Managing Depression in Cancer Patients

Study finds depression in African American cancer patients has gone under-recognized.

Depression in African American cancer patients is an under-recognized factor in treatment, a recent study indicated.

The accurate assessment of depression in cancer patients has been found to be difficult due to the similarity of the physical symptoms for both cancer and depression, including decreased energy, lack of sleep, and loss of appetite, the study noted. The identification and treatment of depression during cancer therapy is vital due to the correlation between an optimistic outlook and longer survival, according to the study.

"African American cancer patients are often sicker and have more severe physical symptoms," researcher Amy Zhang, PhD, said in a press release. "So I wanted to see if something was missing in how and what we were asking patients."

The researchers evaluated 74 cancer patients, 34 of whom were depressed, 23 were non-depressed African Americans, and 17 were depressed Caucasians. The investigators sought to identify the symptoms of depression in African American cancer patients through comparisons with the other patient groups.

The participants underwent treatment for early-stage breast cancer or prostate cancer within the previous 3 years and were at least 6 months removed from their last treatment. During a series of open-ended questions to measure depression, the depressed African American patients reported feelings of irritability and wanting to be alone more frequently than non-depressed patients.

These feelings are generally not described on the diagnostic test for depression, according to the study.

The patients also reported increased insomnia, fatigue, and said they cried more frequently.

The depressed African American patients were found to report sad feelings less frequently than depressed Caucasian patients, however. Additionally, numerous African American cancer patients used terms other than depressed to describe their feelings, including saying they were "feeling down," "gloomy," "low" or "blue."

"Because we don't use those words in standardized testing, we could be losing people with depression," Zhang said.

The study concluded that standard psychological tests are primarily based on responses from Caucasian patients, therefore more culturally sensitive depression benchmarks may be useful to measure irritability and social isolation.

The study results may aid clinicians to more accurately diagnose and treat depression through new questions that target its symptoms. The researchers next plan to test a greater number of participants to evaluate whether new culturally sensitive questions and descriptions of symptoms conclude with improved diagnoses and treatment for African American patients suffering from depression.