DEPRESSIVE REACTIONS TO LUNG-CANCER ARE COMMON AND OFTEN FOLLOWED BY A POOR OUTCOME

In diverse human malignancies, including lung cancer, quality of life (QOL) affects the clinical outcome of patients, Many QOL dimensions, h owever, are influenced by physical status. The current study was under taken to delineate the role of depression, a state of mind not necessa rily influenced by somatic factors. All patients, seen for a newly dia gnosed carcinoma of the lung, received a copy of the Self-rating Depre ssion Scale (SDS) proposed by W.W.K. Zung. One hundred and thirty thre e patients were able and willing to complete the questionnaire, A depr ession index was calculated, as originally described. Nineteen other p rognostically important variables were recorded and available for eval uation. Among the 95 patients who completed all 20 items included in t he questionnaire, 53 had an SDS index less than or equal to 50 (no dep ression), while 42 were moderately or severely depressed (SDS index >5 0). The survival of depressed patients was significantly lower (p=0.04 8). Diverse SDS subscales were associated with survival, in either uni variate or multivariate analysis, SDS item 19, ''I feel that others wo uld be better off if I were dead'', emerged as the most significant on e. A multivariate model of survival, constructed using only SDS data, had a global Chi-squared value of 29.78, and a p-value of 0.00023. Bas ed on this evidence, it appears that a relationship does exist between patients' depression and prognosis, at least in lung cancer. Further studies are needed to clarify the prognostic effect of depression in m ore specific (and homogeneous) subgroups of patients.