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Measuring Somatic Symptoms With the CES–D to Assess Depression in Cancer Patients After Treatment: Comparison Among Patients With Oral/Oropharyngeal, Gynecological, Colorectal, and Breast Cancer

Received March 8, 2005; revised November 8, 2005; accepted November 10, 2005. From the Dept. of Oral and Maxillofacial Surgery, Dept. of Rehabilitation, and the Pain Center, University Medical Center, Groningen; and the Northern Centre for Health Care Research, Groningen, the Netherlands. Address correspondence and reprint requests to Dr. van Wilgen, Pain Center, University Medical Center Groningen, Univ. of Groningen, P.O. Box 30.001, 9700 RB Groningen, the Netherlands. e-mail: c.p.van.wilgen{at}anest.umcg.nl

There is a high prevalence of depression after cancer treatment. In the literature, several authors have raised questions about assessing somatic symptoms to explore depression after cancer treatment. These somatic sequelae are a consequence of cancer treatment and should cause higher depression rates in cancer patients. In this study, the Somatic domain on a depression questionnaire, the Center for Epidemiologic Studies–Depression scale (CES–D) was analyzed in different cancer patients after treatment, as compared with a control group. Data from 566 cancer patients (oral/oropharyngeal, gynecological, colorectal, and breast cancer) and 255 randomly chosen comparison patients were analyzed. The total score on the CES–D domain of Somatic Retarded Activity significantly differed between the cancer and comparison groups; but the cancer groups showed both less somatic morbidity (colorectal cancer) and more somatic morbidity (oral/oropharyngeal, breast) than the comparison group. In the analyses of the CES–D with and without the Somatic domain, the prevalence of depression symptoms with the Somatic domain is lower for the cancer groups. Authors conclude that cancer patients are not a homogenous group as regards somatic sequelae. Evidence for removing Somatic items from the CES–D for patients after cancer treatment was not confirmed.

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