Background: Most studies of anxiety (A) and depression (D) among women with ovarian cancer (OC) have used a cross-sectional design and/or not considered prior history or medication. Our aims were to quantify A/D among women with OC; the proportions who experienced symptoms only after their OC diagnosis and those with persistent symptoms; and determine use of medication/services by those affected.
Methods: The OPAL (Ovarian cancer Prognosis And Lifestyle) Study is a prospective study of Australian women diagnosed with OC from 2012-15. At baseline, women were asked if they had ever been diagnosed with A or D in the year before their OC diagnosis. At follow-up (3, 6, 9, 12, 24, 36 & 48 months after diagnosis) women completed the Hospital Anxiety and Depression Scale and were asked about current medication use.
Results: Of 893 women, almost half (42%) reported clinical anxiety (18%) and/or depression (15%) and/or use of anxiolytic or antidepressant medications (A/D meds) (18%) on ≥1 occasion during the first 3 years after diagnosis. An additional 166 women (19%) reported subclinical A or D. Of those with clinical A/D or taking A/D meds, 159 (42%) reported this at ≥3 time-points and 218 (58%) reported no prior history of A or D. When women reported clinical A or D, only 45% reported taking medication (37%) and/or seeing a psychiatrist or psychologist (19%). A prior history of A/D and low levels of optimism were the strongest predictors of A/D onset.
Conclusions: More than 40% of women with OC experienced clinical A or D during the first 3 years of follow-up. For 42% of those affected this was their first experience of A/D and >50% did not receive treatment. The hidden burden of A/D in this population is much greater than previously reported but is amenable to effective intervention if recognised.