Socioeconomic, lifestyle, and clinical determinants of depression among cancer patients in India

A cancer diagnosis can have a significant impact on mental health that may hinder treatment, recovery, and quality of life. The extent of this impact may vary depending on certain factors such as socioeconomic, clinical conditions, and other risk factors experienced by patients throughout their cancer life. Thus, this highlights the need to study how socioeconomic and risk factors contribute to depression among cancer patients. This cross-sectional study of 1200 cancer patients from Punjab, India, utilised the Patient Health Questionnaire (PHQ) to assess depression. Interviews were conducted with 24.50% of patients at the Advanced Cancer Institute, Bathinda, and 75.50% at Homi Bhabha Cancer Hospital, Sangrur. The study evaluated associations between depression and socioeconomic status (SES), exposure to risk factors before (BERF) and after (AERF) cancer diagnosis, and awareness of risk factors (ARF), controlling for various clinical factors and demographic groups using descriptive analysis and partial least squares structural equation modelling. The analysis revealed that SES influences cancer patients’ AERF, BERF, ARF, and PHQ. Patients with comorbidities or higher BERF or ARF perceived higher depression. Gender was strongly associated with all endogenous variables, where men reported lower AERF and higher BERF, ARF, and PHQ than women. With an increase in out-of-pocket expenditure, duration of the disease, cancer stage and symptom severity, depression increased. Breast, cervical, oesophageal, and stomach cancer patients reported higher rates of depression compared to patients with oral and lung cancer. The interplay between SES, BERF, AERF, ARF, and PHQ scores presents an opportunity to enhance psychological support for cancer patients. With the increasing prevalence of cancer, our study can help in understanding the role of significant factors that impact depression among patients.