Depression and anxiety symptoms and their association with quality of life in patients with colorectal cancer: A cross-sectional study

Abstract

Background: Colorectal cancer is one of the most common types of cancer worldwide, including in Indonesia, and has a significant impact on patients’ quality of life. In addition to the physical burden it causes, colorectal cancer patients often experience psychological disorders such as depression and anxiety, which worsen their quality of life.
Aim: Although many studies have assessed the physical impact of cancer, the relationship between psychological disorders and quality of life still requires further attention.
Setting: This study was conducted at H. Adam Malik General Hospital in Medan, Sumatra.
Methods: This study used a correlative analytical design with a cross-sectional approach, involving 300 colorectal cancer patients. Data were collected using the Patient Health Questionnaire-9 (PHQ-9), Hospital Anxiety and Depression Scale-Anxiety subscale (HADS-A) and World Health Organization Quality of Life-Brief (WHOQOL-BREF) questionnaires to evaluate depression syndrome, anxiety levels and quality of life. Spearman’s test, logistic regression and linear regression model were used in this study.
Results: The results of the study show that 41% of patients experienced severe depression, while 58% of patients experienced severe anxiety. There was a strong negative correlation between symptoms of depression (PHQ-9) and anxiety (HADS-A) and quality of life (WHOQOL-BREF), with a p-value < 0.001 for both. Clinical factors such as stage IV and metastasis, as well as socioeconomic status such as employment and education, were also found to have a significant association.
Conclusion: Psychological disorders, particularly depression and anxiety, significantly affect the quality of life of colorectal cancer patients. Psychological interventions, such as cognitive behavioural therapy (CBT), are essential to reduce symptoms of depression and anxiety and improve patients’ quality of life.
Contribution: Strong social support has also been shown to play an important role in improving patients’ psychological well-being and treatment outcomes.