Depression, Anxiety, and Other Mental Disorders in Patients With Cancer in Low- and Lower-Middle–Income Countries: A Systematic Review and Meta-Analysis
PURPOSECancer is a growing public health issue in low- and lower-middle–income countries (LLMICs), but the mental health consequences in this setting have not been well-characterized. We aimed to systematically evaluate the available literature on the prevalence, associates, and treatment of mental...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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American Society of Clinical Oncology
2021-12-01
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| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO.21.00056 |
| _version_ | 1818314455422861312 |
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| author | Zoe J. Walker Siqi Xue Michael P. Jones Arun V. Ravindran |
| author_facet | Zoe J. Walker Siqi Xue Michael P. Jones Arun V. Ravindran |
| author_sort | Zoe J. Walker |
| collection | DOAJ |
| description | PURPOSECancer is a growing public health issue in low- and lower-middle–income countries (LLMICs), but the mental health consequences in this setting have not been well-characterized. We aimed to systematically evaluate the available literature on the prevalence, associates, and treatment of mental disorders in patients with cancer in LLMICs.METHODSWe systematically searched Medline, PsycINFO, EMBASE, and CINAHL. We performed a random effects meta-analysis to determine the pooled prevalence of major depression or anxiety disorders in this population, defined by Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases criteria. We qualitatively reviewed studies that examined the prevalence of depressive or anxiety disorders defined by self-report tools, the prevalence of other mental disorders, associated factors of depressive and anxiety symptoms, and the treatment of mental disorders in this population.RESULTSForty studies spanning a 15-year period were included in the review. The pooled prevalence defined by Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases criteria was 21% for major depression (95% CI, 15 to 28) and 18% for anxiety disorders (95% CI, 8 to 30). Depressive and anxiety symptoms were most frequently associated with advanced disease and low levels of education. Among the four studies evaluating treatment, three evaluated the effectiveness of psychotherapy and one evaluated a yoga program.CONCLUSIONThe prevalence of depression and anxiety in patients with cancer generally appears higher in LLMICs than in upper-income countries. Our findings demonstrate the existence of a significant and underappreciated disease burden. We suggest that clinicians remain vigilant to psychiatric symptoms. Improved screening and treatment are likely to improve quality of life and reduce both morbidity and mortality. |
| first_indexed | 2024-12-13T08:49:55Z |
| format | Article |
| id | doaj.art-fb055724fdbc4f23b3a954544b5ebb35 |
| institution | Directory Open Access Journal |
| issn | 2687-8941 |
| language | English |
| last_indexed | 2024-12-13T08:49:55Z |
| publishDate | 2021-12-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | JCO Global Oncology |
| spelling | doaj.art-fb055724fdbc4f23b3a954544b5ebb352022-12-21T23:53:23ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412021-12-0171233125010.1200/GO.21.00056Depression, Anxiety, and Other Mental Disorders in Patients With Cancer in Low- and Lower-Middle–Income Countries: A Systematic Review and Meta-AnalysisZoe J. Walker0Siqi Xue1Michael P. Jones2Arun V. Ravindran3Department of Psychiatry, University of Toronto, Toronto, Ontario, CanadaDepartment of Psychiatry, University of Toronto, Toronto, Ontario, CanadaRoyal Hobart Hospital, Hobart, AustraliaDepartment of Psychiatry, University of Toronto, Toronto, Ontario, CanadaPURPOSECancer is a growing public health issue in low- and lower-middle–income countries (LLMICs), but the mental health consequences in this setting have not been well-characterized. We aimed to systematically evaluate the available literature on the prevalence, associates, and treatment of mental disorders in patients with cancer in LLMICs.METHODSWe systematically searched Medline, PsycINFO, EMBASE, and CINAHL. We performed a random effects meta-analysis to determine the pooled prevalence of major depression or anxiety disorders in this population, defined by Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases criteria. We qualitatively reviewed studies that examined the prevalence of depressive or anxiety disorders defined by self-report tools, the prevalence of other mental disorders, associated factors of depressive and anxiety symptoms, and the treatment of mental disorders in this population.RESULTSForty studies spanning a 15-year period were included in the review. The pooled prevalence defined by Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases criteria was 21% for major depression (95% CI, 15 to 28) and 18% for anxiety disorders (95% CI, 8 to 30). Depressive and anxiety symptoms were most frequently associated with advanced disease and low levels of education. Among the four studies evaluating treatment, three evaluated the effectiveness of psychotherapy and one evaluated a yoga program.CONCLUSIONThe prevalence of depression and anxiety in patients with cancer generally appears higher in LLMICs than in upper-income countries. Our findings demonstrate the existence of a significant and underappreciated disease burden. We suggest that clinicians remain vigilant to psychiatric symptoms. Improved screening and treatment are likely to improve quality of life and reduce both morbidity and mortality.https://ascopubs.org/doi/10.1200/GO.21.00056 |
| spellingShingle | Zoe J. Walker Siqi Xue Michael P. Jones Arun V. Ravindran Depression, Anxiety, and Other Mental Disorders in Patients With Cancer in Low- and Lower-Middle–Income Countries: A Systematic Review and Meta-Analysis JCO Global Oncology |
| title | Depression, Anxiety, and Other Mental Disorders in Patients With Cancer in Low- and Lower-Middle–Income Countries: A Systematic Review and Meta-Analysis |
| title_full | Depression, Anxiety, and Other Mental Disorders in Patients With Cancer in Low- and Lower-Middle–Income Countries: A Systematic Review and Meta-Analysis |
| title_fullStr | Depression, Anxiety, and Other Mental Disorders in Patients With Cancer in Low- and Lower-Middle–Income Countries: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Depression, Anxiety, and Other Mental Disorders in Patients With Cancer in Low- and Lower-Middle–Income Countries: A Systematic Review and Meta-Analysis |
| title_short | Depression, Anxiety, and Other Mental Disorders in Patients With Cancer in Low- and Lower-Middle–Income Countries: A Systematic Review and Meta-Analysis |
| title_sort | depression anxiety and other mental disorders in patients with cancer in low and lower middle income countries a systematic review and meta analysis |
| url | https://ascopubs.org/doi/10.1200/GO.21.00056 |
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