Predictors of anxiety and depression in people with colorectal cancer

Nicola M. Gray, Susan J. Hall, Susan Browne, Marie Johnston, Amanda J. Lee, Una Macleod, Elizabeth d Mitchell, Leslie Samuel, Neil C. Campbell

Research output: Contribution to journalArticlepeer-review

58 Citations (Scopus)


Background People living with colorectal cancer are at risk of anxiety and depression. We investigated what factors were most highly associated with these.
Methods Four hundred and ninety-six people with colorectal cancer completed the Hospital Anxiety and Depression Scale (HADS). Data on functioning, symptoms, illness perceptions and social difficulties were collected by questionnaire. Casenote-identified disease, treatment and co-morbidity data were
recorded. Multiple logistic regression identified factors independently predictive of anxiety and depression caseness.
Results Self-reported history of anxiety/depression predicted anxiety but not depression caseness. Depression caseness predicted anxiety caseness (p =0.043), as did poorer selfreported
cognitive functioning (p =0.001), dyspnoea (p = 0.015) or diarrhoea (p =0.021), reporting a high negative life and emotional impact (p <0.001) and having difficulties with finance (p =0.007). Having neo-adjuvant radiotherapy increased the odds of depression caseness (p =0.007), as did
poorer physical (p =0.007), cognitive (p <0.001) and social (p <0.001) functioning, having constipation (p =0.011), reporting a high negative life and emotional impact (p < 0.001), having difficulties with personal care (p =0.022) and communicating with others (p =0.014).
Conclusion Levels of anxiety caseness were similar to those of non-clinical samples, but depression caseness was higher, particularly in those who had received neo-adjuvant radiotherapy. Most factors associated with possible or probable depression may be modified with appropriate intervention.
Original languageEnglish
Pages (from-to)307-314
Number of pages8
JournalSupportive Care in Cancer
Issue number2
Early online date1 Oct 2013
Publication statusPublished - Feb 2014


  • anxiety
  • depression
  • colorectal cancer


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