(14)70313-X
  • Wang X, Wang N, Zhong L, et al. Prognostic value of depression and anxiety on breast cancer recurrence and mortality: a systematic review and meta-analysis of 282,203 patients. Mol Psychiatry. 2020;25(12):3186-3197. doi:10.1038/s41380-020-00865-6
  • Warth M, Zöller J, Köhler F, Aguilar-Raab C, Kessler J, Ditzen B. Psychosocial interventions for pain management in advanced cancer patients: a systematic review and meta-analysis. Curr Oncol Rep. 2020; 22(1):3. doi:10.1007/s11912-020-0870-7
  • Tarhani M, Goudarzi F, Hasanvand S, Ebrahimzadeh F, Rassouli M. Uncertainty, anxiety, depression, and the quality of life in patients with cancer. Oncol Radiotherapy. 2020;1(46):20-27.
  • Walker J, Mulick A, Magill N, et al. Major depression and survival in people with cancer. Psychosom. Med. 2021:83(5):410-416. doi:10.1097/PSY.0000000000000942
  • Andersen BL, DeRubeis RJ, Berman BS, et al. Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: an American Society of Clinical Oncology guideline adaptation. J Clin Oncol. 2014;32(15):1605-1619. doi:10.1200/JCO.2013.52.4611
  • Kangas M, Henry JL, Bryant RA. Correlates of acute stress disorder in cancer patients. J Trauma Stress. 2007;20(3):325-334. doi:10.1002/jts. 20253
  • Vella SL, Pai NB. A theoretical review of psychological resilience: defining resilience and resilience research over the decades. Arch Med Health Sci. 2019;7(2):233-239. doi:10.4103/amhs.amhs_119_19
  • Ngan TT, Tien TH, Donnelly M, O'Neill C. Financial toxicity among cancer patients, survivors and their families in the United Kingdom: a scoping review. J Public Health (Oxf). 2023;45(4):e702-e713. doi:10.1093/pubmed/fdad143
  • Wang YH, Li JQ, Shi JF, et al. Depression and anxiety in relation to cancer incidence and mortality: a systematic review and meta-analysis of cohort studies. Mol Psychiatry. 2020;25(7):1487-1499. doi:10.1038/s41380-019-0595-x
  • Crist JV, Grunfeld EA. Factors reported to influence fear of recurrence in cancer patients: a systematic review. Psycho-Oncology. 2013;22(5):978-986. doi:10.1002/pon.3114
  • Vitale E, Halemani K, Shetty A, et al. Sex differences in anxiety and depression conditions among cancer patients: a systematic review and meta-analysis. Cancers 2024:16(11);1969. doi:10.3390/cancers16111969
  • Hopwood P, Sumo G, Mills J, Haviland J, Bliss JM; START Trials Management Group. The course of anxiety and depression over 5 years of follow-up and risk factors in women with early breast cancer: results from the UK Standardisation of Radiotherapy Trials (START). Breast. 2010;19(2):84-91. doi:10.1016/j.breast.2009.11.007
  • Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988; 56:893-897. doi:10.1037/0022-006X.56.6.893
  • Hong Y, Yuhan L, Youhui G, et al. Death anxiety among advanced cancer patients: a cross-sectional survey. Support Care Cancer. 2022;30(4):3531-3539. doi:10.1007/s00520-022-06795-z
  • Arch JJ, Bright EE, Finkelstein LB, et al. Anxiety and depression in metastatic cancer: a critical review of negative impacts on advanced care planning and end-of-life decision making with practical recommendations. JCO Oncol Pract. 2023;19(12):1097-1108. doi:10.1200/OP.23.00287
  • Laporte-Estela G, Rivera-Vélez M, Ayala-Rodríguez P, et al. The impact of employment and economic perception on nutrition and depression among cancer survivors. Healthcare (Basel). 2025;13(16):2075. doi:10. 3390/healthcare13162075
  • Riedl D, Schüßler G. Factors associated with and risk factors for depression in cancer patients-a systematic literature review. Transl Oncol. 2022;16:101328. doi:10.1016/j.tranon.2021.101328
  • Marzorati C, Voskanyan V, Sala D, et al.; EUonQoL Consortium. Psychosocial factors associated with quality of life in cancer patients undergoing treatment: an umbrella review. Health Qual Life Outcomes. 2025;23(1):31. doi:10.1186/s12955-025-02357-z
  • Lopes C, Severo M, Fontes F, et al. Trajectories of anxiety and depression symptoms over five years since breast cancer diagnosis: results of the NEON-BC prospective study. Healthcare. 2022;10(4):661. doi:10.3390/healthcare10040661
  • Chen F, Deng Y, Li S, et al. Fear of cancer recurrence and perceived pain in patients with breast cancer: a network analysis approach. Asia Pac J Oncol Nurs. 2025;12:100763. doi:10.1016/j.apjon.2025.100763
  • Finck C, Barradas S, Zenger M, Hinz A. Quality of life in breast cancer patients: associations with optimism and social support. Int J Clin Health Psychol. 2018;18(1):27-34. doi:10.1016/j.ijchp.2017.11.002
  • Arrieta O, Angulo LP, Núñez-Valencia C, et al. Association of depression and anxiety on quality of life, treatment adherence, and prognosis in patients with advanced non-small cell lung cancer. Ann Surg Oncol. 2013;20(6):1941-1948. doi:10.1245/s10434-012-2793-5
  • Price SN, Palmer AM, Fucito LM, et al. Tobacco use and cancer-related symptom burden: analysis of the US Population Assessment of Tobacco and Health Study. Cancer. 2023;129(15):2385-2394. doi:10.1002/cncr. 34746
  • Riba MB, Donovan KA, Ahmed K, et al. NCCN Guidelines® insights: distress management, version 2.2023. J Natl Compr Canc Netw. 2023; 21(5):450-457. doi:10.6004/jnccn.2023.0026
Toplam 26 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Klinik Onkoloji, Psikiyatri
Bölüm Research Articles [en] Araştırma Makaleleri [tr]
Yazarlar

Nurullah İlhan 0000-0001-9908-9284

Süleyman Baş 0000-0002-5883-445X

Ayşegül Hopur İlhan 0000-0002-1108-8314

Alpaslan Tanoğlu 0000-0002-7477-6640

Yayımlanma Tarihi 24 Ekim 2025
Gönderilme Tarihi 25 Eylül 2025
Kabul Tarihi 16 Ekim 2025
Yayımlandığı Sayı Yıl 2025 Cilt: 6 Sayı: 5

Kaynak Göster

AMA İlhan N, Baş S, Hopur İlhan A, Tanoğlu A. Comprehensive evaluation of anxiety, depression, and quality of life in cancer patients: clinical, sociodemographic, and psychosocial influences. J Med Palliat Care / JOMPAC / Jompac. Ekim 2025;6(5):575-581.

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