Abstract

Objective: This study aimed to assess the prevalence of depression and anxiety in patients with cancer in palliative care at King Abdullah Medical City, Makkah, Saudi Arabia, using the Arabic validated Hospital Anxiety and Depression Scale (HADS) and to identify sociodemographic and clinical variables associated with distress.
Methods: A cross-sectional study was performed in 120 adult cancer patients receiving palliative care in King Abdullah Medical City. Participants filled out the validated Arabic version of the HADS. Patient interviews and medical records were used to gather sociodemographic and clinical information.
Results: Abnormal anxiety and depression were found in 29.2% and 31.7% of participants, respectively, with an additional 16.7% and 26.7% showing borderline symptoms. Anxiety was significantly associated with marital status, employment status, shorter diagnosis duration, psychiatric medication use, Do-Not-Resuscitate (DNR) status, pain severity, and inadequate family support. Depression was significantly associated with shorter diagnosis duration, metastatic disease, psychiatric medication use, DNR status, dyspnea, and inadequate family support. Lower Palliative Performance Scale scores correlated weakly with higher depression (r= -0.190, p = 0.038). Hematological malignancies and prostate cancer showed the highest abnormal anxiety (50.0% each), while pancreatic cancer demonstrated the highest abnormal depression (66.7%).
Conclusion: Depression and anxiety were significant psychological problems in a palliative care population. Incorporating routine psychological assessment with validated instruments, full symptom management, and family-centered psychosocial support into palliative care services should help to identify psychological distress at an earlier stage and enable timely intervention.

Key words: anxiety, depression, cancer, palliative care, psychological distress, hospital anxiety and depression scale, palliative performance scale, Saudi Arabia