Background:
Depression significantly predicts cancer death, but is often under recognized among cancer patients due to similarities of physical symptoms observed in cancer and depression. Accurately assessing depression in African American cancer patients is particularly difficult, because African Americans, when feeling depressed, mainly complain about physical symptoms.
Aim:
To compare experiences of depressed African American cancer patients with other cancer patient groups to identify both universal and distinctive symptoms for improving assessment of depression among this population.
Methods:
Seventy-four cancer patients (34 depressed and 23 nondepressed African Americans, and 17 depressed Whites) that had completed cancer treatment for six to 36 months were interviewed face to face. The interviews were audiotaped and transcribed. Qualitative and quantitative analyses were conducted.
Results:
Compared to their nondepressed African American counterparts, depressed African American cancer patients reported irritability, social isolation, insomnia, fatigue, and crying (p≤.05) more frequently over time. Compared to depressed White cancer patients, they reported sadness, frustration, and intrusive thoughts less frequently (p≤.05), but insomnia and fatigue more frequently (p≤.05) during cancer treatment. The depressed African American patients also reported irritability, social isolation, and feeling “down” at a higher frequency than the White patient groups, which did not approach statistical significance.
Conclusions:
Depressed African American cancer patients exhibited a greater tendency of irritability, social isolation and altered expression of depressive mood. They may benefit from new assessment measures that are culturally and linguistically appropriate for improving the early detection and treatment of depression. Clinicians need to be aware of such symptoms as irritability, social withdraw or isolation, as they may be associated with depression in this minority group of cancer patients.