Background: Opioid has become one of main therapies in palliative care regarding to cancer pain. Management of chronic cancer pain by opioid may affect patient’s quality of life. Nevertheless, oral opioid therapy has been reported correlated with increasing incidences of depression in chronic non-cancer pain. This study is the first study to analyze correlation of opioid with depression in chronic cancer pain. The aim of this study is to investigate the effect of oral opioid therapy, including its duration and dosage, with the degree of depression in chronic cancer pain. Methods: This is a retrospective study including all patients who visited palliative outpatient clinic of Soetomo Hospital from April to June 2021. History of opioid therapy and depression scale collected from medical records. Depression assessed by trained physician using Hamilton Depression Rating Scale (HDRS). Data was analyzed using Chi Square and Spearman tests. Results: This study included 87 patients, consisted of 59 males and 38 females. Fifty-three (60.9%) patients were found given oral opioid therapy. Significant association found between oral opioid prescription and incidence of depression (p = 0.003). Opioid dosage (MED) (p=0.0001) and using opioid ≥90 days (p=0.011) were also found associated with the severity of depression. Severity of pain was also analyzed and found to be associated with severity of depression (p<0.0001). Multivariate analysis of all factors was done and found that severe pain [OR 8.99 (CI 95%, 1.68-48.13)] have the highest risk of getting depression in chronic cancer pain although oral opioid therapy also increased the risk [OR 2.91 (CI 95%, 1.07- 7.96)]. Duration and dosage of opioid use were not significantly associated with severity of depression. Conclusion: Oral opioid therapy and severity of pain were associated with severity of depression in chronic cancer pain. Nevertheless, opioid prescription to achieve adequate pain management may still be beneficial in preventing depression in cancer patients.

Keywords : Opioid, Duration of Opioid, Opioid Dosage, Severity of Pain, Severity of Depression, Chronic Cancer Pain.