Depression in patients with chronic and malignant diseases

Cilj istraživanja: Cilj istraživanja bio je utvrditi prevalenciju depresije međubolesnicima s kroničnim tjelesnim i malignim bolestima te utvrditi zastupljenost depresije među najčešćim bolestima koje su dijagnosticirane među ispitanicima. Materijali i metode: Presječnim istraživanjem obuhvaćeno je 111 ispitanika koji su podijeljeni u četiri skupine s obzirom na mjesto gdje su hospitalizirani i liječeni: Klinici za plućne bolesti, Klinici za neurologiju, Klinici za onkologiju i radioterapiju i Zavodu za gastroenterologiju Kliničkog bolničkog centra u Splitu. Uzorkovanje je provedeno tijekom ožujka, travnja i svibnja 2019. godine. Učestalost depresije utvrđivala se koristeći se standardiziranim Beckovim upitnikom za depresiju (BDI). U analizi podataka korišten je Hi kvadrat test, Kolmogorov-Smirnov testom te Mann-Whitney U test. Razina statističke značajnosti postavljena je na P<0,05. Rezultati: U ovom istraživanju uspjeli smo dokazati značajno veću učestalost depresije u bolesnika s kroničnim tjelesnim i malignim bolestima (48,65%) naspram prevalencije depresije u općoj populaciji (13%). Među našim rezultatima najučestalija je blaga depresija (50%), zatim slijedi umjerena depresija (27,78%) te teška depresija (22,22%). Nije pronađena statistički značajna razlika u učestalosti depresije među spolovima. Najveća prevalencija depresije je bila među bolesnicima koji imaju dijagnozu karcinoma pluća, ciroze jetre i kroničnom opstruktivnom plućnom bolesti. Statistički značajna mala učestalost depresije bila je u bolesnika s dijagnozom karcinoma debelog crijeva u usporedbi s drugim ispitivanim bolestima. Bolesnici s kroničnim tjelesnim i malignim bolestima kao najveći problem iskazuju oslabljeni libido (18,02%), bez obzira na dijagnosticiranu depresiju. Zaključak: Potrebni su daljnja istraživanja na većem uzorku ispitanika, kao možda i istraživanja drugačijeg ustroja da bi se dokazala uzročno posljedična veza između depresije i težeg izlječenja odnosno većeg mortaliteta u bolesnika sa kroničnim i malignim bolestima. Također su potrebni daljnji napori da bi se medicinsko osoblje educiralo o simptomatologiji i pravovremenom prepoznavanju depresije. Dobiveni rezultati otvaraju i nove mogućnosti, a prije svega mogućnost pravodobne intervencije i poboljšanje kvalitete života liječenjem depresije psihoterapijskim metodama, ali i antidepresivima kojima se postiže poboljšanje simptoma depresije i povećava kvaliteta života u kroničnih tjelesnih bolesnika.Objective of the study: The aim of the study was to determine the frequency of depression among patients with chronic physical and malignant diseases and to determine the frequency of depression among the most commonly diagnosed diseases among the respondents. Materials and Methods: Cross-sectional study included 111 patients divided into four groups with regard to hospitalization and treatment: the Clinic for pulmonary disease, the Neurology Clinic, the Oncology and Radiotherapy Clinic and the Department of Gastroenterology of the Clinical Hospital. Center in Split. Sampling was conducted in March, April and May 2019. The frequency of depression was established by the standardized Beck's Depression Questionnaire (BDI). In the data analysis the Hi squared test, the Kolmogorov-Smirnov test and the Mann-Whitney U test were used. The level of statistical significance is set at P <0.05. Results: In this study, we have proved a significant incidence of depression in patients with chronic physical and malignant diseases (48.65%) according to prevalence of depression in the general population (13%). Among our results most frequent is mild depression (50%) followed by moderate depression (27.78%) and severe depression (22.22%). There was no statistically significant difference in the frequency of depression among the sexes. The highest prevalence of depression was among patients with diagnoses of lung cancer, liver cirrhosis, and chronic obstructive pulmonary disease. A statistically significant incidence of depression was in a patient with colon cancer diagnosis compared with other subjects. Patients with chronic physical and malignant diseases are the biggest problem with impaired libido (18.02%), regardless of the diagnosis of depression. Conclusion: Further research is needed on a larger sample of respondents, as well as research into a different approach to proving the causal link between depression and healing or greater mortality in patients with chronic and malignant diseases. Further efforts are also needed to educate medical staff about symptomatology and timely recognition of depression. The results also open new possibilities, above all the possibility of timely interventions and improvement of the quality of life by treating depression with psychotherapeutic methods, as well as antidepressants that improve the symptoms of depression and increase the quality of life in chronic physical patients