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The Gynecologic Oncology Consult: Symptom Presentation and Concurrent Symptoms of Depression and Anxiety

Jeffrey M. Fowler, MD^*, Kristen M. Carpenter, MA, Parul Gupta, MD^*, Deanna M. Golden-Kreutz, PhD and Barbara L. Andersen, PhD¹

From the *Department of Obstetrics–Gynecology, Division of Gynecologic Oncology, and Department of Psychology and the Comprehensive Cancer Center, The Ohio State University, Columbus, Ohio.

Address reprint requests to: ¹Barbara L. Andersen, Department of Psychology, 1885 Neil Avenue, The Ohio State University, Columbus, OH 43210–1222; e-mail: Andersen.1{at}osu.edu.

OBJECTIVE: To detail the relationship of gynecologic symptoms and sociodemographic variables to depression and anxiety reports among women who were referred to gynecologic oncologists for evaluation.

METHODS: Consecutive patients (N = 151) from an National Cancer Institute–designated comprehensive cancer center were accrued and participated on the day of consultation. Patients completed measures assessing depression (Center for Epidemiological Studies Depression Scale) and anxiety (Beck Anxiety Inventory) symptoms, common gynecologic signs/symptoms, and sociodemographic characteristics. Patients were followed up and subsequent diagnoses yielded 73 (48%) cancer and 78 (52%) benign cases.

RESULTS: Descriptive analyses revealed that the cancer group was significantly older (52 versus 45 years) than the benign group, and variables correlated with age also differed significantly, with the cancer sample more likely to be postmenopausal, unemployed, and if employed, working fewer hours per week. Importantly, the groups did not differ on reports of depressive, anxiety, or gynecologic symptoms. Hierarchical multiple regression analyses, collapsing across groups, yielded significant correlates of emotional distress. Women who were older, without a spouse/partner, and who had more gynecologic symptoms had higher levels of both depressive and anxiety symptoms. Among the women who did have a partner, those with relationships of longer duration reported lower levels of depression/anxiety

CONCLUSION: Reports of clinically significant depressive (42%) and anxiety symptoms (30%) were high. The number of gynecologic symptoms was reliably correlated with emotional distress. Age and absence of partner may have conferred added vulnerability. For those women with partners, lengthier relationships appeared to offer protection from both depressive and anxiety symptoms.

LEVEL OF EVIDENCE: III

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