Depression Risk and Cancer in Ecuador: The Protective Role of Social Support

Abstract

Introduction: Depression is a determinant of quality of life for cancer patients and predicts cancer progression and mortality. Our study assessed depression and distress among cancer patients receiving care at the hospital Sociedad de Lucha Contra el Cancer (SOLCA) in Quito, Ecuador and evaluated the role of interpersonal support in protecting against depression. Awareness of the specific benefit of interpersonal support for cancer patients at risk for depression is critical for the ongoing care provided by PCPs to the patient and family in community. Methods: Computer tablets were used to collect demographic information and to administer three questionnaires: the Patient Health Questionnaire (PHQ-9) to assess severity of depression symptoms, the Distress Thermometer to characterize level and nature of distress, and the Experiences in Close Relationships assessment (ECR) to measure social support from one’s partner. Results: A high level of depression was reported by 29.1% of patients (N=300). Those with high levels of depression reported significantly more distress. Those demonstrating high levels of depression also reported significantly less support from their partners. The demographic factors found to be related to increased risk of depression were unemployment and lack of higher education; young age was related to increased distress. Conclusions: Depression is common in the cancer patient population and strong support from one’s partner is a protective factor. The importance of strengthening support from a patient’s partner is emphasized at all levels of care, especially the community based PCP engaged with the patient and family longterm.