Differentiating symptoms of depression from diabetes-specific distress: relationships with self-care in type 2 diabetes

AIMS/HYPOTHESIS: The aim of this study was to examine the relationship between depressive symptoms and diabetes-specific distress and the independent relationships of each of these factors with diabetes self-care. We expected that symptoms of depression would be associated with poorer diabetes self-care, independent of diabetes-specific distress. METHODS: We surveyed 848 primary care patients with type 2 diabetes using the Harvard Department of Psychiatry/National Depression Screening Day Scale (HANDS), Problem Areas in Diabetes scale (PAID), Summary of Diabetes Self-Care Activities, and self-reported medication adherence. RESULTS: The PAID and HANDS scores were positively correlated in the overall sample (r=0.54, p<0.0001), among those who did not meet diagnostic criteria for major depressive disorder (MDD) based on the HANDS screening result (n=685; r=0.36, p<0.001) and in patients who did meet the screening criteria for MDD (n=163; r=0.36, p<0.001). Higher PAID scores significantly predicted lower levels of diet, exercise and medication adherence (all p values <0.05). However, once depression symptom scores were entered into these models, most relationships were reduced to non-significance, while the HANDS score retained significant relationships with most indices of diabetes self-care. The same pattern of results was found in the subset of patients who did not screen positive for MDD. CONCLUSIONS/INTERPRETATION: These results suggest that specific symptoms of depression have a greater negative relationship with diabetes self-care than diabetes-specific distress, even among those patients who do not meet screening criteria for MDD. Interventions that focus on improving the management of specific symptoms of depression may be more effective in improving self-care than those that focus on reducing distress.     

The relationship between depression and diabetes mellitus: findings from the Hertfordshire Cohort Study

Aims To assess the relationship between depression scores and diabetes, glucose and insulin in a cross‐sectional population‐based study. Methods One thousand, five hundred and seventy‐nine men and 1418 women from the Hertfordshire Cohort Study were assessed for diabetes. Plasma glucose and insulin concentrations were measured at 0, 30 and 120 min during a standard 75‐g oral glucose tolerance test. Depressive and anxiety symptoms were measured using the Hospital Anxiety and Depression Scale (HADS). Results Overall, 431 (14.6%) were diagnosed with diabetes [232 men (14.9%) and 199 women (14.3%)]. One hundred and eight (47%) men and 74 (37%) women had known diabetes. The remainder were previously undiagnosed. Fifty‐nine (3.7%) men and 65 (4.6%) women had possible depression (HAD‐D scores 8–10) and 17 (1.1%) men and 20 (1.4%) women had probable depression (HAD‐D scores ≥ 11). Probable depression was associated with an adjusted odds ratio for diabetes of 3.89 [95% confidence interval (CI) 1.28–11.88] in men and 1.51 (95% CI 0.47–4.84) in women. In men without previously diagnosed diabetes, fasting insulin (P = 0.035), 2‐h glucose concentrations (P = 0.028) and insulin resistance (P = 0.032) were significantly associated with HAD‐D scores. With the exception of 2‐h glucose concentrations (P = 0.034), the associations were not significant in women. Conclusions These data support the hypothesis that depression may increase the risk for diabetes. The relationship between depression score and metabolic variables extends across the whole population and is not confined to those with either diagnosed depression or diabetes. This relationship should lead clinicians to consider screening for diabetes in those with depression and vice versa.     

Depression in Croatian Type 2 diabetic patients: prevalence and risk factors. A Croatian survey from the European Depression in Diabetes (EDID) Research Consortium.

AIMS: To determine the prevalence rate of and risk factors for depression in Croatian Type 2 diabetic patients. METHODS: Depressive mood was examined in 384 randomly selected outpatients with Type 2 diabetes. Center for Epidemiological Studies Depression Scale (CES-D) and Structured Clinical Interview for DSM-IV Axis I Disorders (SCID) were used to identify depressive disturbances. The groups with CES-D > or = 16 and < 16 were compared with respect to demographic, psychological and clinical characteristics. Regression analysis was used to determine risk factors for depression. RESULTS: Of the examined patients, 22% had CES-D scores > or = 16, and in 33% of them clinical depression was confirmed by the psychiatric interview. Depressed patients compared with the non-depressed ones reported more diabetes-related problems and poorer well-being (t = 6.71, P < 0.001 and t = 11.98, P < 0.001, respectively). Multiple regression analysis indicated female gender, experienced support and the level of emotional well-being to predict depression (R = 0.74, F = 15.3, P < 0.001). CONCLUSIONS: The obtained data indicate that the prevalence rate in Croatian Type 2 diabetic patients is comparable to findings from other cultural settings. Depressive symptoms can be predicted by psychological rather than disease-related variables. Psychological care for diabetic patients may be necessary to prevent depressive symptomatology.     

Coronary risk assessment in subjects with type 2 diabetes mellitus. General population-based scores or specific scores?

Coronary risk in patients with type 2 diabetes mellitus can be calculated using population-based scores or diabetes-specific scores. Our objective was to compare the results with both scores in a group of patients with type 2 diabetes and no history of cardiovascular disease. We analyzed the results for 101 patients aged 40 to 65 years with type 2 diabetes and no prior cardiovascular disease. Two scales were used, one based on the general population (Framingham function adapted from the REGICOR study), and the other based on the population with type 2 diabetes mellitus (UKPDS risk engine). The average 10-year likelihood of coronary events was 5.8 (2.5)% and 15.7 (8.4)% for the REGICOR risk score and the UKPDS risk score, respectively (P<.001), with a Pearson correlation coefficient of 0.525 (P<.01). Risk was higher in men (19.2 [8.7]% based on the UKPDS score, and 5.6 [2.8]% based on the REGICOR score, P<.001). The figures for women were 11.3 [5.9]% and 5.9 [2.1]% with the UKPDS and REGICOR scores, respectively (P<.001). Our results suggest that substantially different findings are obtained when general population-based scores or specific scores are used to assess cardiovascular risk in subjects with type 2 diabetes.     

Depression bei älteren Menschen mit Typ-2-Diabetes

Diabetes is associated with an increased risk of depression which represents a life-threatening comorbidity especially for elderly patients. The comorbidity with depression is associated with hyperglycemia, microvascular and macrovascular diabetes complications as well as increased mortality. This increased risk can even be observed when minor depression symptoms are present in the elderly. Generic and diabetes-specific quality of life as well as the adherence to therapy is decreased when depression occurs together with diabetes. In elderly depressed patients with diabetes the functional and cognitive decline is more pronounced than in age-controlled diabetes patients without depression. Depression can be treated with antidepressants, psychotherapy or a flexible combination of both with relatively good results which are comparable to those of patients who have depression but not diabetes. However, no single form of treatment has been clearly identified which consistently leads to better medical outcomes in patients with both depression and diabetes. Despite the fact that depression can be treated in elderly patients with good results, there is a lack of research for the treatment of diabetes patients in advanced age.     

How to screen for depression and emotional problems in patients with diabetes: comparison of screening characteristics of depression questionnaires, measurement of diabetes-specific emotional problems and standard clinical assessment

Aims/hypothesis We compared the screening performance of different measures of depression: the standard clinical assessment (SCA); the Beck Depression Inventory (BDI); the Center of Epidemiological Studies-Depression Scale (CES-D); and the Problem Areas in Diabetes (PAID) questionnaire, which assesses diabetes-specific distress. We also studied the ability of these measures to detect diabetes-related distress. Materials and methods A total of 376 diabetic patients (37.2% type 1; 23.9% type 2 without insulin treatment, 38.8% type 2 with insulin) completed the BDI and CES-D; patients who screened positive participated in a diagnostic interview, the Composite International Diagnostic Interview (CIDI). Also, all patients completed the PAID questionnaire. Results of the SCA that related to depression diagnosis were reviewed to correct for false negative screening results. Results The prevalence of clinical depression was 14.1%, with an additional 18.9% of patients receiving a diagnosis of subclinical depression. Sensitivity for clinical depression in SCA (56%) was moderate, whereas BDI, CES-D and the PAID questionnaire showed satisfactory sensitivity (87, 79 and 81%, respectively). For subclinical depression, the sensitivity of the PAID questionnaire (79%) was sufficient, whereas that of SCA (25%) was poor. All methods showed low sensitivity for the detection of diabetes-specific emotional problems (SCA 19%, CIDI 34%, BDI 60%, CES-D 49%). Conclusions/interpretation The screening performance of SCA for clinical and subclinical depression was modest. Additional screening for depression using the PAID or another depression questionnaire seems reasonable. The ability of depression screening measures to identify diabetes-related distress is modest, suggesting that the PAID questionnaire could be useful when screening diabetic patients for both depression and emotional problems.     

Association between depression and subclinical carotid atherosclerosis in patients with Type 1 diabetes

Aims Recent studies have suggested an association between depression and subclinical atherosclerosis as measured by presence of carotid atherosclerotic plaque and increased intima‐media thickening in non‐clinical populations. Given the high prevalence of depression in patients with Type 1 diabetes and the diabetes‐related risk factors for atherosclerosis, we hypothesized that this relation might also be of special relevance in Type 1 diabetic patients. Methods Intima‐media thickness (IMT) and the presence of plaques in the carotid arteries were quantitatively assessed by high‐resolution ultrasound in 175 adults (89 men, 86 women) with an established diagnosis of Type 1 diabetes. Having been treated for depression or current Beck Depression Inventory scores > 10 were considered to indicate depression. Results In men, the risk of plaque was higher in depressed subjects relative to non‐depressed participants after adjustment for age, smoking status, systolic blood pressure, dyslipidaemia and body mass index [odds ratio (OR) 5.19; 95% confidence interval (CI) 1.29, 20.81]. Depressed women did not have an increased risk of plaque compared with non‐depressed women (OR 0.97; 95% 95% CI 0.22, 4.34). We did not observe an association between depression and IMT, in men or in women. Conclusions In line with previous research, our findings suggest a link between depression and subclinical atherosclerosis in Type 1 diabetic men, but not in women.     

Association of diabetes-related emotional distress with diabetes treatment in primary care patients with Type 2 diabetes.

AIMS: To characterize the determinants of diabetes-related emotional distress by treatment modality (diet only, oral medication only, or insulin). METHODS: A total of 815 primary care patients with Type 2 diabetes completed the Problem Areas in Diabetes (PAID) Scale and other questions. We linked survey data to a diabetes clinical research database and used linear regression models to assess the associations of treatment with PAID score. RESULTS: PAID scores were significantly higher among insulin-treated (24.6) compared with oral-treated (17.8, P < 0.001) or diet-treated patients (14.7, P < 0.001), but not different between oral- vs. diet-treated patients (P = 0.2). Group scores remained similar, but the statistical significance of their differences was reduced and ultimately eliminated after sequential adjustment for diabetes severity, HbA(1c), body mass index, regimen adherence, and self-blood-glucose monitoring. Insulin-treated patients reported significantly higher distress than oral- or diet-treated patients on 16 of 20 PAID items. 'Worrying about the future' and 'guilt/anxiety when ... off track with diabetes' were the top two serious problems (PAID >or= 5) in all treatment groups. Not accepting diabetes diagnosis was a top concern for oral- and diet-treated patients, and unclear management goals distressed diet-treated patients. CONCLUSIONS: Primary care patients treated with insulin reported higher diabetes-related emotional distress compared with oral- or diet-treated patients. Greater distress was largely explained by greater disease severity and self-care burdens. To improve diabetes-specific quality of life, clinicians should address patients' sense of worry and guilt, uncertain acceptance of diabetes diagnosis, and unclear treatment goals.     

Validation of the Spanish version of the Problem Areas in Diabetes (PAID-SP) Scale

This study aimed to assess the psychometric properties of the Spanish version of the Problem Areas in Diabetes (PAID-SP) Scale. Data were collected from patients with type 1 and type 2 diabetes. The findings suggested that the PAID-SP is a reliable and valid measure of diabetes-specific emotional problems.     

The relationship between quality of life and perceived body weight and dieting history in Dutch men and women

OBJECTIVES: (1) To study the relationship between quality of life (QoL) and measured and perceived weight and dieting history in Dutch men and women; (2) to assess the effect of weight loss over a 5 y period on QoL. DESIGN: A cross-sectional study, in a sub-sample longitudinal over 5 y. SUBJECTS: A total of 2155 men and 2446 women, aged 20-59 and recruited from the general population from three towns in The Netherlands. MEASUREMENTS: Body weight, height, self-administered questionnaire including questions concerning demographic variables and weight loss practices as part of the Dutch Monitoring project on Risk Factors for Chronic Disease (MORGEN). The Rand-36 questionnaire was used as the QoL measure. RESULTS: In men, measured overweight (body mass index, BMI>25 kg/m(2)) was not associated with any dimension of QoL after adjustment for age, educational level and perceived overweight. Perceived overweight was related to reduced scores for general health and vitality. This relationship was independent of measured obesity. A history of repeated weight loss was associated with reduced scores for role functioning due to both physical and emotional problems. In women, measured overweight was significantly associated with lower scores for five out of eight QoL dimensions and perceived overweight with three: general health, vitality and physical functioning. A history of frequent weight loss was related to significantly reduced scores in six dimensions. However, only with history of frequent weight loss, and uniquely in women, was there a significant reduction in scores on mental health and limited emotional role functioning. Measured and perceived overweight and frequent weight loss were all related to reduced scores for physical functioning. Longitudinal data indicate that in older women weight gain of 10% body weight or more was associated with a significant deterioration in QoL. CONCLUSIONS: When looking at measures of QoL in relation to overweight it is important to separate the effects of perception of weight status and history of weight loss. We observed that the latter two factors were associated with reduced scores on several dimensions of QoL, particularly in women. These associations were observed to be independent of body weight.     

Medical patients’ attitudes toward emotional problems and their treatment

BACKGROUND: Understanding medical patients' attitudes toward emotional problems and their management is crucial to overcoming obstacles to efficient depression treatment. OBJECTIVE: To investigate attitudes toward emotional problems, psychotherapy, antidepressants, alternative treatment approaches, and self-management techniques in depressed and nondepressed medical outpatients. DESIGN: Cross-sectional interview study, including quantitative and qualitative methods. PATIENTS: Eighty-seven depressed subjects (mean age, 41.0 years; 66% female) and 91 nondepressed subjects (mean age, 41.4 years; 67% female) from 7 internal medicine outpatient clinics and 12 family practices (participation rate, 91%). MEASUREMENTS: Depression diagnoses were established using a structured diagnostic interview, and patient attitudes were investigated with open-ended interview questions regarding treatment preferences, factors improving and impairing emotional well-being, and patients' self-management to improve well-being. RESULTS: Among the depressed patients, psychotherapy was the most frequently preferred treatment (29%) and the most common factor reported to improve emotional well-being (36%). Twenty-two percent of the depressed patients desired depression treatment within their current medical system, but requested substantially more time to communicate with their physician. Antidepressants were rarely mentioned as a preferred treatment (6%) or factor improving well-being (11%). Thirty-eight percent of the depressed patients attributed their impaired mood to health problems. Compared with the depressed patients, the nondepressed controls preferred significantly less frequent depression-specific therapies. CONCLUSIONS: The vast majority of medical outpatients prefer treatment approaches for emotional problems that go beyond antidepressant medication therapy. Health care providers should consider providing sufficient time to communicate with their patients, the strong preference for psychotherapy, and an appropriate treatment of comorbid physical conditions.     

History of major depressive disorder and diabetes outcomes in diet- and tablet-treated post-menopausal women: a case control study.

AIMS: Little is known about the long-term associations between remitted major depressive disorder (MDD) and clinical diabetes outcomes. This study investigated associations between a remote history of fully remitted MDD and (i) glycaemic control, (ii) diabetes symptoms, and (iii) physical and emotional functioning in post-menopausal women with Type 2 diabetes (T2DM). METHODS: Forty-four post-menopausal women with diet- or tablet-treated T2DM participated. Twenty-three had never experienced depression and 21 had a history of MDD. All participants had been free of MDD and antidepressant treatment for > or = 1 year. RESULTS: Compared with their never-depressed counterparts, women with a history of MDD had significantly higher HbA(1c) (7.0 vs. 6.5%), more diabetes symptoms, and worse emotional functioning, after controlling for confounding variables. Differences in HbA(1c) and diabetes symptoms were not accounted for by the higher current subclinical depressive symptoms observed in the previously depressed group. Differences in emotional functioning were accounted for by current subclinical depressive symptoms. CONCLUSIONS: Most health-care providers overlook fully remitted depression. However, previously depressed patients, who outnumber currently depressed patients, may still have poorer glycaemic control than never-depressed patients.     

Depressive symptoms after acute myocardial infarction: evidence for highest rates in younger women

BACKGROUND: Depression is common in patients hospitalized with acute myocardial infarction (AMI). In the community, younger women are uniquely prone to depression. Whether younger women are also more likely to have depression during hospitalization with AMI is unknown. METHODS: A total of 2498 AMI patients (1284 patients 相似文献   

心脏起搏患者术前心理状况及其心理干预的作用

为了解心脏起搏患者术前的心理状态及心理干预的作用 ,采用症状自评量表 (SCL 90 )调查 86例心脏起搏患者 ,总分 >16 0分或单个因子分 >2分示有心理问题。用焦虑自评量表 (SAS) ,抑郁自评量表 (SDS)分别评价 86例心脏起搏患者心理干预前后的焦虑、抑郁得分变化及其与 39例对照组的差别。结果 :SCL 90调查显示 :86例心脏起搏患者存在以焦虑 (4 3人 )、躯体化 (36人 )、恐怖 (34人 )、抑郁 (2 5人 )、人际关系 (2 2人 )为主要表现的心理问题 ,其得分均高于国内常模 (分别为 2 .0 9± 0 .5 9vs1.39± 0 .4 3,2 .19± 0 .5 4vs 1.37± 0 .4 8,2 .2 0± 0 .6 1vs1.2 3± 0 .4 1,2 .0 2± 0 .6 2vs 1.5 0± 0 .5 9,P均 <0 .0 1;2 .12± 0 .4 8vs 1.6 5± 0 .5 1,P <0 .0 5 )。心理干预后患者焦虑、抑郁得分明显下降 ,与干预前相比有统计学显著性差异 (分别为 4 1.2 4± 7.2 6vs 4 6 .78± 9.2 5 ,38.6 9± 6 .14vs4 4 .5 6± 7.82 ,P均 <0 .0 1) ;而对照组焦虑、抑郁两次评分比较无统计学显著性差异。结论 :心脏起搏患者存在焦虑、躯体化、恐怖、抑郁、人际关系等明显心理问题 ,心理干预能明显缓解患者的焦虑、抑郁状况。     

Coping strategies in immigrant men and women with type 2 diabetes

The aim of this study was to assess coping strategies of foreign-born men and women with type 2 diabetes in relation to demographic (sex, age, time in Sweden), medical, and socio-economic situation, and as compared with Swedish-born patients. Participants were foreign-born type 2 diabetic patients of European and non-European origin in primary health care in Stockholm County, comprising 41 men and 36 women aged 35-64 years, compared with Swedish-born type 2 diabetes patients, 121 men and 111 women. The General Coping Questionnaire, which measures five main orientations, dichotomised into "positive" and "negative" factors, i.e. 10 coping strategies, was used in the assessment. Medical and socio-economic data were obtained from medical records and postal questionnaires. Foreign-born men showed an impact on 6 of 10 coping strategies, and foreign-born women on 2 of 10 coping strategies, as compared to Swedish-born subjects. Longer time since migration and higher educational level were associated with lower scores for stressful coping strategies, while having financial problems and receiving a disability pension were associated with higher scores. In conclusion, the most stressful coping strategies were found among foreign-born men. It seems to be essential to improve and adjust diabetes care for immigrants, also including the psycho-social perspective.     

Psychotherapy intervention to reduce depressive symptoms in patients with diabetic foot syndrome

Aims Compared to the population as a whole, patients with diabetes mellitus suffer a significantly higher rate of depressive symptoms, especially when they develop complications. Psychotherapy treatments in diabetes mellitus can lead to improvements in both depressive symptoms and glycaemic control. The objective of this study was to investigate whether depressive symptoms can be reduced by psychotherapy treatment delivered as a joint interdisciplinary service to in‐patients with diabetic foot syndrome and comorbid depression. Methods Thirty in‐patients with diabetic foot syndrome and comorbid depression were randomized to either an intervention group (n = 15) with supportive psychotherapy treatment or a control group (n = 15) that received only standard medical treatment. Patients completed a set of questionnaires at the beginning and end of treatment. These recorded sociodemographic variables, anxiety and depression (Hospital Anxiety and Depression Scale) and diabetes‐related problems (Problem Areas in Diabetes Scale). Results Although the diabetic foot syndrome improved significantly in 75% of patients, the extent of depressive symptoms and anxiety reported by the control group did not decrease by the end of treatment. In contrast, in the intervention group, anxiety, depression and diabetes‐related problems were all reduced. The extent of anxiety and depression was not, as had been anticipated, associated with the severity of the physical symptoms. Conclusions These results indicate that psychotherapeutic intervention during in‐patient treatment can have a positive influence on anxiety, depressive symptoms and diabetes‐related problems in patients with diabetic foot syndrome.     

Symptoms of depression and diabetes‐specific emotional distress are associated with a negative appraisal of insulin therapy in insulin‐naïve patients with Type 2 diabetes mellitus. A study from the European Depression in Diabetes [EDID] Research Consortium

Aims A meta‐analysis concluded that depression is associated with poor glycaemic control in Type 2 diabetes (DM2). In DM2 patients with deteriorating glycaemic control, the initiation of insulin therapy is often postponed. The aim of the present study was to determine whether symptoms of depression and diabetes‐specific emotional distress are associated with a more negative appraisal of insulin therapy. Methods We collected cross‐sectional data in two outpatient university clinics in Istanbul, Turkey. The study sample consisted of 154 insulin‐naïve patients with DM2. A self‐report questionnaire was used to obtain demographic and clinical data. Main instruments were the Centre for Epidemiologic Studies Depression Scale, (CES‐D), the Problem Areas In Diabetes scale (PAID) and the Insulin Treatment Appraisal Scale (ITAS). Results Analysis of variance revealed that patients with a higher depression score rated insulin therapy significantly more negative then patients with lower depression scores. Moreover, 47% of patients with a high depression score had a negative appraisal of insulin therapy on 7 or more of the 20 ITAS‐items, compared to 25 to 29% of those with low‐moderate depression scores. Multiple regression analyses showed that a negative appraisal of insulin therapy was significantly associated with higher depression and diabetes‐distress scores and low education, but not with sex, age or duration of diabetes. Conclusions Our results suggest that in insulin‐naïve Type 2 diabetes patients, higher levels of depression and diabetes‐distress tend to be associated with more negative beliefs about insulin. Whether these negative attitudes translate into postponing initiation of insulin therapy needs to be tested in longitudinal research.     

A comparison of health-related quality of life of elderly and younger insulin-treated adults with diabetes

BACKGROUND: diabetes is a significant disease of elderly people, an age group whose numbers will double over the next 20-30 years. Yet studies which assess diabetes-related quality of life have rarely included elderly participants. OBJECTIVES: to compare and contrast the health-related quality of life of elderly (> or = 65 years) and younger individuals with diabetes using reliable and valid assessment tools. METHODS: 191 adults (> or = 30 years) with diabetes currently on an insulin regimen were recruited. Medical and demographic data were gathered from the medical chart. Participants completed a generic quality of life measure (SF-36) and 3 diabetes-specific measures. Statistical analyses compared adults (30-64 years) to elderly adults (> or = 65 years). RESULTS: on the generic SF-36, physical and mental summary scores did not differ. However, elderly participants reported greater role limitations due to physical problems, and better social function. On diabetes-specific measures, elderly participants reported higher satisfaction with diabetes-related aspects of their lives, less diabetes-related emotional distress, and better ability to cope with their diabetes. CONCLUSIONS: the differences that did emerge between the two groups suggest that, though experiencing more limitations in their ability to function in their roles, elderly individuals with diabetes may still feel that they can cope with these limitations and thus manage the distress and lifestyle demands of the diabetes. The value of subscale analysis of the SF-36 and use of diabetes-specific health-related quality of life measures is also affirmed.     

Prevalence and predictors of anxiety and depression among esophageal cancer patients prior to surgery

This study aims to establish the prevalence and predictors of anxiety and depression among esophageal cancer patients, post‐diagnosis but prior to curatively intended surgery. This was a cross‐sectional study using data from a hospital‐based prospective cohort study, carried out at St Thomas' Hospital, London. Potential predictor variables were retrieved from medical charts and self‐report questionnaires. Anxiety and depression were measured prior to esophageal cancer surgery, using the Hospital Anxiety and Depression Scale. Prevalence of anxiety and depression was calculated using the established cutoff (scores ≥8 on each subscale) indicating cases of ‘possible‐probable’ anxiety or depression, and multivariable logistic regression analyses were performed to examine predictors of emotional distress. Among the 106 included patients, 36 (34%) scored above the cutoff (≥8) for anxiety and 24 (23%) for depression. Women were more likely to report anxiety than men (odds ratio 4.04, 95% confidence interval 1.45–11.16), and patients reporting limitations in their activity status had more than five times greater odds of reporting depression (odds ratio 6.07, 95% confidence interval 1.53–24.10). A substantial proportion of esophageal cancer patients report anxiety and/or depression prior to surgery, particularly women and those with limited activity status, which highlights a need for qualified emotional support.