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

Journal: BMJ open

Volume: 3

Issue: 6

Year of Publication: 2013

Affiliated Institutions:  Department of Oncology, University Hospitals of Leicester NHS Trust, Leicester, UK.

Abstract summary 

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.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.Leicestershire Cancer Centre, UK.94 BSA and 185 BW recently diagnosed patients with cancer.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.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.

Authors & Co-authors:  Lord Karen K Ibrahim Kausher K Kumar Sawan S Mitchell Alex J AJ Rudd Nicky N Symonds R Paul RP

Study Outcome 

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Citations :  Kennard BD, Stewart SM, Olvera R, et al. Nonadherence in adolescent oncology patients: preliminary data on psychological risk factors and relationships to outcome. J Clin Psychol Med S 2004;11:31–9
Authors :  6
Identifiers
Doi : e002650
SSN : 2044-6055
Study Population
Male,Female
Mesh Terms
Other Terms
Depression;Ethnicity;Mental Health
Study Design
Cross Sectional Study
Study Approach
Country of Study
Publication Country
England