Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Feb 19, 2024; 14(2): 287-295
Published online Feb 19, 2024. doi: 10.5498/wjp.v14.i2.287
Depression and anxiety among cancer patients visiting a tertiary care cancer hospital
Maheshor Kaphle, Diya Bajracharya, Nirmala Regmi, Dipsikha Aryal, Rajesh Karki
Maheshor Kaphle, Dipsikha Aryal, Department of Public Health, Peoples Dental College and Hospital, Tribhuvan University, Kathmandu 44600, Bagmati, Nepal
Diya Bajracharya, Department of Public Health, CiST College, Pokhara University, Kathmandu 44600, Bagmati, Nepal
Nirmala Regmi, Department of Oncology, Kanti Hospital, Maharajgunj, Kathmandu 44600, Nepal
Rajesh Karki, Central Department of Public Health, Institute of Medicine, Tribhuvan University, Maharajgunj, Kathmandu 44600, Bagmati, Nepal
Co-first authors: Maheshor Kaphle and Diya Bajracharya.
Author contributions: Kaphle M and Bajracharya D (equal contributors) conceptualized the study and prepared the proposal, data collection, data analysis, and preliminary preparation of the manuscript; Regmi N was involved in data curation and review of the manuscript; Aryal D was involved in writing and editing the manuscript; Karki R was involved in investigating, editing, and critically reviewing the manuscript; Kaphle M had the final authority to submit for publication; all authors have read and agreed to the published final version of the manuscript. Kaphle M and Bajracharya D have been designated co-first authors in recognition of their distinct yet complementary contributions throughout the research. Kaphle M excelled in data management, analysis, and bringing expertise in the critical review of the manuscript, while Bajracharya D played a key role in data collection, entry, preliminary analysis and contributed significantly to manuscript writing. Both authors demonstrated equal dedication and effort from project inception to completion, particularly during concept development, design, and critical writing and response to the reviewer. The collaborative nature of the research team was essential, with each member contributing unique skills and acknowledging it. It's important to note that while Kaphle M and Bajracharya D are co-first authors, appreciation extends to the entire team for their valuable contributions. The decision for co-first authorship reflects a transparent and inclusive process, honoring the collaborative spirit that propelled the success of the research.
Institutional review board statement: Permission was obtained from the hospital and ethical clearance was obtained from the Institutional Review Committee of CiST College (Ref. No.152/077/078) before the study.
Informed consent statement: Written consent was taken from the patients before interviewing them. The names of the participants were not used in any documents, instead, identification codes were used. Voluntarism and the freedom to withdraw from the study at any time were maintained.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: The data related to this research can be found from correspondence author with reasonable demand.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Maheshor Kaphle, MHsc, Reader (Associate Professor), Department of Public Health, Peoples Dental College and Hospital, Nayabazar, Kathmandu 44600, Bagmati, Nepal. kafmahesh@gmail.com
Received: September 29, 2023
Peer-review started: September 29, 2023
First decision: December 6, 2023
Revised: December 25, 2023
Accepted: January 19, 2024
Article in press: January 19, 2024
Published online: February 19, 2024

Cancer patients frequently experience psychological problems related to reactions to cancer diagnosis, cancer type and stage, treatment effects, recurrence, fear of end-of-life, survivorship, and financial burden. Depression and anxiety are both psychological and physiological disturbances among cancer patients.


To assess the prevalence of depression and anxiety among cancer patients attending a tertiary care cancer hospital.


A cross-sectional study was conducted at Bhaktapur Cancer Hospital in Kathmandu Valley among 220 cancer patients aged from 18 years to 70 years. Ethical approval was taken from the Institutional Review Committee of CiST College. Convenient sampling was used to interview patients with the standardized Patient-Health Questionnaire (PHQ-9) for Depression and Hospital Anxiety and Depression sub-scale (HADS-A) for anxiety. Epi-Data was used for data entry and transferred to SPSS Version 25 for analysis.


The study revealed that of 220 patients, most of the respondents belonged to the age group 51-60 years. More than half 131 (59.6%) of the respondents were female, most of them had depression, and one-third had anxiety. Among the respondents, 124 (56.4%) had mild depression, 70 (31.8%) had moderate depression, and 3 (1.3%) had severe depression; 79 (35.9%) had mild anxiety, 64 (29.1%) had moderate anxiety, and 4 (1.8%) had severe anxiety.


Most respondents were depressed and one-third had anxiety. More than half and nearly one-third had mild and moderate depression, respectively, and nearly one-third had mild and moderate anxiety, which is higher than other studies.

Keywords: Anxiety, Cancer patients, Depression, Nepal, Prevalence

Core Tip: A cancer diagnosis sparks fear, and those with this condition commonly exhibit greater psychological and emotional stress levels than the general population. Most cancer patients may face psychological problems due to the unavailability of appropriate services in middle and low-income countries like Nepal. We conducted a cross-sectional study among 220 cancer patients to assess the prevalence of depression and anxiety through standard tools. This study found a high prevalence of depression and some anxiety among the patients and suggested that physicians organize counseling services and cancer therapy in hospitals.