Anxiety, Depression, and Associated Factors among Cancer Patients and Survivors in Japan Following the Reclassification of COVID-19 to a Category V Infectious Disease

Abstract

Background: The COVID-19 pandemic has had a significant impact on cancer patients and survivors, raising concerns about increases in anxiety and depression. In Japan, COVID-19 was reclassified as a Category V Infectious Disease in May 2023, and social interactions gradually resumed. However, there is limited knowledge about the psychological state of cancer patients and survivors and associated factors. This study aimed to clarify the actual state of anxiety and depression among cancer patients and survivors after the pandemic and their associated factors.

Materials and Methods: In June 2023, an Internet survey was conducted targeting 700 cancer patients and survivors (mean age, 63.1 ± 13.0) to evaluate anxiety and depression (HADS), social support, physical symptoms (STAS-J), and other factors.

Results: HADS anxiety and depression scores were significantly higher in cancer patients and survivors younger than 64 years than in those 65 years or older (p < 0.05). Anxiety and depression scores were higher in women than in men (p < 0.05). All components of support (emotional, instrumental, informational, and appraisal) were significantly associated with anxiety and depression, and scores were lower among those receiving support (p < 0.05). The proportion of patients receiving support was low, particularly in patients younger than 65 years. Anxiety and depression scores were significantly higher among those with severe symptoms (p < 0.05).

Discussion: Even after the COVID-19 pandemic, cancer patients and survivors continue to experience a substantial psychological burden. Levels of anxiety and depression tended to be higher particularly in adults younger than 64 years, women, those receiving inadequate social support, and those with severe symptoms. In the future, support strategies should emphasize facilitating social interaction among adult patients and survivors and strengthening symptom management. The findings of this study serve as a basis for considering appropriate support measures during future pandemics or periods of social restriction.