Understanding psychological distress during chemotherapy: Assessment of anxiety and depression in Middle Eastern cancer patients.

Abstract

e24117 Background: Anxiety and depression are common but often under-recognized in patients receiving chemotherapy and may adversely affect adherence, symptom reporting, and quality of life. Data from Middle Eastern oncology populations are limited, and use of brief screening tools is not widely implemented in regional practice. Methods: In this cross-sectional study at Burjeel Hospital, Oman, adults aged 18–75 years with solid tumors on active chemotherapy completed PHQ-9 and GAD-2 questionnaires during routine visits. Demographic and clinical data (age, sex, cancer type, stage, therapy line, ECOG performance status) were collected from records. Moderate-to-severe depression was defined as PHQ-9 ≥10 and clinically significant anxiety as GAD-2 ≥3. Descriptive statistics and multivariable logistic regression identified factors associated with higher symptom burden. Results: Of 112 eligible patients, 108 (96%) completed both instruments (61% female; mean age 54 ± 11 years). Tumor types reflected regional patterns: breast (28%), colorectal (19%), lung (14%), ovarian (6%), endometrial (4%), head and neck (9%), lymphoma (8%), others (12%). Overall, 38% met criteria for moderate-to-severe depression and 31% had significant anxiety. Depression was more frequent in females (46% vs 27%, p = 0.04), advanced disease (OR 2.3, 95% CI 1.1–4.7), and second-line or later chemotherapy (OR 1.9, 95% CI 1.0–3.8, p = 0.02). Anxiety correlated with depression (r = 0.68, p < 0.001) but not age, tumor site, or performance status. Conclusions: A high burden of anxiety and depression was observed among chemotherapy patients in Oman, underscoring the need for routine psychosocial screening. Integrating brief tools such as PHQ-9 and GAD-2 with referral pathways to psycho-oncology, counseling, and culturally adapted supportive programs may help reduce distress and improve adherence and outcomes. Depression and anxiety prevalence across clinical characteristics. Characteristic Subgroup Depression PHQ-9>10 n/N(%) Anxiety GAD-2 n/N (%) Depression (p) Anxiety (p) Gender Female 30/66 (46%) 23/66 (35%) 0.04 0.12 Male 11/42 (2 7%) 11/42 (26%) Disease Stage Early (I-II) 8/35 (22%) 8/35 (23%) <0.05 0.08 Advanced (III-IV) 33/73 (45%) 26/73 (3 6%) OR (I. 1-4.7) Treatment Line First-Line 15/54 (2 8%) 12/54 (22%) 0.02 0.03 Second-Line 16/3 8 (42%) 13/3 8 (3 4%) Third-Line + 10/16 (5 5%) 9/16 ( 56%) OR 1.9 (1.0-3.8) ECOG PS 0-1 30/85 (3 5%) 25/85 (29%) 0.45 >/= 2 11/23 (48%) 9/23 (39%)