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Depression and Psychological Distress in Patients During the Year After Curative Resection of Non–Small-Cell Lung Cancer

From the Psycho-Oncology Division, National Cancer Center Research Institute East, and Psychiatry Division, National Cancer Center Hospital East, Kashiwa, Chiba; Psychiatry Division, National Shikoku Cancer Center, Matsuyama, Ehime; Thoracic Oncology Division, National Cancer Center Hospital East, Kashiwa, Chiba; and Division of Occupational Therapy, Institute of Health Sciences, Hiroshima University School of Medicine, Hiroshima, Japan.

Address reprint requests to Yosuke Uchitomi, MD, PhD, Psycho-Oncology Division, National Cancer Center Research Institute East, Kashiwanoha 6-5-1, Kashiwa, Chiba 277-8577, Japan; email: yuchitom{at}east.ncc.go.jp.

Purpose: There have been few psychosocial studies of patients after curative resection of non–small-cell lung cancer (NSCLC). The purpose of this study was to clarify the clinical course of depression and psychological distress of such patients during the year after surgery and to identify predictors of their long-term outcome.

Patients and Methods: A total of 212 patients completed assessments during a 12-month follow-up period after curative resection of NSCLC. Psychological measurements at 1, 3, and 12 months after surgery were conducted using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (ed 3), Revised, and the Profiles of Mood States (POMS) scale. Univariate and multivariate analyses were used to identify predictors of psychological outcome according to these two methods of assessment.

Results: The prevalence of depression did not change during the year after curative resection (range, 4.7% to 8.0%). The total POMS score was also unaltered during the year after surgery: the anger-hostility (P < .001) and tension-anxiety subscale scores (P < .026) had increased at 12 months, but the vigor-activity subscale score had also increased (P < .001). All predictors of psychological outcome at 12 months included a depression episode after the diagnosis of lung cancer or at 1 month after surgery. Less-educated status was also a significant predictor of depression at 12 months.

Conclusion: These results suggest the need for psychosocial support even after curative resection of NSCLC and indicate that an approach that includes repetitive perioperative assessment of depression and careful attention to less-educated patients might be of benefit to patients in ameliorating depression and psychological distress during the year after curative resection.

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