Psychological impacts of COVID-19 pandemic in cancer patients on active treatment

Abstract

Introduction: Although cancer patients have a high risk of exposing COVID-19 and developing severe complica-tions, they have to receive active treatment. We aimed to determine the psychological conditions of cancer pa-tients and shed light on the establishment of early psychological intervention and intervention policies by making specific recommendations.Method: We consecutively evaluated 385 cancer patients under treatment. Post-traumatic stress disorder (PTSD) symptoms, depression, anxiety, stress, and associated sociodemographic/clinical characteristics were investi-gated. In addition, we applied depression-anxiety-stress-scale-21 (DASS-21) for the mental states of patients and Impact of Event-Scale-Revised (IES-R) for the psychological effects of Covid-19.Results: The mean age was 58 (18-88). 47.2% were psychologically distressful per DASS-21, and 39.3% were traumatic per IES-R scores. 71.9% stated the risk of getting COVID-19 was high since they had cancer, and 82% stated serious complications would develop if they had COVID-19 infection. Patients diagnosed for more than one year were more stressed, anxious, and depressive (p-value = 0.001,0.003,0.049, respectively). Singles were more stressed, depressed, and traumatized than couples (p-value = 0.001, 0.011, 0.001). In multivariate analysis, a significant correlation with being under psychiatric treatment before the pandemic was found for depression (OR: 3.743, 95 %CI: 1.790-7.827) anxiety (OR: 3.776-95 %CI: 1.945-7.332) and stress levels (OR: 4.129, 95 %CI: 1.728-9.866). Having relatives who died or received treatment for COVID-19(OR: 0.515,0.296-0.895) and being unmarried (OR: 2.445-95% CI: 1.260-4.747) predicts PTSD development.Conclusions: When the psychological effects of the COVID-19 pandemic are manifesting strongly, cancer patients' anxiety and exposure levels are high. It is of great importance that clinicians understand needs, recognize psy-chological distress, and direct them to relevant departments for supportive care.