Anxiety and Depression Among Cancer Patients Receiving Radiation therapy in Karbala.
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Objective: To assess the prevalence and severity of anxiety and depression before and during radiotherapy among cancer patients in Karbala, Iraq.
Methods and Materials: A prospective descriptive quantitative study was conducted at Al-Hassan Al-Mujtaba Teaching Hospital (Oncology and Blood Diseases Center), Karbala, from September 2024 to June 2025. Of 100 eligible adults (≥18 years) scheduled for external beam radiotherapy, 81 completed both assessments and were included in the analysis. Patients with severe cognitive impairment, pre-existing psychiatric illness (before cancer), or concurrent chemotherapy during data collection were excluded. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS; Cronbach’s α=0.837). Because the distributions were non-normal, pre-treatment and during-treatment scores were compared using the Wilcoxon signed-rank test; effect sizes were calculated as r = Z/√N.
Findings: Participants had moderate anxiety and depression at both time points, with higher scores during radiotherapy. Anxiety increased from pre-treatment (mean=11.38, SD=3.30) to during treatment (mean=12.29, SD=3.12) (p=0.025; r=0.175). Depression increased from pre-treatment (mean=10.19, SD=2.97) to during treatment (mean=11.55, SD=3.01) (p=0.008; r=0.209). Effect sizes were small.
Conclusion: Radiotherapy was associated with statistically significant increases in anxiety and depression; integrating routine psychological screening and supportive care into oncology services is recommended.
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