Objective: The aim of this study was to examine the association between haemoglobin levels, anxiety disorder, and depression in cancer patients.
Methods: Cancer patients attending The Norwegian Radium Hospital (NRH) rated themselves on the Hospital Anxiety and Depression Scale (HADS). Five hundred thirty-two patients also had valid measurements of haemoglobin at the same time. The associations between tertile haemoglobin levels (7.0-12.3 g/dl, 12.4-13.8 g/dl, 13.9-17.1 g/dl) and HADS-defined anxiety disorder and depression were analysed by logistic regression.
Results: HADS-defined depression was identified in 116 cases (22%) and anxiety disorder in 149 (28%). The haemoglobin levels of the lower and middle tertiles were associated with depression (OR=3.85, 95% CI: 2.06-7.21, and OR=2.45, 95% CI: 1.25-4.81, respectively). Adjustment for covariates did not change the association significantly. No association between haemoglobin and anxiety disorder was found.
Conclusion: In cancer patients, the risk of depression increases with decreasing haemoglobin levels. This should be taken into account when treatment of anaemic or depressed cancer patients is decided upon.