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Are depressive symptoms more common among British South Asian patients compared with British White patients with cancer? A cross-sectional survey.

Abstract：

OBJECTIVES:This cross-sectional survey investigated whether there were ethnic differences in depressive symptoms among British South Asian (BSA) patients with cancer compared with British White (BW) patients during 9 months following presentation at a UK Cancer Centre. We examined associations between depressed mood, coping strategies and the burden of symptoms. DESIGN:Questionnaires were administered to 94 BSA and 185 BW recently diagnosed patients with cancer at baseline and at 3 and 9 months. In total, 53.8% of the BSA samples were born in the Indian subcontinent, 33% in Africa and 12.9% in the UK. Three screening tools for depression were used to counter concerns about ethnic bias and validity in linguistic translation. The Hospital Anxiety and Depression Scale (HADS-D), Patient Health Questionnaire-9 (both validated in Gujarati), Emotion Thermometers (including the Distress Thermometer (DT), Mini-MAC and the newly developed Cancer Insight and Denial questionnaire (CIDQ) were completed. SETTING:Leicestershire Cancer Centre, UK. PARTICIPANTS:94 BSA and 185 BW recently diagnosed patients with cancer. RESULTS:BSA self-reported significantly higher rates of depressive symptoms compared with BW patients longitudinally (HADS-D ≥8: baseline: BSA 35.1% vs BW 16.8%, p=0.001; 3 months BSA 45.6% vs BW 20.8%, p=0.001; 9 months BSA 40.6% vs BW 15.3%, p=0.004). BSA patients used potentially maladaptive coping strategies more frequently than BW patients at baseline (hopelessness/helplessness p=0.005, fatalism p=0.0005, avoidance p=0.005; the CIDQ denial statement 'I do not really believe I have cancer' p=0.0005). BSA patients experienced more physical symptoms (DT checklist), which correlated with ethnic differences in depressive symptoms especially at 3 months. CONCLUSIONS:Health professionals need to be aware of a greater probability of depressive symptomatology (including somatic symptoms) and how this may present clinically in the first 9 months after diagnosis if this ethnic disparity in mental well-being is to be addressed.

journal_name

BMJ Open

journal_title

BMJ open

authors

Lord K,Ibrahim K,Kumar S,Mitchell AJ,Rudd N,Symonds RP

doi

10.1136/bmjopen-2013-002650

subject

Has Abstract

pub_date

2013-06-20 00:00:00

issue

issn

2044-6055

pii

bmjopen-2013-002650

journal_volume

pub_type

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Are depressive symptoms more common among British South Asian patients compared with British White patients with cancer? A cross-sectional survey.