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What precipitates depression in African-American cancer patients? Triggers and stressors

Published online by Cambridge University Press:  22 March 2012

Amy Y. Zhang ,
Faye Gary  and
Hui Zhu
Amy Y. Zhang*
Affiliation:
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio
Faye Gary
Affiliation:
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio
Hui Zhu
Affiliation:
Department of Urology, School of Medicine, Case Western Reserve University, Cleveland, Ohio
*
Address correspondence and reprint requests to: Amy Y. Zhang, Frances Payne Bolton School of Nursing, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106-4904. E-mail: axz16@case.edu
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Abstract

Objective:

This study examined general and cancer-related stressors of depression that are unique to African-American cancer patients.

Method:

The study used cohort design and mixed methods. Seventy-four breast and prostate cancer survivors including 34 depressed and 23 non-depressed African-Americans and 17 depressed whites were interviewed. Qualitative data analysis identified themes. The thematic codes were converted to a SPSS data set numerically. The Fisher's exact test was performed to examine group differences in the experience of stress.

Results:

Significantly more depressed African-Americans experienced a dramatic reaction to a cancer diagnosis (p = 0.03) or had concerns about functional decline (p = 0.01), arguments with relatives or friends (p = 0.02), and unemployment status (p = 0.03) than did non-depressed African-Americans, who reacted to the cancer diagnosis as a matter of reality (p = 0.02). Significantly more depressed African-Americans talked about feeling shocked by a cancer diagnosis (p = 0.04) and being unable to do things that they used to do (p = 0.02) than did depressed whites. Qualitative analysis shed light on the extent of such group differences.

Significance of results:

Distress from the initial cancer diagnosis and functional decline were likely to have triggered or worsened depression in African-American cancer patients. This study highlighted racial differences in this aspect. It is critical to screen African-American cancer patients for depression at two critical junctures: immediately after the disclosure of a cancer diagnosis and at the onset of functional decline. This will enhance the chance of prompt diagnosis and treatment of depression in this underserved population.

Keywords

DepressionStressCancerAfrican-AmericansHealth disparity
Type
Original Articles
Information
Palliative & Supportive Care , Volume 10 , Issue 4 , December 2012 , pp. 279 - 286
Copyright
Copyright © Cambridge University Press 2012

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References

REFERENCES

American Cancer Society (2009). Cancer Facts & Figures for African Americans 2009–2010. Atlanta, GA: American Cancer Society, Inc.Google Scholar
Agarwal, M., Hamilton, J.B., Moore, C.E., et al. (2010). Predictors of depression among older African American cancer patients. Cancer Nursing, 33, 156–163.Google Scholar
Akechi, T., Okuyama, T., Akizuki, N., et al. (2006). Course of psychological distress and its predictors in advanced non-small cell lung cancer patients. Psycho-oncology, 1596, 463–473.CrossRefGoogle Scholar
Cummings, S.M., Neff, J.A. & Husaini, B.A. (2003). Functional impairment as a predictor of depressive symptomatology: The role of race, religiosity, and social support. Health & Social Work, 28, 23–32.Google Scholar
Dantzer, R., Wollman, E.E. & Yirmiya, R. (1999). Cytokines, Stress, and Depression. (Advances in Experimental Medicine and Biology, Vol. 461.)New York: Kluwer Academic.Google Scholar
Deimling, G.T., Bowman, K.F., Sterns, S., et al. (2006). Cancer-related health worries and psychological distress among older adult, long–term cancer survivors. Psycho-oncology, 15, 306–320.CrossRefGoogle ScholarPubMed
Garofalo, J.P., Hamann, H., Ashworth, K., et al. (2006). Stress and quality of life in African American cancer survivors. Ethnicity & Disease, 16, 732–738.Google Scholar
Goodwin, G.S., Zhang, D.D. & Ostir, G. (2004). Effect of depression on diagnosis, treatment, and survival of older women with breast cancer. Journal of the American Geriatrics Society, 52, 106–111.Google Scholar
Kurtz, M.E., Kurtz, J.C., Stommel, M., et al. (2002). Predictors of depressive symptomatology of geriatric patients with colorectal cancer: A longitudinal view. Supportive Care in Cancer, 10, 494–501.Google Scholar
Nelson, C., Balk, E.M. & Roth, A.J. (2010). Distress, anxiety, depression, and emotional well-being in African American men with prostate cancer. Psycho-oncology, 19, 1052–1060.Google Scholar
Pinquart, M. & Duberstein, P.R. (2010). Depression and cancer mortality: A meta-analysis. Psychological Medicine, 40, 1797–1810.Google Scholar
Satin, J.R., Linden, W. & Phillips, M. (2009). Depression as a predictor of disease progression and mortality in cancer patients. Cancer, 15, 5349–5361.Google Scholar
Spiegel, D. & Giese-Davis, J. (2003). Depression and cancer: Mechanism and disease progression. Biologic Psychiatry, 54, 269–282.CrossRefGoogle ScholarPubMed
Talley, A., Molix, L., Schlegel, R. J., et al. (2010). The influence of breast cancer survivors' perceived partner social support and need satisfaction on depressive symptoms: A longitudinal analysis. Psychology & Health, 25, 433–449.Google Scholar
Zhang, A.Y., Zyzanski, S.J. & Siminoff, L.A. (2010). Differential patient–caregiver opinions of treatment and care for advanced lung cancer patients. Social Science & Medicine, 70, 1155–1158.Google Scholar