Factors associated with depression among adult primary brain tumor patients diagnosed at a tertiary care hospital in Karachi, Pakistan : a cross-sectional study

Date of Award

2018

Document Type

Thesis

Degree Name

Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)

Department

Community Health Sciences

Abstract

The prevalence of depression among primary brain tumor patients ranges from 15% to 40% globally. Several individual and clinical factors contribute in the development of depression. However, their association with depression in Pakistani setting has not yet been assessed. Thus, we aim to study the factors associated with depression among adult primary brain tumor patients at a tertiary care hospital in Karachi, Pakistan. METHOD: We conducted a cross-sectional study at Aga Khan University Hospital, Karachi, Pakistan. Sample size of 132 patients with primary brain tumor was calculated. Presumptive diagnosis of depression (Outcome) was based on patient health questionnaire-9. We used a pre-structured questionnaire to assess patient-related, tumor-related, and treatment-related factors. Cox-regression analysis was performed to assess association between patient-related, tumor-related, and treatment-related factors and depression. Propensity scores were computed to examine the factors associated with functional status. RESULTS: Fifty-one (39%) patients had depression. There was significant association between depression and Functional status (PR: 3.25 and CI: 1.87-5.62). We also found significant association between functional status and employment status, treatment stage, and tumor recurrence. Overall, propensity scores for functional status showed statistically significant relationship with depression. Both tumorrelated and treatment related factors including tumor grade, location, type, hemispheric lateralization, and treatment stage were found insignificant. CONCLUS ION: This high prevalence of depression among primary brain tumor patients was primarily affected by functional status. Incorporating psychosocial domain for' early diagnosis and treatment of depression among primary brain tumor patients need to be considered during course of illness for better Neurooncology management. Future researches need to address role of psychosocial domain in the care of primary brain tumor patients.

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