Tuesday, 19 August 2008

Cancer and depression

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Depression in people with cancer is not "normal"

A recent study reported widely (although not referenced) has shown that feeling significantly depressed occurred in 8% of a sample of 2900 people with cancer in the UK compared to 2.6% in the general population. The study was done by the Psychological Medicine Research group at the University of Edinburgh. It builds on ten years of major work in this area including their recent Lancet RCT which used problem solving therapy (amongst other interventions) in depressed people (Strong, V., Waters, R., Hibberd, C., Murray, G. D., Wall, L., McHugh, G. L., Walker, A., & Sharpe, M. 2008,"Management of depression for people with cancer (SMaRT oncology 1): a randomised trial",The Lancet - Vol. 372, Issue 9632, 5 July 2008, Pages 40-48).

The fact that depression is common in people with cancer is not on the face of it that surprising. When bad things happen to people they grieve for what they have lost - which includes going through a period of depression. Maybe what is more surprising is that 92% of people reported not feeling significantly depressed. In liaison psychiatry one of the major day to day issues is the problem of other health professions not recognising significant depression because it is "understandable" or normal. One take home message from this study is that even when bad things happen most people do not get depressed and feeling that they would be better off dead is not a normal and "understandable" reaction.