Depression, hopelessness, and sleep in cancer patients' desire for death

Objective: The aim of this study was to evaluate the prevalence of clinical characteristics and risk factors for hastened death in advanced cancer patients. Methods: Patients completed the Greek version of Schedule of Attitudes toward Hastened Death (G-SAHD), a sleep quality measure, the Pittsburgh Sleep Quality Index (PSQI), a Greek version of a depression inventory, the Beck Depression Inventory (BDI), a hopelessness scale, the Beck Hopelessness Scale (BHS), and a Visual Analogue Scale (VAS) for the assessment of pain. Patients: The final sample consisted of 102 terminally ill cancer patients attending a Palliative Care Unit. Results: Statistically significant associations were found between G-SAHD and patients performance status (ECOG) (chi(2) = 8.62, p = 0.003). Strongest associations were observed between desire for death, depression, and hopelessness (r = 0.468, p < 0.0005, r = 0.678, p < 0.0005, respectively). In the prediction of G-SHAD the contribution of "hopelessness" (p < 0.0005), "depression" (p < 0.0005), "use of sleeping medication" (p < 0.0005), and "sleep quality" (p = 0.001) was high (59% of variance). Conclusion: Depression, hopelessness, and sleep quality appeared to have a statistically significant relationship with desire for hastened death. Health care professionals finding desire for death in advanced cancer patients should not only consider depression and hopelessness, but also other factors such as poor sleep quality in their diagnostic formulations in order to provide the appropriate treatment.