THE RELATIONSHIP BETWEEN SELF-REPORTED GENERAL HEALTH AND OBSERVED DEPRESSION AND ANXIETY IN CANCER-PATIENTS DURING CHEMOTHERAPY

In a prospective follow-up study of 30 patients before and during inte rmittent chemotherapy for solid malignancies, depression and anxiety w ere assessed with the Hamilton rating scales, and self-reported genera l health was measured by the General Health Questionnaire (GHQ), Funct ional Living Index-Cancer (FLIC), and Quality of Life Index (QLI). The re were no significant changes in levels of psychopathology or self-re ported health after 3 months of chemotherapy, but a significant decrea se in Hamilton scores was seen after 6 months among patients respondin g favorably to chemotherapy. Although states of depression and anxiety occurred in more than 40% of the patients, they were not adequately d etected with the GHQ when using the recommended threshold score. Moreo ver, the commonly used FLIC and QLI were only moderately associated wi th observer ratings for anxiety and depression. The health-related qua lity of life concept is discussed, and the risk of neglecting signs of significant psychopathology in cancer patients is emphasized. It is s uggested that screening for depression in cancer patients should be pe rformed routinely.