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Cancer-Related Fatigue and Its Associations With Depression and Anxiety: A Systematic Review

Received March 28, 2008; revised June 20, 2008; accepted June 23, 2008. From Indiana University Purdue University, Indianapolis, IN; and Indiana University School of Medicine and Regenstrief Institute. Address correspondence and reprint requests to Linda F. Brown, M.S., Psychology Department, IN University Purdue University Indianapolis, 402 North Blackford St., LD 124, Indianapolis, IN 46202. e-mail: lfbrown{at}iupui.edu
© 2009 The Academy of Psychosomatic Medicine

BACKGROUND: Fatigue is an important symptom in cancer and has been shown to be associated with psychological distress. OBJECTIVE: This review assesses evidence regarding associations of cancer-related fatigue with depression and anxiety. METHOD: Database searches yielded 59 studies reporting correlation coefficients or odds ratios. RESULTS: The combined sample size was 12,103. Almost all studies showed a correlation of fatigue with depression and with anxiety. However, 31 different instruments were used to assess fatigue, suggesting a lack of consensus on measurement. CONCLUSION: This review confirms the association of fatigue with depression and anxiety. Directionality needs to be better delineated in longitudinal studies.

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