Factors linked with depression and anxiety in adult patients diagnosed with breast cancer - A case study of Cancer Diseases Hospital, Lusaka, Zambia

Abstract

Background: Psychological distress is common among women diagnosed with breast cancer, particularly in low- to middle-income countries where mental health screening and psychosocial support services are limited. This study assessed the prevalence of anxiety and depression symptoms among women with breast cancer at Zambia's national cancer referral hospital and explored patient-identified causes of distress.

Methods: We conducted a hospital-based cross- sectional study among 113 women attending the Cancer Diseases Hospital in Lusaka, Zambia. Psychological distress was assessed using the 21- item Beck Depression Inventory (BDI) and the Beck Anxiety Inventory (BAI). Participants also responded to structured questions about the perceived causes of their emotional burden. Descriptive statistics with 95% confidence intervals (CIs) were used to estimate the prevalence of depression and anxiety. Reported causes of distress were categorised thematically.

Results: Nearly 70% of participants reported moderate-to-severe depression (69.1%, 95% CI: 60.1-77.1), and more than 60% experienced moderate-to-severe anxiety (61.9%, 95% CI: 52.6- 70.4). Severe depression was observed in 31.9% (95% CI: 23.7-41.1), while severe anxiety was present in 26.5% (95% CI: 18.7-35.5). The most frequently cited sources of emotional distress were fear of death (66.4%), body image changes (45.1%), financial burden (39.8%), and uncertainty about treatment (35.4%).

Conclusion: The study highlights a substantial burden of psychological distress among women with breast cancer in Zambia. Routine mental health screening using validated tools such as BAI and BDI, combined with responsive psychosocial support, should be prioritised in oncology care. Strengthening psycho-oncology services is crucial for enhancing patient well-being and treatment adherence in low-resource settings.