Prevalence and Associated Psychological Factors of Anxiety and Depression Among Patients With Breast Cancer Receiving Chemotherapy at Bugando Medical Centre in Mwanza: the Need for Interdepartmental Management Approach

Abstract Background: The diagnosis of breast cancer and the traumatic treatment can cause profound emotional distress for breast cancer patients. Several psychological disorders are experienced by the patient with breast cancer at all the times studies identified. The burden of the psychological disorders, the factors associated and the psychological disorder interventions during breast cancer management have not been elucidated in Tanzania and other low-income settings. This study has therefore aimed at determining the prevalence and associated psychological factors of Anxiety and Depression among patients with breast cancer received hospitals therapy in tertiary care Hospital in Tanzania. Methods:A cross-sectional design involved one hundred and thirty-one breast cancer patients receiving chemotherapy at Bugando Medical Centre from September 2017 to March 2018 The Hospital Anxiety and Depression Scale (HADS) was used to determine the prevalence and associated psychological factors of depression and anxiety of breast cancer patients. Results:According to Hospital Anxiety and Depression Scale (HADS), Prevalence of depression among breast cancer patient in chemotherapy was 27 (20.6%). While, prevalence of anxiety in this study was 13 (9.9%). Severity of depression was significantly associated to having health insurance (p value 0.023 OR 0.438), religion (p value 0.045 OR 1.017) familial history of breast cancer (p value 0.041 OR 1.756). Conclusion: Majority of participants in this study were in earlier stage of breast cancer. However, the prevalence of depression and anxiety among breast cancer patients in chemotherapy was unexpectedly high. The psychological factors associated with the depression and anxiety were those related to patient’s socio-economic circumstances affecting accessibility treatment rather than to the breast cancer as pathology or its treatment. This study recommends that there is a need for the interdepartmental approach in management of breast cancer patients especially those in chemotherapy. Mental health practitioners including Psychiatrist and Psychologist should be involved in the management of breast cancer especially during chemotherapy. Universal Coverage of the health services including health insurances should be promoted especially the cancer, psychiatric and psychological services.