Depression and desire for hastened death (DHD) in patients with cancers at the University College Hospital (UCH), Ibadan

Abstract

Abstract Background: Cancer diagnosis and treatment affect people in a variety of ways. It exerts remarkable emotional toll on many of those living with or surviving cancers. It is commonly linked with depression and a preoccupation with thoughts of death. Depression is a common and serious mental illness that can affect people of all ages, including those with advanced cancer. This study aimed to determine the frequency of depression and desire for hastened death (DHD) in patients with advanced cancers in need of palliative services at University College Hospital, Ibadan, and to identify factors and themes associated with a DHD. Methods: Using a sequential mixed-method approach involving an initial quantitative phase followed by a qualitative phase, we conducted a cross-sectional study of 106 participants. Depression was assessed with the Centre for Epidemiological Studies-Depression (CES-D) and DHD with Schedule of Attitude toward Hastened Death (SAHD). In-depth interviews were conducted for purposively selected participants based on SAHD scores. Results: 63.2% of participants were depressed with a CES-D score of >15, and 12.3% of participants had high DHD based on a SAHD score of ≥10. We found a weakly positive correlation between depression scores and the SAHD scores, Pearson r (106) = 0.27, P < 0.01. Depression (β = 0.07, P = 0.013), income (β = 1.21, P = 0.010), and religiosity (β = 1.28, P = 0.010) were significant predictors of DHD. Subjective themes associated with DHD were hospital-related stress, treatment failure, and physical pain in those reporting high DHD, whereas improved physical functioning, positive self-image, ability to finance treatment, and a good patient-doctor relationship were themes associated with lower DHD. Coping strategies and causal attributions varied remarkably among participants. Conclusion: Depression and DHD are common in patients with cancers in need of palliative services. Sociodemographic and clinical factors significantly associated with DHD were income, religiosity, and depression. This study recommends that psycho-oncology services should be important complements in all cancer treatments.