Prevalence of Depression and Associated Factors Among Patients with Cancer at Public Hospitals in Eastern Ethiopia, 2024

Jerman Dereje; Samuel Demissie Darcho; Kidist Mehari Azene; Bethelhem Fekadeselassie Lemma; Lemesa Abdisa; Olifan Getachew Wakjira

doi:doi:10.11648/j.rs.20251003.12

Research Article |

| Peer-Reviewed

Prevalence of Depression and Associated Factors Among Patients with Cancer at Public Hospitals in Eastern Ethiopia, 2024

Jerman Dereje^*

, Samuel Demissie Darcho

, Kidist Mehari Azene, Bethelhem Fekadeselassie Lemma, Lemesa Abdisa

, Olifan Getachew Wakjira

Published in Rehabilitation Science (Volume 10, Issue 3)

Received: 23 August 2025 Accepted: 9 September 2025 Published: 28 October 2025

Views: Downloads:

Download PDF

Share This Article

Twitter
Linked In
Facebook

Abstract

Depression is a major public health problem among cancer patients. One in three people with cancer experience depression or anxiety disorders before, during, or after treatment. Currently, there is little data on the prevalence of depression among cancer patients in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of depression among patients with cancer attending public hospitals in Harar town, eastern Ethiopia. An institution-based cross-sectional study was conducted among 342 patients with cancer attending public hospitals in Harar town, eastern Ethiopia, from June 1-30, 2024. A systematic random sampling technique was used to recruit participants. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). The collected data was entered into Epi-data 4.6 and imported to the statistical package for Social Science version 25 for analysis. Bivariate and multivariate logistic regression analyses were used to identify associated factors with depression. The odds ratio (OR) with a 95% confidence interval (CI) was used to assess the strength of the association. The prevalence of depression among patients with cancer was 43.9% (95% CI: 38.6, 49.2). Poor medication adherence (AOR = 3.98, 95% CI: 1.87, 8.51), poor social support (AOR = 2.14, 95% CI: 1.21, 3.79), unemployment (AOR = 2.31, 95% CI: 1.05, 5.04) were significantly associated with depression. In the current study, a significant number of patients with cancer had depression. Poor medication adherence, poor social support, and unemployment were significantly associated with depression among patients with cancer. Therefore, special attention should be given to patients with cancer with the mentioned risk factors of depression.

Published in	Rehabilitation Science (Volume 10, Issue 3)
DOI	10.11648/j.rs.20251003.12
Page(s)	43-51
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2025. Published by Science Publishing Group

Keywords

Prevalence, Associated Factors, Depression, Cancer Patient, Harar, Ethiopia

1. Introduction

A person diagnosed with cancer is more likely to experience adverse mental health outcomes such as depression and anxiety

[1]

. The cancer diagnosis causes a wide range of complicated emotions and lifestyle changes. Many people feel to blame for getting cancer and suffer from psychological disorders like major depression and anxiety

[2]

. Depression and anxiety are the two most prevalent and debilitating neuropsychiatric disorders caused by cancer

[3]

. Both are psychological and physiological disturbances characterized by physical, emotional, and behavioral elements

[4]

. Almost half of cancer patients have psychological disorders such as depression and anxiety

[5]

Globally, the prevalence of depression among patients with cancer ranges from 6.49% to 95%

[6-8]

. A prospective, multicenter cohort study in Spain reported that the prevalence of depression was 36.6%

[9]

. In a study conducted in Nigeria, the prevalence of depression among patients with cancer was 40.3%

[10]

. In Ethiopia, depression prevalence rates ranged from 25% to 70.86%

[8, 11]

. Patients with cancer are more likely to experience depressive symptoms than the general population (25% vs. 6%)

[12]

. A cross-sectional study conducted among patients with cancer at Black Lion Hospital in Ethiopia revealed that the prevalence of depression was 40.4%

[13]

. The pooled prevalence of depression among cancer patients in Ethiopia was 42.96%

[14]

Depression among patients with cancer is related to different factors as per different literature. Factors like age, sex, marital status, education level, income level, poor patient-provider interaction, social support, financial support, sleep quality, being unemployed, comorbid psychotic symptoms, eating problems, type of cancer, and stage of cancer were documented as significant predictors of depression among cancer patients

[8, 13, 15-18]

Despite the significant financial and medical consequences associated with depression, little is known about the prevalence of depression among patients with cancer, especially in the eastern part of Ethiopia. Therefore, the purpose of this study was to assess the prevalence and associated factors of depression among patients with cancer at public hospitals in Harar town, eastern Ethiopia, in 2024.

2. Methods and Materials

2.1. Study Setting, Design, and Period

An institution-based cross-sectional study was conducted in the Harari region, located 525 KM from Addis Ababa to Eastern Ethiopia. In the Harari region, there are 2 public hospitals namely Jagulla General Hospital and Hiwot Fana Specialized University hospital. The study was carried out from June 1 to 30, 2024.

2.2. Population

2.2.1. Source Population

All adult patients with cancer attending public hospitals in Harar town, eastern Ethiopia, were the source population for this study.

2.2.2. Study Population

All randomly selected adult patients with cancer attending public hospitals in Harar town, eastern Ethiopia, during the data collection period were the study population for this study.

2.3. Eligibility Criteria

2.3.1. Inclusion Criteria

All adult (≥18) patients with cancer who were attending public hospitals in Harar town, eastern Ethiopia, during the data collection period were included in this study.

2.3.2. Exclusion Criteria

Patients with cancer who were critically ill during the study period were excluded from this study.

2.4. Sample Size Determination

The sample size was determined by using a single population proportion formula at 95% CI and 5% marginal error. The proportion of depression is P 33.1%, which was taken from a previously conducted study in Addis Ababa

[17]

. Then sample size was calculated as:

n = {(\frac{Zα}{2})}^{2} \frac{P (1 - P)}{d^{2}}

n = \frac{{1.96}^{2} x 0.331 (1 - 0.331)}{{0.05}^{2}}

n = \frac{{1.96}^{2} x 0.331 (0.689)}{{0.05}^{2}}

=338

Considering 10% for the non-response rate; (338x0.1=34) and 338 +34=372 so, our final sample size was 372.

2.5. Sampling Procedure and Technique

A systematic random sampling technique was used to get a total of 372 cancer patients on follow-up in a Public hospital in Harari Regional State. On average, the total number of cancer patients on follow-up in the health institutions selected was 740 per month. The sample size allocation was done according to proportionality to the cancer patients in each health facility. Therefore, as we use the systematic random sampling method, to find the K value, we divide N=740 to n=372 which becomes ~ 1.9 (K=2). The first study participant was selected by a lottery method, and the next study participants were chosen at regular intervals (every 2) and interviewed by data collectors.

2.6. Study Variables

2.6.1. Dependent Variable

Depression (Yes/No)

2.6.2. Independent Variables

Socio-demographic characteristics: age, sex, marital status, occupational status, educational status, monthly income; substances-related factors: alcohol, khat, cigarette; clinical characteristics: types of cancer, duration of illness, duration between treatment and onset of illness, duration of treatment, and comorbid illness.

2.7. Operational Definitions

Depression: Participants with a patient health questionnaire-9 (PHQ-9) score with a cut-off point ≥ 10

[19, 13]

Strong social support: Participants with an Oslo-3 score of 12-14

[20]

Moderate social support: Participants with an Oslo-3 score of 9-11

[20]

Poor social support: Participants with an Oslo-3 score of 3-8

[20]

Poor medication adherence: Participants with a MARS score of 0-4

[17]

Strong medication adherence: Participants with a MARS score of 5-10

[17]

2.8. Data Collection Methods and Instruments

Pretested, structured, interviewer-administered questionnaires and a data extraction checklist were used to collect the data. The Patient Health Questionnaire (PHQ-9) is a 9-item scale composed of questions that correspond to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) diagnostic criteria for a major depressive episode. PHQ-9 scores ≥10 indicate depression

[19, 13]

. Social support was assessed by Oslo-3. The Oslo-3 consists of only three items that ask for the number of close confidants, the sense of concern from other people, and the relationship with neighbors with a focus on the accessibility of practical help

[21]

. Treatment adherence was assessed by the Medication Adherence Rating Scale (MARS)

[17]

. It is a 10-item self-reporting multidimensional instrument describing three dimensions: medication adherence behavior (items 1-4), attitude toward taking medication (items 5-8), and negative side effects and attitudes to psychotropic medication (items 9-10). Additionally, clinical-related variables were assessed by "yes/no" questions that developed from different literature.

2.9. Data Quality Control

Data quality was assured before, during, and after the data collection. Before data collection, a standardized questionnaire was prepared. The questionnaire was pretested outside the study area on about 5% of the sample size. The questionnaire developed in English was translated to the local language (Amharic and Afan Oromo) and then translated back to English to see the consistency. Data collectors and supervisors received one-day instruction on how to use the questionnaire, sampling methodologies, ethical principles, data management, and participant identification. During the data collection process, there was close day-to-day supervision, and the questionnaire was checked to ensure completeness and validity by supervisors and the principal investigator. Double data entry was done by two independent data clerks. Then, the two data sets were validated in the software for consistency and mismatches.

2.10. Data Analysis and Management

The data was checked, entered into Epi-data software version 4.6, and imported to SPSS version 25 for analysis. Socio-demographic characteristics and other factors were analyzed by descriptive statistics. A bivariable logistic regression analysis was run to determine the association between the independent variables and the outcome variable. The P-value and an odd ratio with a 95% CI were computed. Then, the variables with a p-value < 0.2 were taken into a multivariable model to control for all possible confounders. For model fitness, the Hosmer-Lemeshow model of fitness was checked, and the test fit the model. The strength of associations was evaluated using the adjusted odds ratio with a 95% CI, and a P value < 0.05 was considered statistically significant.

3. Results

3.1. Socio-demographic Characteristics of the Participants

A total of 342 patients with cancer were involved in this study, with a response rate of 92%. More than three-fifths (69.3%) of the participants were female and the majority (70.5%) of the respondents were married. The mean (± standard deviation) age of the participants was 41.08 (± 10.23) years. More than one-fifth (23.4%) of the participants completed secondary school. (Table 1)

Table 1. Socio-demographic characteristics of study participants among adult patients with cancer at public hospitals in Harar town, eastern Ethiopia, 2023 (n = 342).

Variables	Frequency (%)
Sex
Male	237 (69.3)
Female	105 (30.5)
Age (in year)
18-34	94 (27.5)
35-51	188 (55)
≥ 52	60 (17.5)
Religion
Muslim	174 (50.9)
Orthodox	100 (29.2)
Protestant	68 (19.9)
Marital status
Single	58 (17)
Married	241 (70.5)
Divorced	23 (6.7)
Windowed	20 (5.8)
Residence
Urban	181 (52.9)
Rural	161 (47.1)
Educational level
Un able to read and write	82 (24)
1-8^th grade	117 (34.2)
9-12^th grade	80 (23.4)
College	42 (12.3)
Degree and above	21 (6.1)
Occupation
Farmer	63 (18.4)
Merchant	33 (9.6)
Government employee	83 (24.3)
Unemployed	90 (26.3)
Other	73 (21.3)
Living status
With family	318 (93)
Living alone	24 (7)
Monthly income
Less and equal to 1000	199 (58)
1000-4500	90 (26.3)
>4501	53 (15.5)
Social support
Strong social support	30 (8.8)
Moderate social support	192 (56.1)
Poor social support	120 (35.1)

Others*student, housewife, retired

3.2. Clinical Characteristics and Medication Adherence Status of the Study Participants

Close to one-fourth (23.4%) of the participants have breast cancer. The majority (86%) of the respondents have comorbidity and more than four-fifths (82.2%) have poor medication adherence. (Table 2)

Table 2. Clinical characteristics and medication adherence status of study participants among adult cancer patients among adult patients with cancer at public hospitals in Harar town, eastern Ethiopia, 2024, (n = 342).

Variables	Frequency (%)
Types of cancer
Breast	80 (23.4)
Uterus	78 (22.8)
Cervical	55 (16.1)
Lung	48 (14)
Testicular	25 (7.3)
Other	56 (16.4)
Duration of illness (in years)
1-3 years	309 (90.4)
>4 years	33 (9.6)
Duration of treatment (in years)
<3	331 (96.8)
>4	11 (3.2)
Gap between onset of illness and treatment duration (in years)
1-4	332 (97.1)
>5	10 (2.9)
Co-morbidity
Yes	48 (14)
No	294 (86)
Medication adherence
Poor	281 (82.2)
Good	61 (17.8)

3.3. Prevalence of Depression among Cancer Patients

The overall prevalence of depression among adult patients with cancer was 43.9% (95% CI: 38.6, 49.2).

3.4. Factors Associated with Depression

To determine the association of independent variables with depression, bivariable and multivariable logistic regression analyses were carried out. In the bivariate analysis, factors including marital status, educational status, occupation, income level, type of cancer, medication adherence status, and social support were associated with depression at a P-value less than 0.2. These factors were entered into the multivariate logistic regression model to control confounding effects. Factors such as poor medication adherence, poor social support, and being unemployed were significantly associated with depression at a p-value less than 0.05.

The odds of developing depression were 3.98 (AOR = 3.98, 95% CI: 1.87, 8.51) times more likely among patients with poor medication adherence than patients with good medication adherence. The odds of developing depression were 2.31 (AOR = 2.31, 95% CI: 1.05, 5.04) times more likely among patients who were unemployed than employed patients. The odds of developing depression were 2.14 (AOR = 2.14, 95% CI: 1.21, 3.79) more likely among patients who had poor social support than strong social support. (Table 3)

Table 3. Factors associated with depression on bivariable and multivariable analysis among adult patients with cancer at public hospitals in Harar town, eastern Ethiopia, 2024, (n = 342).

Variables	Depression		COR (95%CI)	AOR (95%CI)	P-value
Variables	No (n, %)	Yes (n, %)	COR (95%CI)	AOR (95%CI)	P-value
Income
< 1000	106 (53.3)	93 (46.7)	1.06 (0.58, 1.95)	0.79 (0.19, 3.26)	0.75
1000-4500	57 (63.3)	33 (36.7)	0.70 (0.35, 1.39)	0.97 (0.31, 3.00)	0.98
>4500	29 (54.7)	24 (45.3)	1	1
Marital status
Single	30 (51.7)	28 (48.3)	0.40 (0.14, 1.19)	0.99 (4.6, 2.13)	0.98
Married	152 (63.1)	89 (36.9)	1	1	0.29
Divorced	4 (17.4)	19 (82.6)	0.25 (0.09, 0.68)	2.16 (0.51, 9.14)	0.44
Windowed	6 (30)	14 (70)	2.04 (0.48, 8.61)	1.67 (0.46, 6.11)
Occupation
Farmer	43 (68.3)	20 (31.7)	0.63 (0.31, 1.28)	0.76 (0.32, 0.18)	0.54
Merchant	22 (66.0)	11 (33.3)	0.68 (0.29, 1.60)	0.91 (0.31, 2.74)	0.87
Government employee	48(57.8)	35 (42.2)	1	1	0.04*
Unemployed	37(41.1)	53 (58.8)	0.98 (0.52, 1.87)	2.31 (1.05, 5.04)	0.56
Others	42(57.5)	31 (42.5)	1.94 (1.04, 3.63)	1.45 (0.42, 5.05)
Educational status
Unable to read and write	36 (43.9)	46 (56.1)	1.16 (0.44, 3.04)	2.29(0.45, 11.75)	0.32
1-8^th grade	75 (42.4)	42 (57.6)	0.51 (0.2, 1.13)	1.42 (0.29, 6.68)	0.66
9-12^th grade	43 (53.8)	37 (46.2)	0.78 (0.3, 2.05)	1.44 (0.34, 6.22)	0.63
College	28 (66.7)	14 (33.3)	0.46 (0.16, 1.33)	0.45 (0.12, 1.73)	0.25
Degree and above	10 (47.6)	11(52.4)	1	1
Type of cancer
Breast	42 (52.5)	38 (47.5)	1.63 (0.81, 3.28)	1.04(0.44, 2.45)	0.93
Uterus	54 (69.2)	24 (30.8)	0.80 (0.39, 1.66)	0.49(0.20, 1.21)	0.12
Cervical	24 (43.6)	31 (56.4)	2.33 (1.08, 4.98)	1.54(0.62, 3.82)	0.35
Lung	23 (47.9)	25 (52.1)	1.98 (0.89, 4.29)	1.18(0.46, 3.05)	0.74
Testicular	13 (52)	12 (48)	1.66 (0.64, 4.32)	1.18(0.39, 3.56)	0.77
Other	36 (64.3)	20 (35.7)	1	1
Social support
Poor	47 (39.1)	73 (60.9)	1.55 (0.695, 3.47)	2.14 (1.21, 3.79)	0.01*
Moderate	130 (67.7)	62 (32.3)	0.477 (0.219, 1.04)	2.65 (1.01, 6.92)	0.05
Strong	15 (50)	15 (50)	1	1
Medication adherence status
Poor	177 (63)	104 (37)	0.19 (0.11, 0.36)	3.98 (1.87, 8.51)	0.001*
Good	15 (24.6)	46 (75.4)	1	1

4. Discussion

This study aimed to assess the prevalence and associated factors of depression among patients with cancer attending public hospitals in Harar town, eastern Ethiopia. In this study, the prevalence of depression among adult patients with cancer was 43.9% (95% CI: 38.6%, 49.2%). This finding was in line with the study conducted in Ethiopia (39.6%)

[21]

and southeast Iran

[22]

. However, the finding of this study was lower than studies conducted in southern Ethiopia (58.8%)

[15]

, Gondar (58.4%)

[23]

, Bahir Dar and Gondar, Ethiopia (70.8%)

[24]

, the Amhara region (60.2)

[2]

, China (57.1%)

[6]

, Addis Ababa (54.6%)

[13]

, and India

[25]

. The finding of this study was higher than the study conducted in Debre Berhan (33.1%)

[17]

, Jordan (23.4%)

[26]

, India (22%)

[27]

, Germany (24%)

[28]

, Addis Ababa (25.0%)

[11]

, Egypt

[19]

, and Taiwan (8.33%)

[29]

. This discrepancy might be due to variations in the study population in terms of cancer types, screening tools used, severity of depression, and other sociodemographic variations. The differences might also be due to variations in the clinical characteristics of the participants. Another reason might be due to better health service interventions and psychological counseling delivered to patients with cancer in the aforementioned high-income countries.

In this study, patients with poor medication adherence had a higher risk of developing depression compared to patients who had good medication adherence. This finding is consistent with the study conducted in Mekelle, Ethiopia

[30]

, Germany

[31]

, and Canada

[32]

. This might be due to poor medication adherence, wastage of medication, reduced functional abilities, and a lower quality of life, which leads to depression

[33]

In the current study, patients who had poor social support had a higher risk of developing depression compared to patients who had good social support. This finding is in line with the study conducted in Addis Ababa

[34]

, the Amhara region

[2]

, a systematic study in Ethiopia

[14]

, the United States of America

[35]

, Istanbul, Turkey

[36]

, Austria

[37]

, and Iran

[38]

. This might be because social support provides physical and psychological benefits to patients who are faced with stressful physical and psychosocial events. Social support is thought to be a factor that lowers psychological distress in stressful situations. Increasing the level of social support may help the patient with cancer to reduce depression symptoms. Social support mitigates the negative impact of cancer diagnosis and treatment through the belonging and care they receive from others

[39]

. Poor social support tends to increase loneliness and stress and often leads to mental health problems such as depression and anxiety

[40]

In this study, unemployed patients with cancer are more likely to be affected by depression when compared with employed patients with cancer. This finding is supported by the study conducted in Addis Ababa

[17]

, northwest Ethiopia

[8]

, and Denmark

[41]

. This might be due to patients who were unemployed suffering from extreme physical and psychological stress, including depression. Being unemployed may cause sadness, upset, and feelings of hopelessness in patients with cancer.

Limitations of the study

Since the study was a cross-sectional study design, it didn’t allow for a temporal relationship between depression and associated factors among cancer patients.

5. Conclusion

In the current study, a significant number of patients with cancer had depression. Poor medication adherence, poor social support, and unemployment were significantly associated with depression among patients with cancer. Therefore, special attention should be given to patients with cancer with the mentioned risk factors of depression.

Abbreviations

DSM-V	Diagnostic and Statistical Manual of Mental Disorders
HRQOL	Health Related Quality of Life
HFCSUH	Hiwot Fana Comprehensive Specialized University Hospital
ICD-10	International Classification of Disease 10
MDD	Major Depressive Disorder
MARS	Medication Adherence Scale
OSSS-3	Oslo Social Support Scale 3
PHQ-9	Patient Health Questionnaire-9
SPSS	Statistical Package for Social Science
WHO	World Health Organization

Acknowledgments

The authors like to sincerely thank our data collectors for their outstanding dedication and assistance. We also like to express our gratitude to the study participants who voluntarily participated in this research.

Author Contributions

Jerman Dereje: Conceptualization, Data curation, Formal Analysis, Methodology, Writing – original draft and Writing – review & editing

Samuel Demissie Darcho: Formal Analysis, Methodology, Validation, Visualization, Writing – original draft, and Writing – review & editing

Kidist Mehari Azene: Methodology, Validation, Visualization, Writing – original draft, and Writing – review & editing

Bethelhem Fekadeselassie Lemma: Validation, Visualization, Writing – original draft, and Writing – review & editing

Lemesa Abdisa: Formal Analysis, Methodology, Writing – original draft and Writing – review & editing

Olifan Getachew Wakjira: Methodology, Writing – original draft and Writing – review & editing

Funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article.

Ethical Consideration and Consent to Participate

The Haramaya University School of Medicine and Health Sciences Research and Ethics Review Committee provided ethical approval and clearance (Ref. No. IHRERC/164/2024). Each participant gave written consent after being informed of the significance of the study and the benefits and risks of the study, which are well mentioned in the information sheet.

Availability of Data and Materials

The article contains the original contributions of the study; for additional information, send an email to Mr. Jerman Dereje.

Conflicts of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relation-ships that could be construed as potential conflicts of interest.

References

[1]	Zhu, J., et al., First-onset mental disorders after cancer diagnosis and cancer-specific mortality: a nationwide cohort study. Ann Oncol, 2017. 28(8): p. 1964-1969. https://doi.org/10.1093/annonc/mdx265
[2]	Endeshaw, D., T. A. Walle, and S. Yohannes, Depression, anxiety and their associated factors among patients with cancer receiving treatment at oncology units in Amhara Region, Ethiopia: a cross-sectional study. BMJ Open, 2022. 12(11): p. e063965. https://doi.org/10.1136/bmjopen-2022-063965
[3]	Walker J, H. H. C., Martin P, et al, Prevalence of depression in adults with cancer: a systematic review. Ann Oncol 2019; 24: 895–900. https://doi.org/10.1093/annonc/mds575
[4]	Ali S, S. M., Peters JL, et al, The prevalence of co-morbid depression in adults with type 2 diabetes: a systematic review and meta-analysis. Diabet Med 2019; 23: 1165–73. https://doi.org/10.1111/j.1464-5491.2006.01943.x
[5]	Barrera I, S. D., DJIrop S, Review of psychotherapeutic interventions on depression in cancer patients and their impact on disease progression. International Review of Psychiatry 2019; 26: 31–43. https://doi.org/10.3109/09540261.2013.864259
[6]	Yan, X., et al., Prevalence and risk factors of anxiety and depression in Chinese patients with lung cancer：a cross-sectional study. Cancer Manag Res, 2019. 11: p. 4347-4356. https://doi.org/10.2147/CMAR.S202119
[7]	Uwayezu MG, G. D., Sego R, et al, Anxiety and depression among cancer patients: prevalence and associated factors at a Rwandan referral hospital. 2019; 2: 118–25. https://doi.org/10.4314/rjmhs.v2i2.7
[8]	Baraki, A. G., G. M. Tessema, and E. A. Demeke, High burden of depression among cancer patients on chemotherapy in University of Gondar comprehensive hospital and Felege Hiwot referral hospital, Northwest Ethiopia. PLoS One, 2020. 15(8): p. e0237837. https://doi.org/10.1371/journal.pone.0237837
[9]	Fonseca PJ, H. C., Ramón T, Mut CM, Donnay ARO Factors associated with anxiety and depression in cancer patients prior to initiating adjuvant therapy. Clin Transl Oncol. (2018) 20: 1408–15. https://doi.org/10.1007/s12094-018-1873-9
[10]	Popoola AO, A. A., Prevalence and correlates of depressive disorders in outpatients with breast cancer in Lagos, Nigeria. Psychooncology. (2018) 21: 675–9. https://doi.org/10.1002/pon.1968
[11]	Wondimagegnehu, A., et al., Depression and social support among breast cancer patients in Addis Ababa, Ethiopia. BMC Cancer, 2019. 19(1): p. 836. https://doi.org/10.1186/s12885-019-6007-4
[12]	Harris, M. G., et al., Findings From World Mental Health Surveys of the Perceived Helpfulness of Treatment for Patients With Major Depressive Disorder. JAMA Psychiatry, 2020. 77(8): p. 830-841. https://doi.org/10.1001/jamapsychiatry.2020.1107
[13]	Abraham, Y., et al., Depression and anxiety prevalence and correlations among cancer patients at Tikur Anbesa Hospital in Addis Ababa, Ethiopia, 2018: Cross-sectional study. Front Psychiatry, 2022. 13: p. 939043. https://doi.org/10.3389/fpsyt.2022.939043
[14]	Geremew, H., et al., Anxiety and depression among cancer patients in Ethiopia: a systematic review and meta-analysis. Front Psychiatry, 2024. 15: p. 1341448. https://doi.org/10.3389/fpsyt.2024.1341448
[15]	Ayalew, M., B. Deribe, and B. Duko, Prevalence of depression and anxiety symptoms and their determinant factors among patients with cancer in southern Ethiopia: a cross-sectional study. 2022. 12(1): p. e051317. https://doi.org/10.1136/bmjopen-2021-051317
[16]	Breidenbach, C. and P. Heidkamp, Prevalence and determinants of anxiety and depression in long-term breast cancer survivors. 2022. 22(1): p. 101. https://doi.org/10.1186/s12888-022-03735-3
[17]	Belete, A.M., et al., Prevalence of depression and associated factors among adult cancer patients receiving chemotherapy during the era of COVID-19 in Ethiopia. Hospital-based cross-sectional study. 2022. 17(6): p. e0270293. https://doi.org/10.1371/journal.pone.0270293
[18]	Mekonnen, H., G. T. Gebreyohannis, and A. Cherie, Depression and associated factors among parents of children diagnosed with cancer at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia. Psychooncology, 2020. 29(7): p. 1141-1147. https://doi.org/10.1002/pon.5389
[19]	Degefa M, D. B., Bayouh F, Ayele B, Zewde Y, Validation of the PHQ-9 depression scale in Ethiopian cancer patients attending the oncology clinic at Tikur Anbessa specialized hospital. BMC Psychiatry (2020) 20: 446. https://doi.org/10.1186/s12888-020-02850-3
[20]	KOCALEVENT, R.-D., BERG, L., BEUTEL, M. E., HINZ, A., ZENGER, M., HÄRTER, M., NATER, U. & BRÄHLER, E, Social support in the general population: standardization of the Oslo social support scale (OSSS-3). 2018 BMC psychology, 6, 1-8. https://doi.org/10.1186/s40359-018-0249-9
[21]	ALEMAYEHU, M., DEYESSA, N., MEDIHIN, G. & FEKADU, A, A descriptive analysis of depression and pain complaints among patients with cancer in a low income country. 2018. PloS one, 13, e0193713. https://doi.org/10.1371/journal.pone.0193713
[22]	HASHEMI, S.-M., HORMOZI, M., ALLAHYARI, A., ANOUSHIRVANI, A. A., AMERI, Z. & GHASEMIPOUR, S, The prevalence of depression, anxiety, and stress in patients with breast cancer in Southeast Iran in 2019: a cross-sectional study. Oncology in Clinical Practice, 16, 104-108 https://doi.org/10.5603/OCP.2020.0015
[23]	Berihun F, H. S., Abawa M, Archives of depression and anxiety prevalence and correlates of anxiety and depression among cancer patients in the University of Gondar comprehensive specialized Hospital, Northwest Ethiopia. Arch Depress Anxiety 2017; 3: 42–8. https://doi.org/http://doi.org/10.17352/2455-5460.000022
[24]	Wondie, Y., A. Mehnert, and A. Hinz, The Hospital Anxiety and Depression Scale (HADS) applied to Ethiopian cancer patients. 2020. 15(12): p. e0243357. https://doi.org/10.1371/journal.pone.0243357
[25]	Rajakumar, R. R., Original article. N Engl J Med. (2020) 31: 257–61.
[26]	Naser, A. Y., et al., Depression and Anxiety in Patients With Cancer: A Cross-Sectional Study. Front Psychol, 2021. 12: p. 585534. https://doi.org/10.3389/fpsyg.2021.585534
[27]	Purkayastha, D., et al., Prevalence of Depression in Breast Cancer Patients and its Association with their Quality of Life: A Cross-sectional Observational Study. Indian J Palliat Care, 2017. 23(3): p. 268-273. https://doi.org/10.4103/IJPC.IJPC_6_17
[28]	Hartung, T. J., et al., The risk of being depressed is significantly higher in cancer patients than in the general population: Prevalence and severity of depressive symptoms across major cancer types. Eur J Cancer, 2017. 72: p. 46-53. https://doi.org/10.1016/j.ejca.2016.11.017
[29]	Alagizy HA, S. M., Soliman SS, et al, Anxiety, depression and perceived stress among breast cancer patients: single institute experience. Middle East Curr Psychiatry 2020; 27(1): 29. https://doi.org/10.1186/s43045-020-00036-x
[30]	TSEGAY, A., MOKENEN, W. & GEBREHIWOT, B, Assessment and Associated Factors of Suicidal Behaviour Among Cancer Patients Visiting the Oncology Outpatient Unit in Mekelle Oncologic Clinics, Tigray, Ethiopia: 2023 A cross Sectional Study. Journal of Neuro and Spine, 1, 16-25.
[31]	Schönenberg, A., K. G. Heimrich, and T. Prell, Impact of depressive symptoms on medication adherence in older adults with chronic neurological diseases. BMC Psychiatry, 2024. 24(1): p. 131. https://doi.org/10.1186/s12888-024-05585-7
[32]	Wishart, D. S., et al., DrugBank 5.0: a major update to the DrugBank database for 2018. Nucleic Acids Res, 2018. 46(D1): p. D1074-d1082. https://doi.org/10.1093/nar/gkx1037
[33]	BALTENBERGER, E. P., SCHMITT, G. & THOMAS, C. J, Treatment of depressive symptoms in patients with cancer. Mental Health Clinician, 2019. 4, 114-117.
[34]	Sebro, E. and E. Biranu, Depression and associated factors among adult breast cancer patients attending at selected public hospital in Addis Ababa, Ethiopia. 2024. 12: p. 20503121241283727. https://doi.org/10.1177/20503121241283727
[35]	Arcaya M, G. M., Christakis NA, Kawachi I, Subramanian S Individual and spousal unemployment as predictors of smoking and drinking behavior. Soc Sci Med (2018) 110: 89–95. https://doi.org/10.1016/j.socscimed.2014.03.034
[36]	Bener, A., et al., Depression, Hopelessness and Social Support among Breast Cancer Patients: in Highly Endogamous Population. Asian Pac J Cancer Prev, 2017. 18(7): p. 1889-1896. https://doi.org/10.22034/APJCP.2017.18.7.1889
[37]	Riedl, D. and G. Schuessler, Prevalence of Depression and Cancer - A systematic review. Z Psychosom Med Psychother, 2022. 68(1): p. 74-86. https://doi.org/10.13109/zptm.2021.67.oa11
[38]	Harandi, T. F., M. M. Taghinasab, and T. D. Nayeri, The correlation of social support with mental health: A meta-analysis. Electron Physician, 2017. 9(9): p. 5212-5222. https://doi.org/10.19082/5212
[39]	Kadambi, S., et al., Social support for older adults with cancer: Young International Society of Geriatric Oncology review paper. J Geriatr Oncol, 2020. 11(2): p. 217-224. https://doi.org/10.1016/j.jgo.2019.09.005
[40]	Zamanian, H., et al., Perceived social support, coping strategies, anxiety and depression among women with breast cancer: Evaluation of a mediation model. Eur J Oncol Nurs, 2021. 50: p. 101892. https://doi.org/10.1016/j.ejon.2020.101892
[41]	Friberg, A. S., I. Rask Moustsen, and S. Benzon Larsen, Educational level and the risk of depression after prostate cancer. 2019. 58(5): p. 722-729. https://doi.org/10.1080/0284186X.2019.1566773

Cite This Article

Plain Text BibTeX RIS

APA Style

Dereje, J., Darcho, S. D., Azene, K. M., Lemma, B. F., Abdisa, L., et al. (2025). Prevalence of Depression and Associated Factors Among Patients with Cancer at Public Hospitals in Eastern Ethiopia, 2024. Rehabilitation Science, 10(3), 43-51. https://doi.org/10.11648/j.rs.20251003.12

Copy | Download

ACS Style

Dereje, J.; Darcho, S. D.; Azene, K. M.; Lemma, B. F.; Abdisa, L., et al. Prevalence of Depression and Associated Factors Among Patients with Cancer at Public Hospitals in Eastern Ethiopia, 2024. Rehabil. Sci. 2025, 10(3), 43-51. doi: 10.11648/j.rs.20251003.12

Copy | Download

AMA Style

Dereje J, Darcho SD, Azene KM, Lemma BF, Abdisa L, et al. Prevalence of Depression and Associated Factors Among Patients with Cancer at Public Hospitals in Eastern Ethiopia, 2024. Rehabil Sci. 2025;10(3):43-51. doi: 10.11648/j.rs.20251003.12

Copy | Download

@article{10.11648/j.rs.20251003.12,
  author = {Jerman Dereje and Samuel Demissie Darcho and Kidist Mehari Azene and Bethelhem Fekadeselassie Lemma and Lemesa Abdisa and Olifan Getachew Wakjira},
  title = {Prevalence of Depression and Associated Factors Among Patients with Cancer at Public Hospitals in Eastern Ethiopia, 2024
},
  journal = {Rehabilitation Science},
  volume = {10},
  number = {3},
  pages = {43-51},
  doi = {10.11648/j.rs.20251003.12},
  url = {https://doi.org/10.11648/j.rs.20251003.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.rs.20251003.12},
  abstract = {Depression is a major public health problem among cancer patients. One in three people with cancer experience depression or anxiety disorders before, during, or after treatment. Currently, there is little data on the prevalence of depression among cancer patients in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of depression among patients with cancer attending public hospitals in Harar town, eastern Ethiopia. An institution-based cross-sectional study was conducted among 342 patients with cancer attending public hospitals in Harar town, eastern Ethiopia, from June 1-30, 2024. A systematic random sampling technique was used to recruit participants. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). The collected data was entered into Epi-data 4.6 and imported to the statistical package for Social Science version 25 for analysis. Bivariate and multivariate logistic regression analyses were used to identify associated factors with depression. The odds ratio (OR) with a 95% confidence interval (CI) was used to assess the strength of the association. The prevalence of depression among patients with cancer was 43.9% (95% CI: 38.6, 49.2). Poor medication adherence (AOR = 3.98, 95% CI: 1.87, 8.51), poor social support (AOR = 2.14, 95% CI: 1.21, 3.79), unemployment (AOR = 2.31, 95% CI: 1.05, 5.04) were significantly associated with depression. In the current study, a significant number of patients with cancer had depression. Poor medication adherence, poor social support, and unemployment were significantly associated with depression among patients with cancer. Therefore, special attention should be given to patients with cancer with the mentioned risk factors of depression.
},
 year = {2025}
}

Copy | Download

TY  - JOUR
T1  - Prevalence of Depression and Associated Factors Among Patients with Cancer at Public Hospitals in Eastern Ethiopia, 2024

AU  - Jerman Dereje
AU  - Samuel Demissie Darcho
AU  - Kidist Mehari Azene
AU  - Bethelhem Fekadeselassie Lemma
AU  - Lemesa Abdisa
AU  - Olifan Getachew Wakjira
Y1  - 2025/10/28
PY  - 2025
N1  - https://doi.org/10.11648/j.rs.20251003.12
DO  - 10.11648/j.rs.20251003.12
T2  - Rehabilitation Science
JF  - Rehabilitation Science
JO  - Rehabilitation Science
SP  - 43
EP  - 51
PB  - Science Publishing Group
SN  - 2637-594X
UR  - https://doi.org/10.11648/j.rs.20251003.12
AB  - Depression is a major public health problem among cancer patients. One in three people with cancer experience depression or anxiety disorders before, during, or after treatment. Currently, there is little data on the prevalence of depression among cancer patients in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of depression among patients with cancer attending public hospitals in Harar town, eastern Ethiopia. An institution-based cross-sectional study was conducted among 342 patients with cancer attending public hospitals in Harar town, eastern Ethiopia, from June 1-30, 2024. A systematic random sampling technique was used to recruit participants. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). The collected data was entered into Epi-data 4.6 and imported to the statistical package for Social Science version 25 for analysis. Bivariate and multivariate logistic regression analyses were used to identify associated factors with depression. The odds ratio (OR) with a 95% confidence interval (CI) was used to assess the strength of the association. The prevalence of depression among patients with cancer was 43.9% (95% CI: 38.6, 49.2). Poor medication adherence (AOR = 3.98, 95% CI: 1.87, 8.51), poor social support (AOR = 2.14, 95% CI: 1.21, 3.79), unemployment (AOR = 2.31, 95% CI: 1.05, 5.04) were significantly associated with depression. In the current study, a significant number of patients with cancer had depression. Poor medication adherence, poor social support, and unemployment were significantly associated with depression among patients with cancer. Therefore, special attention should be given to patients with cancer with the mentioned risk factors of depression.

VL  - 10
IS  - 3
ER  -

Copy | Download

Author Information

Jerman Dereje

Department of Psychiatry, Haramaya University, Harar, Ethiopia

Contact Email

http://orcid.org/0000-0002-5845-8458
Samuel Demissie Darcho

School of Public Health, Haramaya University, Harar, Ethiopia

http://orcid.org/0009-0002-2242-7489
Kidist Mehari Azene

Ethiopian Public Health Institute, Addis Ababa, Ethiopia
Bethelhem Fekadeselassie Lemma

Commercial Bank of Ethiopia Clinic, Addis Ababa, Ethiopia
Lemesa Abdisa

School of Nursing, Haramaya University, Harar, Ethiopia

http://orcid.org/0000-0002-6912-1025
Olifan Getachew Wakjira

School of Medicine, Haramaya University, Harar, Ethiopia

Download PDF

Submit an Article

Abstract
Keywords
Document Sections
Show Full Outline
Abbreviations
Acknowledgments
Author Contributions
Funding
Ethical Consideration and Consent to Participate
Availability of Data and Materials
Conflicts of Interest
References
Cite This Article
Author Information

Plain Text BibTeX RIS

APA Style

Dereje, J., Darcho, S. D., Azene, K. M., Lemma, B. F., Abdisa, L., et al. (2025). Prevalence of Depression and Associated Factors Among Patients with Cancer at Public Hospitals in Eastern Ethiopia, 2024. Rehabilitation Science, 10(3), 43-51. https://doi.org/10.11648/j.rs.20251003.12

Copy | Download

ACS Style

Dereje, J.; Darcho, S. D.; Azene, K. M.; Lemma, B. F.; Abdisa, L., et al. Prevalence of Depression and Associated Factors Among Patients with Cancer at Public Hospitals in Eastern Ethiopia, 2024. Rehabil. Sci. 2025, 10(3), 43-51. doi: 10.11648/j.rs.20251003.12

Copy | Download

AMA Style

Dereje J, Darcho SD, Azene KM, Lemma BF, Abdisa L, et al. Prevalence of Depression and Associated Factors Among Patients with Cancer at Public Hospitals in Eastern Ethiopia, 2024. Rehabil Sci. 2025;10(3):43-51. doi: 10.11648/j.rs.20251003.12

Copy | Download

@article{10.11648/j.rs.20251003.12,
  author = {Jerman Dereje and Samuel Demissie Darcho and Kidist Mehari Azene and Bethelhem Fekadeselassie Lemma and Lemesa Abdisa and Olifan Getachew Wakjira},
  title = {Prevalence of Depression and Associated Factors Among Patients with Cancer at Public Hospitals in Eastern Ethiopia, 2024
},
  journal = {Rehabilitation Science},
  volume = {10},
  number = {3},
  pages = {43-51},
  doi = {10.11648/j.rs.20251003.12},
  url = {https://doi.org/10.11648/j.rs.20251003.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.rs.20251003.12},
  abstract = {Depression is a major public health problem among cancer patients. One in three people with cancer experience depression or anxiety disorders before, during, or after treatment. Currently, there is little data on the prevalence of depression among cancer patients in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of depression among patients with cancer attending public hospitals in Harar town, eastern Ethiopia. An institution-based cross-sectional study was conducted among 342 patients with cancer attending public hospitals in Harar town, eastern Ethiopia, from June 1-30, 2024. A systematic random sampling technique was used to recruit participants. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). The collected data was entered into Epi-data 4.6 and imported to the statistical package for Social Science version 25 for analysis. Bivariate and multivariate logistic regression analyses were used to identify associated factors with depression. The odds ratio (OR) with a 95% confidence interval (CI) was used to assess the strength of the association. The prevalence of depression among patients with cancer was 43.9% (95% CI: 38.6, 49.2). Poor medication adherence (AOR = 3.98, 95% CI: 1.87, 8.51), poor social support (AOR = 2.14, 95% CI: 1.21, 3.79), unemployment (AOR = 2.31, 95% CI: 1.05, 5.04) were significantly associated with depression. In the current study, a significant number of patients with cancer had depression. Poor medication adherence, poor social support, and unemployment were significantly associated with depression among patients with cancer. Therefore, special attention should be given to patients with cancer with the mentioned risk factors of depression.
},
 year = {2025}
}

Copy | Download

TY  - JOUR
T1  - Prevalence of Depression and Associated Factors Among Patients with Cancer at Public Hospitals in Eastern Ethiopia, 2024

AU  - Jerman Dereje
AU  - Samuel Demissie Darcho
AU  - Kidist Mehari Azene
AU  - Bethelhem Fekadeselassie Lemma
AU  - Lemesa Abdisa
AU  - Olifan Getachew Wakjira
Y1  - 2025/10/28
PY  - 2025
N1  - https://doi.org/10.11648/j.rs.20251003.12
DO  - 10.11648/j.rs.20251003.12
T2  - Rehabilitation Science
JF  - Rehabilitation Science
JO  - Rehabilitation Science
SP  - 43
EP  - 51
PB  - Science Publishing Group
SN  - 2637-594X
UR  - https://doi.org/10.11648/j.rs.20251003.12
AB  - Depression is a major public health problem among cancer patients. One in three people with cancer experience depression or anxiety disorders before, during, or after treatment. Currently, there is little data on the prevalence of depression among cancer patients in Ethiopia. Therefore, this study aimed to assess the prevalence and associated factors of depression among patients with cancer attending public hospitals in Harar town, eastern Ethiopia. An institution-based cross-sectional study was conducted among 342 patients with cancer attending public hospitals in Harar town, eastern Ethiopia, from June 1-30, 2024. A systematic random sampling technique was used to recruit participants. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). The collected data was entered into Epi-data 4.6 and imported to the statistical package for Social Science version 25 for analysis. Bivariate and multivariate logistic regression analyses were used to identify associated factors with depression. The odds ratio (OR) with a 95% confidence interval (CI) was used to assess the strength of the association. The prevalence of depression among patients with cancer was 43.9% (95% CI: 38.6, 49.2). Poor medication adherence (AOR = 3.98, 95% CI: 1.87, 8.51), poor social support (AOR = 2.14, 95% CI: 1.21, 3.79), unemployment (AOR = 2.31, 95% CI: 1.05, 5.04) were significantly associated with depression. In the current study, a significant number of patients with cancer had depression. Poor medication adherence, poor social support, and unemployment were significantly associated with depression among patients with cancer. Therefore, special attention should be given to patients with cancer with the mentioned risk factors of depression.

VL  - 10
IS  - 3
ER  -

Copy | Download