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Nahle AA, Hamdar H, Awada R, Kaddour Z, Rammal Z, Abbas R, Jalloul SI, Ismail NH. Assessing quality of life and depression in non-metastatic breast cancer patients following surgical treatment: A cross-sectional study in Lebanon. Medicine (Baltimore) 2024; 103:e38588. [PMID: 38905381 PMCID: PMC11191868 DOI: 10.1097/md.0000000000038588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 05/23/2024] [Indexed: 06/23/2024] Open
Abstract
Breast cancer is a global health concern that significantly impacts the quality of life (QOL) of individuals. This study aims to comprehensively examine the interplay between QOL and depression among nonmetastatic breast cancer patients in Lebanon, a region with limited research in this context. A cross-sectional study was conducted at Hammoud Hospital-University Medical Center from January 2018 to January 2023. Data was collected through a self-administered questionnaire distributed as Google Forms via WhatsApp. A total of 193 patients had non-metastatic breast cancer. Out of these, 81 valid responses were obtained. The Patient Health Questionnaire and Quality of Life Scale were used to assess depression and QOL, respectively. A total of 81 patients were included with mean age 54.4 years. Results revealed that 77.8% of patients experienced provisional depression, with 35.8% meeting criteria for major depressive disorder. Financial status and chronic diseases were associated with the likelihood of developing major depressive disorder. The mean QOL score was 81.14, lower than the average for healthy individuals. Educational level and presence of chronic diseases were significant factors influencing QOL. Postsurgical depression prevalence is substantial, underscoring the importance of integrating mental health care. Economic status and comorbidities are influential factors, necessitating targeted interventions. Breast cancer's impact on QOL is profound, falling below that of other chronic conditions. Education empowers coping, while comorbidities impact QOL. Our findings emphasize the multidimensional nature of breast cancer care, advocating for holistic support and addressing emotional well-being.
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Affiliation(s)
| | - Hussein Hamdar
- Faculty of Medicine, Damascus University, Damascus, Syria
| | - Rim Awada
- Faculty of Medical Sciences, Lebanese University, Rafic Hariri University Campus, Hadath, Lebanon
| | - Ziad Kaddour
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Zeina Rammal
- Faculty of Medical Sciences, Lebanese University, Rafic Hariri University Campus, Hadath, Lebanon
| | - Rim Abbas
- Faculty of Medical Sciences, Lebanese University, Rafic Hariri University Campus, Hadath, Lebanon
| | - Sarah Ibrahim Jalloul
- Department of Gastroenterology, Faculty of Medicine, University of Balamand, Beirut, Lebanon
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Zhang Q, Wu G, Chen J, Fang K, Liu Q, Zhang P, Zhu H, Zhang C. Factors influencing depressive symptoms in Chinese female breast cancer patients: a meta-analysis. Front Psychol 2024; 15:1332523. [PMID: 38659682 PMCID: PMC11039958 DOI: 10.3389/fpsyg.2024.1332523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
Objective To systematically evaluate and explore the factors influencing depressive symptoms in female breast cancer patients in China through meta-analysis. Methods Relevant data were retrieved from cross-sectional studies or cohort studies on depressive symptoms of Chinese breast cancer within the following databases: PubMed, Embase, Cohrane Library, Web of 105 Science, Database of Medical Literature (CBM), Wan Fang Data, CNKI, and VIP databases. The literature screening, data extraction and literature quality evaluation were performed by two researchers by carefully reading the title, abstract and full text, and meta-analysis was performed using Stata 1.5 software after extracting relevant data. Results Fourteen papers were finally included, with a cumulative total of 3,071 people surveyed, and a total of 1,298 breast cancer patients were detected with depression, with a detection rate of depressive symptoms of 42.26%; meta analysis showed that age less than 40 years old, unmarried, less than undergraduate education, monthly income <5,000 yuan, advanced breast cancer, radical breast cancer surgery, family history, living in rural areas, underlying disease stage and chemotherapy were associated with an increased incidence of depression in breast cancer patients. Conclusion The detection rate of depressive symptoms in female breast cancer patients is high, and there is a need to strengthen depression-related psychological screening of breast cancer patients and provide them with individualized interventions to reduce the incidence of depression in breast cancer patients and to lower the level of depression already present in the patients.
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Affiliation(s)
- Qingyuan Zhang
- Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
- Center of Structural Cardiology, Zhongnan Hospital, Wuhan University, Wuhan, Hubei, China
| | - Gen Wu
- The Fifth Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | | | - Kui Fang
- The First Hospital of China Medical University, Shenyang, Liaoning, China
| | - Qianqian Liu
- Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Pan Zhang
- Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Hongzhen Zhu
- Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
| | - Chunhua Zhang
- Zhongnan Hospital of Wuhan University, Wuhan, Hubei, China
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Koç Z, Kaplan E, Tanrıverdi D. The effectiveness of telehealth programs on the mental health of women with breast cancer: A systematic review. J Telemed Telecare 2024; 30:405-419. [PMID: 35108131 DOI: 10.1177/1357633x211069663] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Objective: The purpose of this systematic review is to determine the evidence-based information and results about the effectiveness of telehealth programs on the mental health of women with breast cancer. Methods: The research process was carried out using PRISMA guidelines. Randomized controlled trials with available abstract and full text, which were published in English with the keywords "telehealth," "telemedicine," "web-based therapy," "telepsychiatry," "online therapy" and "breast cancer" in Pub Med, PsycINFO, Medline, Science Direct, Scopus, Web of Sciences and Cochrane databases between 2015-2019 were searced. As a result of the evaluations, the research was completed with 16 studies meeting the research criteria. Results: There was strong evidence for reduce the fear of relapse of cancer, depressive symptoms and severity of depression, distress, intrusive thoughts, anxiety, sleep disorder, insomnia, improve quality of life and for improve cognitive functions, improve psychological strength and sleep quality of telehealth programs in women with breast cancer. Furthermore, evidence was found for increase psychological health, functionality, optimism and control over the future, positive mood and life appreciation, and drug compliance of these programs. Conclusion: This review found evidence for the effectiveness of telehealth programs on the mental problems of women with breast cancer. In this sense, it is recommended to expand the use of telehealth programs, which can save time and cost, are accessible and easily applicable by nurses, to improve the mental health of women with breast cancer, and further studies are recommended.
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Affiliation(s)
- Zeynep Koç
- Faculty of Health Sciences, Department of Nursing, Gaziantep University, Gaziantep, Turkey
| | - Ece Kaplan
- Faculty of Health Sciences, Department of Nursing, Gaziantep University, Gaziantep, Turkey
| | - Derya Tanrıverdi
- Faculty of Health Sciences, Department of Nursing, Gaziantep University, Gaziantep, Turkey
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Shin Y, Kim H, Lee T, Kim S, Lee SB, Kim J, Chung IY, Ko BS, Lee JW, Son BH, Ahn SH, Kim HW, Kim HJ. Factors in Parenting Stress in Young Patients With Breast Cancer and Implications for Children's Emotional Development: The PSYCHE Study. JAMA Netw Open 2023; 6:e2344835. [PMID: 38015505 PMCID: PMC10685886 DOI: 10.1001/jamanetworkopen.2023.44835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/06/2023] [Indexed: 11/29/2023] Open
Abstract
Importance The number of patients with breast cancer who have children is substantial. However, the emotional burden of this disease and its implication for childhood development remain largely unknown. Objective To investigate the clinical factors in parenting stress in mothers with breast cancer and the association of maternal depression and parenting stress with their children's emotional development. Design, Setting, and Participants This cross-sectional study involved a survey of females with stage 0 to 3 breast cancer and was conducted from June 2020 to April 2021 in Seoul, South Korea. Participants were aged 20 to 45 years and completed the Center for Epidemiologic Studies Depression-Revised scale and basic questionnaires on demographic and clinical characteristics. Participants with children completed the Korean Parenting Stress Index Short Form (K-PSI-SF), Child Behavior Checklist, Junior Temperament and Character Inventory, and Children's Sleep Habits Questionnaire. Exposure Having children in patients with breast cancer. Main Outcomes and Measures Multivariable logistic and linear regression analyses were performed to investigate the association between maternal depression and parenting stress. Results A total of 699 females (mean [SD] age, 39.6 [4.6] years) were included, of whom 499 had children (mean [SD] age of children, 8.0 [2.7] years). Depression was more common in patients with children (odds ratio [OR], 2.25; 95% CI, 1.01-5.05) and patients who had gonadotropin-releasing hormone treatment (OR, 1.68; 95% CI, 1.15-2.44). Disease duration was inversely associated with depression (OR, 0.85; 95% CI, 0.76-0.96). Cancer-related factors were not associated with the K-PSI-SF score. Having children aged 6 years or older (β = 3.09; 95% CI, 0.19-5.99); being the sole primary caregiver (β = -3.43; 95% CI, -5.87 to -0.99); and reporting certain temperament (eg, novelty seeking: β = 0.58; 95% CI, 0.46-0.71), emotional problems (eg, anxious/depressed: β = 8.09; 95% CI, 3.34-12.83), and sleeping pattern (eg, bedtime resistance: β = 0.57; 95% CI, 0.15-0.99) subscale scores in their children were associated with parenting stress. Depression and parenting stress were correlated (β = 0.56; 95% CI, 0.45-0.66; P < .001). The emotional challenges encountered by children of mothers with breast cancer were not significantly different from reference values. Conclusions and Relevance This study found that in patients with breast cancer, child-related factors and depression were significantly associated with parenting stress, but breast cancer-related factors were not correlated. The findings suggest that mothers with breast cancer are susceptible to both depression and parenting stress and that tailored counseling and support are needed.
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Affiliation(s)
- Yungil Shin
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Harin Kim
- Department of Neuropsychiatry, Chamjoeun Hospital, Gyeonggi-do, Korea
| | - Taeyeop Lee
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Seonok Kim
- Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Sae Byul Lee
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Jisun Kim
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Il Yong Chung
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Beom Seok Ko
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Jong Won Lee
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Byung Ho Son
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Sei Hyun Ahn
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Hyo-Won Kim
- Department of Psychiatry, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
| | - Hee Jeong Kim
- Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea
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Lan B, Lv D, Yang M, Sun X, Zhang L, Ma F. Psychological distress and quality of life in Chinese early-stage breast cancer patients throughout chemotherapy. JOURNAL OF THE NATIONAL CANCER CENTER 2022. [DOI: 10.1016/j.jncc.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Kareem M, Taher DH. Effect of Relaxation Training Techniques on Anxiety and Depression among Breast Cancer Patients. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.10462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background and objectives: non-pharmacological treatment for depression and anxiety includes a variety of treatments, such as various types of psychotherapy, education, and supporting measures. Behavioral treatments such as progressive muscle relaxation and abdominal breathing exercises have been shown to be effective in the treatment of anxiety and depression in cancer patients. Therefor this study aimed to evaluate the effect of progressive muscle relaxation and abdominal breathing exercise techniques on anxiety and depression among breast cancer patients in Erbil City- Iraq.
Methods: A quasi-experimental study was conducted at Rizgary Teaching Hospital-department of oncology and Nanakali Oncology Hospital at Erbil city-Iraq, Patients from both hospitals were selected as the intervention and control group respectively. Patients were assessed through; the demographic data questionnaire, Hospital anxiety and depression scale.
Results: A total of 88 patients 44 from the control group and 44 patients from the study group participated. At the end of the study, there were significant improvements in anxiety and depression (p-value was 0.001) result was observed in both post-tests at 4-week and at 8-week.
Conclusion: The women who got progressive muscle relaxation and abdominal breathing exercise techniques had lower anxiety and depression levels than those who only received routine nursing care, according to the findings. Oncology nurses should educate patients with breast cancer to use the progressive muscle relaxation technique to reduce their anxiety and depression.
Keywords: Anxiety, Depression, Breast cancer and Relaxation.
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Lan B, Lv D, Sun X, Yang M, Zhang L, Ma F. Genetic Variations in IFNGR1, BDNF and IL-10 May Predict the Susceptibility to Depression and Anxiety in Chinese Women With Breast Cancer. Clin Breast Cancer 2022; 22:674-680. [DOI: 10.1016/j.clbc.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 06/29/2022] [Accepted: 07/01/2022] [Indexed: 11/03/2022]
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Xu C, Ganesan K, Liu X, Ye Q, Cheung Y, Liu D, Zhong S, Chen J. Prognostic Value of Negative Emotions on the Incidence of Breast Cancer: A Systematic Review and Meta-Analysis of 129,621 Patients with Breast Cancer. Cancers (Basel) 2022; 14:cancers14030475. [PMID: 35158744 PMCID: PMC8833353 DOI: 10.3390/cancers14030475] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 02/06/2023] Open
Abstract
Breast cancer (BC) is one of the common malignant tumors in women and affects 1.6 million new cases globally each year. Investigators have recently found that negative emotions (NEs) and their impacts have greatly influenced the incidence and risk of BC. The present study aims to provide an association between NEs and the incidence of BC with possible risk factors. A total of 9343 studies were screened; nine studies met all inclusion criteria that were considered for the meta-analysis. The qualitative studies were measured by the Newcastle-Ottawa Scale; the observational studies were included with relative risks (RR) and corresponding 95% confidence intervals (CI). Besides the NEs and BC, the possible risk factors were evaluated. We analyzed data from 129,621 women diagnosed with NEs of which 2080 women were diagnosed with BC and their follow-up year ranges were from 4–24 years. NEs were significantly (p < 0.0001) associated with a higher incidence of BC with RR = 1.59, 95% CI:1.15–2.19, with other high-risk factors including, geographical distribution, emotion types, standard diagnosis of NEs, and follow-up duration. This study suggests that NEs significantly increase the risk for the incidence of BC, which can be supportive of the prognosis of the disease.
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Affiliation(s)
- Cong Xu
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; (C.X.); (K.G.); (Y.C.)
| | - Kumar Ganesan
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; (C.X.); (K.G.); (Y.C.)
| | - Xiaoyan Liu
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
| | - Qiaobo Ye
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China;
| | - Yuenshan Cheung
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; (C.X.); (K.G.); (Y.C.)
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
| | - Dan Liu
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
| | - Shaowen Zhong
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
- Correspondence: (S.Z.); (J.C.); Tel.: +852-39-17-6479 (J.C.)
| | - Jianping Chen
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; (C.X.); (K.G.); (Y.C.)
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China;
- Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, China
- Correspondence: (S.Z.); (J.C.); Tel.: +852-39-17-6479 (J.C.)
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Fekih-Romdhane F, Saadallah F, Mbarek M, Bouzaiene H, Cheour M. Prevalence and correlates of hopelessness in Tunisian women with benign breast disease and breast cancer. J Psychosoc Oncol 2021; 40:677-694. [PMID: 34328072 DOI: 10.1080/07347332.2021.1943103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND There is limited research suggesting that women with Benign Breast Disease (BBD) experience psychological distress similar to breast cancer (BC) women. We aimed to examine hopelessness and its related factors in BC and BBD women. METHOD This was a cross-sectional study. The Beck Hopelessness Scale and the Beck Depression Inventory were administered to 51 BBD and 52 BC women. RESULTS BC women had higher hopelessness scores as compared to those with BBD (6.9 ± 4.8 vs. 4.9 ± 3.6; p = .018). After controlling for confounding variables, depression and suicidal ideation/behavior were significantly associated with hopelessness in the BBD group, while only a lower socioeconomic status was associated with higher hopelessness scores in the BC group. CONCLUSION We found that not only BC but also BBD lead to a psychological burden. Early detection and handling of hopeless feelings and thoughts that may arise in this population are recommended.
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Affiliation(s)
- Feten Fekih-Romdhane
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Razi Hospital, Manouba, Tunisia
| | - Fatma Saadallah
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Salah Azaiez Institute, Tunis, Tunisia
| | - Mahdi Mbarek
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Salah Azaiez Institute, Tunis, Tunisia
| | - Hatem Bouzaiene
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Salah Azaiez Institute, Tunis, Tunisia
| | - Majda Cheour
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia.,Razi Hospital, Manouba, Tunisia
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Paek MS, Wong SS, Hsu FC, Avis NE, Fino NF, Clark CJ. Depressive Symptoms and Associated Health-Related Variables in Older Adult Breast Cancer Survivors and Non-Cancer Controls. Oncol Nurs Forum 2021; 48:412-422. [PMID: 34143000 DOI: 10.1188/21.onf.412-422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To examine the prevalence of depressive symptoms and associated risk factors in older adult breast cancer survivors (BCS) and age-matched non-cancer controls. SAMPLE & SETTING Using the Surveillance, Epidemiology, and End Results-Medicare Health Outcome Survey linked dataset from 1998 to 2012, BCS and non-cancer controls aged 65 years or older were identified. METHODS & VARIABLES Depressive symptoms, comorbidities, functional limitations, socio-demographics, and health-related information were examined. Univariate and multivariable logistic regression and marginal models were performed. RESULTS 5,421 BCS and 21,684 controls were identified. BCS and non-cancer controls had similar prevalence of depressive symptoms. Having two or more comorbidities and functional limitations were strongly associated with elevated risk of depressive symptoms in BCS and non-cancer controls. IMPLICATIONS FOR NURSING Having multiple comorbidities and multiple functional status are key factors associated with depressive symptoms in older adult BCS and non-cancer controls. Nurses are in an ideal position to screen older adult BCS and non-cancer controls at risk for depressive symptoms.
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Roy Chowdhury S, Bohara AK, Drope J. Comparison of mental burden across different types of cancer patients in Nepal: a special focus on cervical cancer patients. JOURNAL OF HEALTH RESEARCH 2021. [DOI: 10.1108/jhr-01-2021-0034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
The purpose of the study is to assess the differential impact of gender and cancer sites on mental burden across different types of cancer and control patients.
Design/methodology/approach
The paper is based on a primary survey undertaken in 2015–2016 of 600 cancer and 200 control patients across five hospitals of Nepal. The data was analyzed using propensity score matching methods and treatment effect weighting estimators.
Findings
The authors find that of all the types of patients covered under this study, cervical cancer patients suffered from a greater intensity of anxiety and lack of functional wellbeing. On an average, all other female, male cancer patients, and control patients experience significantly lower intensity of mental burden in the range of 1.83, 2.63 and 3.31, respectively when compared to patients of cervical cancer. The results are robust across all the four treatment effect estimators and through all the measures of mental burden. The implications of suffering from cervical cancer, as a unique gynecological cancer was studied in-depth. An effect size analysis pointed out to the dysfunctional familial relationship as additional causes of concern for cervical cancer patients.
Originality/value
An important finding that emerged is that female cancer patients especially those who have cervical cancer should be given special attention because they appear to be the most vulnerable group. Further work is needed to delineate the reasons behind a cervical cancer patient facing higher amount of stress.
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Thakur M, Sharma R, Mishra AK, Singh KR. Prevalence and Psychobiological Correlates of Depression Among Breast Cancer Patients. Indian J Surg Oncol 2021; 12:251-257. [PMID: 34295067 DOI: 10.1007/s13193-021-01296-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 02/24/2021] [Indexed: 01/06/2023] Open
Abstract
The diagnosis of breast cancer (BC) is associated with psychological stress. Various factors that contribute to psychological reactions are from the diagnosis of cancer to long uncertain treatment. A patient develops many fears in their mind starting after the diagnosis of cancer. Fear of cancer being an incurable disease, changes in body image, fear of death, separation from loved ones, and fear of pain all contribute to psychological disorders and most common disorders in cancer patients are mood, anxiety, depression, and sexual functional disorders. Research studies focus more on cancer. Only a few studies emphasized the coexistence of stress, depression, and the abilities of the individual to cope with such stressors. Depression is a comorbid illness to cancer, and if neglected, it may complicate the treatment of both illnesses, which will result in poor adherence to treatment and less desirable outcome of both the illnesses. Studies from this perspective can have meaningful implications, and can address both areas. Every clinician involved in the care of BC should also plan assessment of stress and depression and arrange medical treatment or coping interventions if symptoms are present. This review article aims to find the prevalence and psychobiological correlates of depressive disorder and its effect on mortality in women diagnosed with BC.
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Affiliation(s)
- Monika Thakur
- AIPS, Amity University Noida, Noida, Uttar Pradesh India
| | - Roopali Sharma
- AIPS, Amity University Noida, Noida, Uttar Pradesh India
| | - Anand Kumar Mishra
- Department of Endocrine Surgery, King George's Medical University, Shah Meena Road, Lucknow, Uttar Pradesh 226003 India
| | - Kul Ranjan Singh
- Department of Endocrine Surgery, King George's Medical University, Shah Meena Road, Lucknow, Uttar Pradesh 226003 India
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Factors associated with psychological distress among patients with breast cancer during the COVID-19 pandemic: a cross-sectional study in Wuhan, China. Support Care Cancer 2021; 29:4773-4782. [PMID: 33527226 PMCID: PMC7849966 DOI: 10.1007/s00520-021-05994-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/12/2021] [Indexed: 10/27/2022]
Abstract
PURPOSE This study aimed to examine the prevalence of psychological distress and the corresponding risk factors among patients with breast cancer affected by the outbreak of coronavirus disease 2019 (COVID-19). METHODS This cross-sectional, survey-based, region-stratified study was conducted from March 14 to March 21, 2020. An online survey was used to collect the basic characteristics of patients with breast cancer. The degree of depression, anxiety, and insomnia symptoms were assessed using the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder (GAD-7), and the Insomnia Severity Index (ISI) questionnaires, respectively. Multivariate logistic analysis was performed to identify factors associated with psychological distress outcomes. RESULTS Among the 834 patients with breast cancer included in the study, the prevalence of depression, anxiety, and insomnia was 21.6%, 15.5%, and 14.7%, respectively. No statistically significant difference in the prevalence of these symptoms was observed between patients in Wuhan and those outside Wuhan. Multivariate logistic regression analyses revealed that comorbidity, living alone, deterioration of breast cancer, and affected treatment plan were risk factors for psychological distress including depression, anxiety, and insomnia. When stratified by location, living alone was associated with depression and insomnia only among patients in Wuhan, but not those outside Wuhan. CONCLUSIONS This study shows an elevated prevalence of depression, anxiety, and insomnia among patients with breast cancer during part of the COVID-19 pandemic. Patients with comorbidity, living alone, deterioration of breast cancer, and whose treatment plan was affected should be paid more attention to prevent mental disorders.
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Depression, anxiety, and their associated factors among Chinese early breast cancer in women under 35 years of age: A cross sectional study. Curr Probl Cancer 2020; 44:100558. [DOI: 10.1016/j.currproblcancer.2020.100558] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 01/22/2020] [Accepted: 01/28/2020] [Indexed: 02/02/2023]
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Zhang D, Feng Y, Li N, Sun X. Fruit and vegetable consumptions in relation to frequent mental distress in breast cancer survivors. Support Care Cancer 2020; 29:193-201. [PMID: 32337626 DOI: 10.1007/s00520-020-05451-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 04/01/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Evidence suggests that fruit and vegetable consumptions may improve mental health among general population. However, their associations among breast cancer survivors are unclear. We planned to investigate this association via a nationwide survey in the USA. METHODS We identified 7988 breast cancer survivors from 2009 Behavioral Risk Factor Surveillance System (BRFSS). Fruit juice, fruit, and vegetable consumptions were categorized as ordinal variables to approximate tertiles. Survivors who were mentally unhealthy for at least 14 days in the past 30 days were defined as having frequent mental distress (FMD). Multivariable logistic regression treating FMD as the outcome was used to calculate adjusted odd ratios (aORs) and 95% confidence intervals (CIs) for exposures. Quadratic model was used to depict the dose-response pattern in primary analysis. Subgroup analyses by adverse lifestyle behaviors were conducted; Wald tests were used to examine if there were interactions between these factors and exposures in relation to FMD. RESULTS Overall, 825 (10.3%) survivors had FMD. Mean age was 67.2 years, and 89.7% of survivors were white. Juice showed non-significant associations with FMD. Moderate (aOR = 0.81, 95% CI = 0.68-0.98) and high (aOR = 0.79, 95% CI = 0.63-0.98) fruit consumptions, as well as moderate vegetable consumption (aOR = 0.78, 95% CI = 0.64-0.94), were significantly and inversely associated with FMD. The dose-response curves were consistent with results in primary analysis. No interaction was identified for adverse lifestyle behaviors. CONCLUSION Fruit and vegetable, but not fruit juice, show potential preventive effects against FMD among breast cancer survivors. The conclusion should be verified by studies with clear temporality in future.
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Affiliation(s)
- Dongyu Zhang
- Department of Oncology, Georgetown University School of Medicine, 3300 Whitehaven Street, NW, Suite 4100, Washington, DC, 20007, USA.
| | - Yilin Feng
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Nan Li
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Xuezheng Sun
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
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McFarland DC, Jutagir DR, Miller A, Nelson C. Physical problem list accompanying the distress thermometer: Its associations with psychological symptoms and survival in patients with metastatic lung cancer. Psychooncology 2020; 29:910-919. [PMID: 32096582 DOI: 10.1002/pon.5367] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 02/01/2020] [Accepted: 02/19/2020] [Indexed: 01/06/2023]
Abstract
BACKGROUND The distress thermometer and problem list (DT&PL) is a recommended screening measure but the utility of the physical problem list (PPL) has not been evaluated in patients with metastatic lung cancer who typically have high rates of both physical and psychological symptoms. We hypothesized that the PPL will provide an accurate representation of lung cancer symptoms and be associated with concomitant distress, anxiety, depression, and worsened survival. METHODS Stage IV lung cancer patients (n = 116) reported physical symptoms from 22 PPL variables and completed the DT&PL for distress, general anxiety disorder-7 for anxiety, and Patient Health Questionnaire 9 for depression. Inferential analyses were controlled for demographic and clinical characteristics. RESULTS The average number of physical problems was 4.7 (SD = 3.8) while the median was 3.0. Fatigue, sleep, pain, and breathing problems were most common. Physical symptom burden was associated with nonmarried/partnered status (P = .003) and depression (P < .001) on multivariate analysis accounting for 43% of physical symptom burden variance. Greater number of physical symptoms and lower BMI were associated with worsened survival. Individual physical symptoms were most often associated with depression. CONCLUSION The PPL of the DT&PL appears to have clinical utility given its associations with the most common lung cancer symptoms, depression, and worsened survival. In addition to its potential role in clinics worldwide already using the DT&PL, physical symptom burden on the DT&PL should trigger a concomitant psychological assessment.
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Affiliation(s)
- Daniel C McFarland
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Devika R Jutagir
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Andrew Miller
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Christian Nelson
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Prevalence of Severe Depression in Iranian Women with Breast Cancer: A Meta-Analysis. DEPRESSION RESEARCH AND TREATMENT 2020; 2020:5871402. [PMID: 32455010 PMCID: PMC7240657 DOI: 10.1155/2020/5871402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 02/28/2020] [Accepted: 04/27/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Breast cancer is one of the most common cancers in women and has mental and emotional effects, which lead to a decline in their quality of life. This study is aimed at determining the prevalence of severe depression in Iranian women with breast cancer. METHODS This meta-analysis study was conducted at Zabol University of Medical Sciences in 2019. Seven electronic databases were searched and evaluated for original research papers published on the prevalence of severe depression in Iranian women with breast cancer. Finally, 13 articles were selected and analyzed via Comprehensive Meta-Analysis software. RESULTS Overall, the prevalence of severe depression in Iranian women with breast cancer was 11% (95% CI (7.2, 16.5)). The highest prevalence was 44% in Tehran City in 2015 (95% CI (31, 57.9)), and the lowest prevalence was 0.8% in Qom City in 2017 (95% CI (0.01, 6.2)). A significant statistical correlation was observed between the prevalence of severe depression and sample size (p < 0.05). CONCLUSION According to the results of this study, the prevalence of severe depression affects more than one-tenth of women with breast cancer.
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Psychological distress, social support, self-management ability and utilization of social resources for female patients with cancer in Oncology Outpatient Settings in Taiwan. Support Care Cancer 2019; 28:3323-3330. [PMID: 31758322 DOI: 10.1007/s00520-019-05143-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 10/21/2019] [Indexed: 12/17/2022]
Abstract
Oncology outpatient care centers generally subjugate patients' psychosocial needs to their physical care requirements. Consequently, the patients' self-management (SM) ability and utilization of social resources are essential in regulating their psychological distress (anxiety and depression). The study aims were (1) to examine the prevalence and severity of psychological distress in female cancer patients in outpatient settings in Taiwan and (2) to identify the major factors of psychological distress. Female cancer patients were recruited from oncology outpatient settings in Taiwan. Patients completed the questionnaires of anxiety, depression, social support, and utilization of social resources, and SM ability. In total, 116 patients were included. A total of 17.2% and 21.6% of the patients were at risk of anxiety and depression, respectively. Patients' mean anxiety and depression scores were 4.2 (SD = 4.1) and 4.1 (SD = 4.0), respectively. The patients' physical function, attendance of social support groups, degree of social support, and SM ability had a significant effect on their anxiety and depression. Patients' anxiety was intensified by the presence of comorbidity. Health professionals in oncology outpatient care centers should assess the patients' physical function, comorbidity, SM ability, and social support/engagement in order to reduce their psychological distress and devise appropriate follow-up interventions.
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Risk factors for early postoperative psychological problems in breast cancer patients after axillary lymph node dissection. Breast Cancer 2019; 27:284-290. [PMID: 31679113 DOI: 10.1007/s12282-019-01020-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 10/26/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND The purpose of this study was to investigate the factors related to early postoperative psychological conditions in breast cancer patients with axillary lymph node dissection 3 months after the surgery. METHODS The subjects of this study were 200 consecutive patients who underwent axillary lymph node dissection for breast cancer at our hospital. Age, body mass index, surgical side, work, marriage, presence of children, presence of co-resident household members, resection of the pectoralis minor muscle, preoperative chemotherapy, postoperative chemotherapy, postoperative hormonal therapy, postoperative radiotherapy, shoulder range of motion, upper limb function (Disabilities of the Arm, Shoulder and Hand; DASH), and psychological conditions were evaluated. In this study, a Distress and Impact Thermometer was used to classify patients with adjustment disorders, depression, or major depression and suicidal ideation into a group with psychological problems and the remaining patients into a group with no psychological problems. RESULTS Logistic regression analysis showed that only DASH was statistically significantly associated with psychological conditions (p < 0.05). Using receiver operating characteristic curve analysis, a DASH score of 18 or greater was found to be very specific for predicting psychological conditions. CONCLUSIONS The observation that somatic symptoms and disability of upper limb function are related to psychological conditions may indicate the importance of postoperative rehabilitation in breast cancer patients with axillary lymph node dissection.
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Edward KL, Chipman M, Giandinoto JA, Robinson K. Quality of life and personal resilience in the first two years after breast cancer diagnosis: systematic integrative review. ACTA ACUST UNITED AC 2019; 28:S4-S14. [PMID: 31116589 DOI: 10.12968/bjon.2019.28.10.s4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The aim of this systematic integrative review was to examine the early impacts of a breast cancer diagnosis (up to 2 years after diagnosis) in relation to quality of life and personal resilience. The bibliographic databases of Medline, CINAHL, Cochrane, and Psychology and Behavioral Science Collection were searched using predetermined search criteria. Research studies published up to February 2019 were considered and following appraisal 36 articles were included in the review. Younger age, disease progression at first presentation, personality factors such as optimism, and moderators such as social support, clinical interventions and development of self-management abilities predicted better quality of life and personal resilience. Not recovering from the physical and psychological impacts of a new diagnosis has implications for future mental and physical health. This systematic, integrative review highlighted that building resilience and working with women's strengths should be the focus for contemporary clinical interventions for women in the early period after diagnosis of breast cancer.
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Affiliation(s)
- Karen-Leigh Edward
- Professor of Nursing and Practice Based Research, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Mitchell Chipman
- Oncologist, Victorian Breast and Oncology Care, East Melbourne, Australia
| | - Jo-Ann Giandinoto
- PhD Student, Faculty of Health Science, Australian Catholic University, Melbourne, Australia
| | - Kayte Robinson
- Research Assistant, Victorian Breast and Oncology Care, East Melbourne, Australia
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Ahmadi Gharaei H, Dianatinasab M, Kouhestani SM, Fararouei M, Moameri H, Pakzad R, Ghaiasvand R. Meta-analysis of the prevalence of depression among breast cancer survivors in Iran: an urgent need for community supportive care programs. Epidemiol Health 2019; 41:e2019030. [PMID: 31319657 PMCID: PMC6791826 DOI: 10.4178/epih.e2019030] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/04/2019] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVES Depression, which is the most common comorbidity in breast cancer (BC) patients, has adverse effects on patients' quality of life, disease progress, and survival. METHODS The protocol of this study was registered in PROSPERO (registration No. CRD42019121494). We electronically searched published studies through January 2019 with the aim of finding articles that investigated the prevalence of depression among BC survivors. Web of Science, Scopus, PubMed/MEDLINE, Science Direct, and Google Scholar were searched to obtain relevant published studies. This review included 14 cross-sectional and 4 cohort studies published from 2000 to 2018. We used a random-effects model to conduct the meta-analysis and generated a summary estimate for the pooled prevalence with 95% confidence intervals (CIs). A subgroup analysis was also conducted based on the depression assessment tool used and the study design. RESULTS The total sample size of the studies contained 2,799 women with BC, including 1,228 women who were diagnosed with depression. The pooled prevalence of depression among Iranian women with BC was 46.83% (95% CI, 33.77 to 59.88) with significant heterogeneity (I2 =98.5%; p<0.001). The prevalence of depression ranged from 14.00% (95% CI, 4.91 to 23.09) to 95.90% (95% CI, 91.97 to 99.83). The results of the subgroup analyses suggested that the depression assessment tool, year of publication, and study design were sources of heterogeneity. CONCLUSIONS Our findings indicate a high prevalence of depression among BC patients, underscoring the urgent need for clinicians and health authorities to provide well-defined social and psychological supportive care programs for these patients.
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Affiliation(s)
- Hassan Ahmadi Gharaei
- Department of Epidemiology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Dianatinasab
- Department of Epidemiology, Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Seyyed Mostafa Kouhestani
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Fararouei
- Department of Epidemiology, Faculty of Public Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hossein Moameri
- Department of Epidemiology, Faculty of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Pakzad
- Noor Research Center for Ophthalmic Epidemiology, Noor Eye Hospital, Tehran, Iran
- Faculty of Health, Ilam University of Medical Sciences, Ilam, Iran
| | - Reza Ghaiasvand
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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Kim J, Paik HJ, Jung Y, Kim DI, Jo H, Lee S, Kim H. A Prospective Longitudinal Study about Change of Sleep, Anxiety, Depression, and Quality of Life in Each Step of Breast Cancer Patients. Oncology 2019; 97:245-253. [DOI: 10.1159/000500724] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 04/30/2019] [Indexed: 11/19/2022]
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Pilevarzadeh M, Amirshahi M, Afsargharehbagh R, Rafiemanesh H, Hashemi SM, Balouchi A. Global prevalence of depression among breast cancer patients: a systematic review and meta-analysis. Breast Cancer Res Treat 2019; 176:519-533. [PMID: 31087199 DOI: 10.1007/s10549-019-05271-3] [Citation(s) in RCA: 154] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 05/04/2019] [Indexed: 01/15/2023]
Abstract
PURPOSE Depression in patients with breast cancer imposes huge costs to patients, families, and healthcare systems. The present study aimed at evaluating the global prevalence depression among patients with breast cancer. METHODS In this meta-analysis, three electronic databases (PubMed, Web of Science, and Scopus) were searched from 1 January, 2000 until 30 March, 2019. The Hoy tool was used to evaluate the quality of the articles included in the meta-analysis. The search, screening, quality evaluation, and data extraction were carried out by two of the researchers. RESULTS Of 47,424 studies, 72 studies performed in 30 countries entered the final stage of analysis. The global prevalence of depression was 32.2%. Specifically, the prevalence of depression was highest in the Eastern Mediterranean region and twice as high in middle-income countries as compared to developed countries. CONCLUSIONS Regarding the high prevalence of depression in patients with breast cancer, it is vital to carry out screening within standard time periods and offer the necessary emotional support.
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Affiliation(s)
- Motahare Pilevarzadeh
- Department of Nursing Education, Nursing and Midwifery School, Jiroft University of Medical Sciences, Jiroft, Iran
| | | | | | - Hosein Rafiemanesh
- Student Research Committee, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed-Mehdi Hashemi
- Clinical Immunology Research Center, Department of Internal Medicine, Hematology and Medical Oncology Ward, Ali-Ebne-Abitalelb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Abbas Balouchi
- Student Research Committee, Nursing and Midwifery School, Iran University of Medical Sciences, Tehran, Iran
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Prevalence of Depression Among Iranian Women with Breast Cancer: A Systematic Review and Meta-Analysis. HEALTH SCOPE 2019. [DOI: 10.5812/jhealthscope.62781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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25
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Wei M, Guo L, Zhu Y, Guo Y, Yv S, Namassevayam G, Xue W, Li J, Li L, Shen Z, Yv J, Zhu Z, Wang W, Liu Y, Zhao J, Chen F. Type C Personality and Depression Among Newly Diagnosed Breast Cancer Patients: The Mediating Role of Sense of Coherence. Neuropsychiatr Dis Treat 2019; 15:3519-3529. [PMID: 31920312 PMCID: PMC6935278 DOI: 10.2147/ndt.s230278] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 12/02/2019] [Indexed: 12/24/2022] Open
Abstract
PURPOSE This study aims to explore the mediating role of sense of coherence in the relationship of type C personality and depression among newly diagnosed breast cancer patients. METHODS A descriptive and correlational survey was conducted in 600 breast cancer patients aged ≥18 years from September 2018 to March 2019 in Zhengzhou, China. The demographic questionnaire, Cancer Behavior Scale, Sense of Coherence Scale and Hamilton Depression Scale were included in this study. Data analysis was performed by correlation analysis, multiple linear regression analysis, and structural equation modeling. RESULTS The valid questionnaires were 575 (effective response rate: 95.8%). The score of sense of coherence was negatively correlated with type C personality and depression (r = -0.41, P < 0.01; r = -0.58, P < 0.01); the score of type C personality and depression were positively correlated (r = 0.51, P < 0.01). The results of multiple linear regression analysis revealed that the effect of type C personality on depression was partly mediated by sense of coherence, which was confirmed by structural equation modeling. The mediation effect accounts for 45.2% (0.269/0.594) of the total effect. CONCLUSION The results of this study revealed that sense of coherence as a partial mediating role is essential for reducing the influence of type C personality on depression. Early and targeted psychological interventions on sense of coherence are needed to alleviate the symptom of depression in newly diagnosed breast cancer patients.
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Affiliation(s)
- Miao Wei
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Lina Guo
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Yiru Zhu
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Yvru Guo
- Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Suyuan Yv
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Genoosha Namassevayam
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Wenhua Xue
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Jieyao Li
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Lifeng Li
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Zhibo Shen
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Junlin Yv
- Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Zijia Zhu
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Wenbin Wang
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Yanjin Liu
- Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Jie Zhao
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
| | - Fu Chen
- Department of Medical Administration, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People's Republic of China
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Ahmed AE, Albalawi AN, Qureshey ET, Qureshey AT, Yenugadhati N, Al-Jahdali H, Jazieh AR. Psychological symptoms in adult Saudi Arabian cancer patients: prevalence and association with self-rated oral health. BREAST CANCER-TARGETS AND THERAPY 2018; 10:153-159. [PMID: 30323659 PMCID: PMC6174894 DOI: 10.2147/bctt.s168139] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Although psychological symptoms and oral health status are associated with health management and outcomes among cancer patients, their association has not been assessed in Saudi Arabia. We aimed to assess the symptoms of depression, anxiety, and stress and their association with their oral health status, adjusting for sociodemographic and clinical factors. Methods A self-reported study included 375 adult cancer patients who received outpatient healthcare services in the Oncology Department, King Abdulaziz Medical City-Riyadh, Saudi Arabia, between April 1 and August 31, 2017. We used the Arabic version of the Depression Anxiety Stress Scale to dichotomize a binary outcome for each. Oral health was evaluated by self-rating from "very good" to "bad". Results A high prevalence of subjective depression, anxiety, and stress was found (44.8%, 52.5%, and 42.7%, respectively). Of the sample, 17.9% self-reported "bad" oral health, which is associated with a high risk of anxiety and stress, and its association remains significant after controlling for other factors (adjusted odds ratio=6.48 and 4.73, respectively). Being <60 years old, high level of formal education, low income, breast cancer, and lung cancer were associated with increased psychological symptoms. Conclusion Every 6 in 10 cancer patients in this study reported at least one psychosocial symptom. The findings suggest that there exists an association between self-reported "bad" oral health and psychosocial symptoms. Being <60 years old, low income, high level of formal education, breast cancer, and lung cancer were associated with psychological symptoms. Routine psychological counseling and oral health screening in outpatient oncology clinics may improve psychological outcomes and cancer management.
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Affiliation(s)
- Anwar E Ahmed
- King Abdullah International Medical Research Center (KAIMRC), Riyadh, Saudi Arabia, .,College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,
| | | | | | | | - Nagarajkumar Yenugadhati
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia,
| | - Hamdan Al-Jahdali
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdul Rahman Jazieh
- Department of Oncology, King Abdulaziz Medical City for National Guard, Ministry of National Guard, Riyadh, Saudi Arabia
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Li Z, Geng W, Yin J, Zhang J. Effect of one comprehensive education course to lower anxiety and depression among Chinese breast cancer patients during the postoperative radiotherapy period - one randomized clinical trial. Radiat Oncol 2018; 13:111. [PMID: 29898748 PMCID: PMC6000931 DOI: 10.1186/s13014-018-1054-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 05/28/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND We investigated the effectiveness of one education course to lower the severity of anxiety and depression symptoms among breast cancer (BC) patients during radiotherapy (RT). METHODS All 290 one-sided BC patients were evenly randomized into intervention or control arm. "Intervention" patient was additionally provided with one three-hour course on psychological stresses and management skills. Changes of anxiety and depression score and their 3-level severity category ('normal', 'borderline' and 'abnormal' scored 0-7, 8-10 and 11-21, respectively) from HADS questionnaire over RT were evaluated by multivariable linear and ordinal logistic regressions. RESULTS Response rates were 94 and 100% by "intervention" and "control" arm, respectively. Means of score changes by "intervention" and "control" (n = 145) were + 0.59 (SD = 2.47) and + 0.11 (SD = 2.55) for anxiety and + 0.81 (SD = 2.81) and + 0.45 (SD = 2.77) for depression scores, respectively. 'Abnormal' anxiety and depression patients were 4.1 and 6.9% at baseline and 4.8 and 6.9% at end of RT at 'control' arm; those rates were 6.6 and 7.4%, and 8.8 and 10.3% at 'intervention' arm, respectively. Both changes on anxiety and depression measurements between two arms were all insignificant (p > 0.20). CONCLUSIONS One education course did not reduce the score and severity of anxiety and depression symptoms over RT period. TRIAL REGISTRATION Chinese Clinical Trial Registry #: ChiCTR-IIR-16008818 at www.chictr.org.cn .
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Affiliation(s)
- Zhensheng Li
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, 169 Tianshan Street, Shijiazhuang, 050035 China
| | - Wenhui Geng
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, 169 Tianshan Street, Shijiazhuang, 050035 China
| | - Junpu Yin
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, 169 Tianshan Street, Shijiazhuang, 050035 China
| | - Jun Zhang
- Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, 169 Tianshan Street, Shijiazhuang, 050035 China
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Depression Induced by Total Mastectomy, Breast Conserving Surgery and Breast Reconstruction: A Systematic Review and Meta-analysis. World J Surg 2018; 42:2076-2085. [DOI: 10.1007/s00268-018-4477-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Paek MS, Lim JW. Understanding the Stress Process of Chinese- and Korean-American Breast Cancer Survivors. J Immigr Minor Health 2018. [PMID: 26223968 DOI: 10.1007/s10903-015-0255-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Guided by the stress process model (SPM), this study investigated the direct and indirect pathways of primary (negative self-image and life stress), secondary stressors (family communication strain) and family coping (external and internal) on mental health outcomes among Chinese- and Korean-American breast cancer survivors (BCS). A total of 156 Chinese- and Korean-American BCS were surveyed. Results showed primary and secondary stressors had a negative effect on better mental health outcomes. External coping was associated with better mental health. Family communication strain mediated the relationship between life stress and mental health outcomes. External coping mediated the relationship between family communication strain and mental health outcomes. Multi-group analysis revealed the stress process did not differ across ethnic groups. Findings suggest the SPM may be applicable to understand the stress process of Chinese- and Korean-American BCS and provide valuable insight into the role of family communication and external coping on mental health outcomes.
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Affiliation(s)
- Min-So Paek
- Division of Public Health Sciences, Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, 27157, USA.
| | - Jung-Won Lim
- College of Social Welfare, Kangnam University, 111 Gugal-dong, Giheung-gu, Yongin-si, Gyeonggi-do, Korea
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Syrowatka A, Motulsky A, Kurteva S, Hanley JA, Dixon WG, Meguerditchian AN, Tamblyn R. Predictors of distress in female breast cancer survivors: a systematic review. Breast Cancer Res Treat 2017; 165:229-245. [PMID: 28553684 PMCID: PMC5543195 DOI: 10.1007/s10549-017-4290-9] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 05/10/2017] [Indexed: 12/12/2022]
Abstract
Purpose Unmanaged distress has been shown to adversely affect survival and quality of life in breast cancer survivors. Fortunately, distress can be managed and even prevented with appropriate evidence-based interventions. Therefore, the objective of this systematic review was to synthesize the published literature around predictors of distress in female breast cancer survivors to help guide targeted intervention to prevent distress. Methods Relevant studies were located by searching MEDLINE, Embase, PsycINFO, and CINAHL databases. Significance and directionality of associations for commonly assessed candidate predictors (n ≥ 5) and predictors shown to be significant (p ≤ 0.05) by at least two studies were summarized descriptively. Predictors were evaluated based on the proportion of studies that showed a significant and positive association with the presence of distress. Results Forty-two studies met the target criteria and were included in the review. Breast cancer and treatment-related predictors were more advanced cancer at diagnosis, treatment with chemotherapy, longer primary treatment duration, more recent transition into survivorship, and breast cancer recurrence. Manageable treatment-related symptoms associated with distress included menopausal/vasomotor symptoms, pain, fatigue, and sleep disturbance. Sociodemographic characteristics that increased the risk of distress were younger age, non-Caucasian ethnicity, being unmarried, and lower socioeconomic status. Comorbidities, history of mental health problems, and perceived functioning limitations were also associated. Modifiable predictors of distress were lower physical activity, lower social support, and cigarette smoking. Conclusions This review established a set of evidence-based predictors that can be used to help identify women at higher risk of experiencing distress following completion of primary breast cancer treatment. Electronic supplementary material The online version of this article (doi:10.1007/s10549-017-4290-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ania Syrowatka
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada. .,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.
| | - Aude Motulsky
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.,Centre de recherche du Centre hospitalier de l'Université de Montréal, Montreal, QC, Canada
| | - Siyana Kurteva
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada
| | - James A Hanley
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Mathematics and Statistics, McGill University, Montreal, QC, Canada
| | - William G Dixon
- Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK.,Health eResearch Centre, Farr Institute, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK
| | - Ari N Meguerditchian
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.,Department of Surgery, McGill University Health Centre, Montreal, QC, Canada.,Department of Oncology, McGill University Health Centre, Montreal, QC, Canada
| | - Robyn Tamblyn
- Clinical and Health Informatics Research Group, McGill University, Montreal, QC, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, QC, Canada.,Department of Medicine, McGill University, Montreal, QC, Canada
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Berhili S, Kadiri S, Bouziane A, Aissa A, Marnouche E, Ogandaga E, Echchikhi Y, Touil A, Loughlimi H, Lahdiri I, El Majjaoui S, El Kacemi H, Kebdani T, Benjaafar N. Associated factors with psychological distress in Moroccan breast cancer patients: A cross-sectional study. Breast 2017; 31:26-33. [DOI: 10.1016/j.breast.2016.10.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 10/11/2016] [Accepted: 10/15/2016] [Indexed: 01/06/2023] Open
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Su JA, Yeh DC, Chang CC, Lin TC, Lai CH, Hu PY, Ho YF, Chen VCH, Wang TN, Gossop M. Depression and family support in breast cancer patients. Neuropsychiatr Dis Treat 2017; 13:2389-2396. [PMID: 28979126 PMCID: PMC5602463 DOI: 10.2147/ndt.s135624] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Breast cancer is the most common cancer in women. Among the survivors, depression is one of the most common psychiatric comorbidities. This paper reports the point prevalence of major depressive disorder among breast cancer patients and the association between family support and major depressive disorder. METHODS Clinical data were collected from a breast cancer clinic of a general hospital in central Taiwan. Participants included 300 patients who were older than 18 years and diagnosed with breast cancer. Among these individuals, we used Mini International Neuropsychiatric Interview (a structural diagnostic tool for psychiatric disorders) to ascertain if they had major depressive disorder. We also used the Family Adaptability, Partnership, Growth, Affection, and Resolve score to assess the family support. RESULTS The point prevalence of major depressive disorder among breast cancer patients was 8.33%, and this was positively associated with insomnia, psychiatric family history, pain severity, and radiotherapy and negatively associated with menopause, cancer duration, hormone therapy, and family support. Family support (adjusted odds ratio =0.87, 95% CI: 0.78-0.98) was found to be an associated factor for major depressive disorder in breast cancer patients after controlling for potential risk factors. CONCLUSION Major depressive disorder is a common comorbidity among breast cancer patients. Family support is an important associated factor for these patients. Health care professionals should evaluate mood problems and family support while treating these patients.
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Affiliation(s)
- Jian-An Su
- Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.,Department of Medicine, School of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Nursing, Chang Gung Institute of Technology, Taoyuan, Taiwan
| | - Dah-Cherng Yeh
- Department of Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Ching-Chi Chang
- Institute of Medicine, Chung Shan Medical University and Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Tzu-Chin Lin
- Department of Psychiatry, Chung Shan Medical University Hospital, Taichung, Taiwan.,Department of Psychiatry, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Ching-Hsiang Lai
- Department of Medical Informatics, Chung Shan Medical University, Taichung, Taiwan
| | - Pei-Yun Hu
- Department of Medical Informatics, Chung Shan Medical University, Taichung, Taiwan
| | - Yi-Feng Ho
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nan-Tou, Taiwan
| | - Vincent Chin-Hung Chen
- Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.,Department of Medicine, School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tsu-Nai Wang
- Department of Public Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan.,Center of Excellence for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Michael Gossop
- King's College London, Institute of Psychiatry, London, UK
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Purkayastha D, Venkateswaran C, Nayar K, Unnikrishnan UG. Prevalence of Depression in Breast Cancer Patients and its Association with their Quality of Life: A Cross-sectional Observational Study. Indian J Palliat Care 2017; 23:268-273. [PMID: 28827929 PMCID: PMC5545951 DOI: 10.4103/ijpc.ijpc_6_17] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background: Breast cancer is the leading cause of cancer death among women worldwide. In India, the incidence rate of breast cancer is found to be 25.8/10,000 females. The statistics for Kerala, India, is 30.5 in urban areas and 19.8 in rural areas. Cancer and treatment-related symptoms are major stressors in patients with breast cancer undergoing treatment for the disease. Depression is a prevalent psychological symptom perceived by breast cancer patients, and it also impacts the quality of life (QOL) in these patients. We aimed to assess the prevalence of depression and its association with QOL of patients with breast cancer undergoing treatment for breast cancer. Materials and Methods: This cross-sectional study enrolled 270 patients diagnosed with breast cancer (>18 years) and undergoing active treatment in a tertiary care center in Kerala, India. Depression was assessed using the Patient Health Questionnaire 9 and International Classification of Diseases, Tenth Edition Research guidelines. We measured the QOL and its domains using the WHOQOL-BREF. Results: The average age of women in research was 53.56 years. Of the 270 patients, 21.5% had depression. Among patients with depression, 22% had moderately severe to severe depression. Patients with depression experienced overall a poor QOL. Twenty-two patients reported their overall QOL was “poor” and 34 patients reported to be dissatisfied with their health. There was an association between depression and domains of QOL. Patients with depression had lower scores in all domains when compared to those without depression. Conclusion: Depression and poor QOL is common among breast cancer patients.
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Affiliation(s)
- Debasweta Purkayastha
- Department of Psychiatry, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ernakulam, Kerala, India
| | - Chitra Venkateswaran
- Department of Psychiatry, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ernakulam, Kerala, India
| | - Kesavankutty Nayar
- Department of Psychiatry, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ernakulam, Kerala, India
| | - U G Unnikrishnan
- Department of Psychiatry, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Ernakulam, Kerala, India
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Regulation of miRNAs by herbal medicine: An emerging field in cancer therapies. Biomed Pharmacother 2016; 86:262-270. [PMID: 28006752 DOI: 10.1016/j.biopha.2016.12.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Revised: 11/29/2016] [Accepted: 12/05/2016] [Indexed: 12/12/2022] Open
Abstract
MicroRNAs' expression profiles have recently gained major attention as far as cancer research is concerned. MicroRNAs are able to inhibit target gene expression via binding to the 3' UTR of target mRNA, resulting in target mRNA cleavage or translation inhibition. MicroRNAs play significant parts in a myriad of biological processes; studies have proven, on the other hand, that aberrant microRNA expression is, more often than not, associated with the growth and progression of cancers. MicroRNAs could act as oncogenes (oncomir) or tumor suppressors and can also be utilized as biomarkers for diagnosis, prognosis, and cancer therapy. Recent studies have shown that such herbal extracts as Shikonin, Sinomenium acutum, curcumin, Olea europaea, ginseng, and Coptidis Rhizoma could alter microRNA expression profiles through inhibiting cancer cell development, activating the apoptosis pathway, or increasing the efficacy of conventional cancer therapeutics. Such findings patently suggest that the novel specific targeting of microRNAs by herbal extracts could complete the restriction of tumors by killing the cancerous cells so as to recover survival results in patients diagnosed with malignancies. In this review, we summarized the current research about microRNA biogenesis, microRNAs in cancer, herbal compounds with anti-cancer effects and novel strategies for employing herbal extracts in order to target microRNAs for a better treatment of patients diagnosed with cancer.
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Steel JL, Geller DA, Kim KH, Butterfield LH, Spring M, Grady J, Sun W, Marsh W, Antoni M, Dew MA, Helgeson V, Schulz R, Tsung A. Web-based collaborative care intervention to manage cancer-related symptoms in the palliative care setting. Cancer 2016; 122:1270-82. [PMID: 26970434 PMCID: PMC4828258 DOI: 10.1002/cncr.29906] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 11/23/2015] [Accepted: 12/28/2015] [Indexed: 01/02/2023]
Abstract
BACKGROUND The aim of this study was to examine the efficacy of a collaborative care intervention in reducing depression, pain, and fatigue and improve quality of life. METHODS A total of 261 patients with advanced cancer and 179 family caregivers were randomized to a web-based collaborative care intervention or enhanced usual care. The intervention included the following: 1) a web site with written and audiovisual self-management strategies, a bulletin board, and other resources; 2) visits with a care coordinator during a physician's appointment every 2 months; and 3) telephone follow-up every 2 weeks. Primary patient outcomes included measures of depression, pain, fatigue, and health-related quality of life. Secondary outcomes included Interleukin (IL)-1α, IL-1β, IL-6, and IL-8 levels, Natural Killer (NK) cell numbers, and caregiver stress and depression. RESULTS At the baseline, 51% of the patients reported 1 or more symptoms in the clinical range. For patients who presented with clinical levels of symptoms and were randomized to the intervention, reductions in depression (Cohen's d = 0.71), pain (Cohen's d = 0.62), and fatigue (Cohen's d = 0.26) and improvements in quality of life (Cohen's d = 0.99) were observed when compared to those in the enhanced usual car arm at 6 months. Reductions in IL-6 (φ = 0.18), IL-1β (φ = 0.35), IL-1α (φ = 0.19), and IL-8 (φ = 0.15) and increases in NK cell numbers (φ = 0.23) were observed in comparison with enhanced usual care arm at 6 months. Reductions in caregiver stress (Cohen's d = 0.75) and depression (Cohen's d = 0.37) were observed at 6 months for caregivers whose loved ones were randomized to the intervention arm. CONCLUSIONS The integration of screening and symptom management into cancer care is recommended.
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Affiliation(s)
- Jennifer L Steel
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - David A Geller
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kevin H Kim
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Lisa H Butterfield
- Departments of Medicine, Surgery and Immunology, Hillman Cancer Center, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Michael Spring
- School of Information Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jonathan Grady
- School of Information Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Weiing Sun
- Cancer Institute, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Wallis Marsh
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael Antoni
- Department of Psychology, University of Miami, Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Mary Amanda Dew
- Departments of Psychiatry, Psychology, Epidemiology, Biostatistics, and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Vicki Helgeson
- Department of Psychology, Carnegie Mellon University, Pittsburgh, Pennsylvania
| | - Richard Schulz
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Allan Tsung
- Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania
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Fang SY, Chang HT, Shu BC. The moderating effect of perceived partner empathy on body image and depression among breast cancer survivors. Psychooncology 2015; 24:1815-22. [PMID: 26110591 DOI: 10.1002/pon.3868] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 04/28/2015] [Accepted: 05/14/2015] [Indexed: 11/09/2022]
Abstract
PURPOSE The aims of the study were the following: (1) to understand the relationship between women's perceptions of empathy from their partners and their depressive symptoms and body image and (2) to examine the moderating effects of women's perceptions of empathy from their partners on the relationship between body image and depressive symptoms. METHODS A cross-sectional and correlational design was used, in which a convenience sample of 151 women who completed surgery and the necessary chemotherapy/radiotherapy were recruited from southern Taiwan. A structured questionnaire including the Other Dyadic Perspective-Taking Scale, the Body Image Scale, and the Center for Epidemiologic Studies Depression scale were administered. Hierarchical regression was used to examine the moderating effects of empathy from partners between the women's body image and their level of depressive symptoms. RESULTS The results showed significant relationships between empathy from a partner and depressive symptoms (p < 0.001). However, there was no significant relationship between empathy from a partner and body image (p > 0.05). The moderating effect of empathy from a partner on the relationship between body image and depressive symptoms was also significant (p < 0.01). CONCLUSION The more empathy women perceived from partners, the fewer depressive symptoms women reported. Empathy from a partner could moderate the impact of body image changes on depressive symptoms. Women's depressive symptoms, resulting from a change in body image after breast cancer surgery, might be minimized if they perceived greater empathy from their partners.
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Affiliation(s)
- Su-Ying Fang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hong-Tai Chang
- Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Bih-Ching Shu
- Institute of Allied Health Sciences and Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Shayan Z, Shahkolahi Z, Ahmadlo N, Vafaee L, Shayan L. Prognostic Factors of Depression in Patients With Cancer Undergoing Chemotherapy and Radiotherapy. HEALTH SCOPE 2014. [DOI: 10.17795/jhealthscope-18609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Suppli NP, Johansen C, Christensen J, Kessing LV, Kroman N, Dalton SO. Increased risk for depression after breast cancer: a nationwide population-based cohort study of associated factors in Denmark, 1998-2011. J Clin Oncol 2014; 32:3831-9. [PMID: 25349294 DOI: 10.1200/jco.2013.54.0419] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To investigate the risk for first depression, assessed as incident hospital contacts for depression and incident use of antidepressants, among women with breast cancer. PATIENTS AND METHODS Danish national registries were used to identify 1,997,669 women with no diagnosis of cancer or a major psychiatric disorder. This cohort was followed from 1998 to 2011 for a diagnosis of breast cancer and for the two outcomes, hospital contact for depression and redeemed prescriptions for antidepressants. Rate ratios for incident hospital contacts for depression and incident use of antidepressants were estimated with Poisson regression models. Multivariable Cox regression was used to evaluate factors associated with the two outcomes among patients with breast cancer. RESULTS We identified 44,494 women with breast cancer. In the first year after diagnosis, the rate ratio for a hospital contact for depression was 1.70 (95% CI 1.41 to 2.05) and that for use of antidepressants was 3.09 (95% CI 2.95 to 3.22); these rate ratios were significantly increased after 3 and 8 years, respectively. Comorbidity, node-positive disease, older age, basic and vocational educational levels, and living alone were associated with use of antidepressants. CONCLUSION Women with breast cancer are at long-term increased risk for first depression, including both severe episodes leading to hospital contact and use of antidepressants. Clinicians should be aware that the risk is highest in women with comorbid conditions, node-positive disease, and age of 70 years or more. We found no clear association between type of surgery or adjuvant treatment and risk for depression.
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Affiliation(s)
- Nis P Suppli
- Nis P. Suppli, Christoffer Johansen, Jane Christensen, Susanne O. Dalton, Danish Cancer Society Research Center; Christoffer Johansen, Niels Kroman, Rigshospitalet; Lars V. Kessing, Psychiatric Center Copenhagen, University of Copenhagen; and Niels Kroman, Danish Breast Cancer Cooperative Group, Copenhagen, Denmark.
| | - Christoffer Johansen
- Nis P. Suppli, Christoffer Johansen, Jane Christensen, Susanne O. Dalton, Danish Cancer Society Research Center; Christoffer Johansen, Niels Kroman, Rigshospitalet; Lars V. Kessing, Psychiatric Center Copenhagen, University of Copenhagen; and Niels Kroman, Danish Breast Cancer Cooperative Group, Copenhagen, Denmark
| | - Jane Christensen
- Nis P. Suppli, Christoffer Johansen, Jane Christensen, Susanne O. Dalton, Danish Cancer Society Research Center; Christoffer Johansen, Niels Kroman, Rigshospitalet; Lars V. Kessing, Psychiatric Center Copenhagen, University of Copenhagen; and Niels Kroman, Danish Breast Cancer Cooperative Group, Copenhagen, Denmark
| | - Lars V Kessing
- Nis P. Suppli, Christoffer Johansen, Jane Christensen, Susanne O. Dalton, Danish Cancer Society Research Center; Christoffer Johansen, Niels Kroman, Rigshospitalet; Lars V. Kessing, Psychiatric Center Copenhagen, University of Copenhagen; and Niels Kroman, Danish Breast Cancer Cooperative Group, Copenhagen, Denmark
| | - Niels Kroman
- Nis P. Suppli, Christoffer Johansen, Jane Christensen, Susanne O. Dalton, Danish Cancer Society Research Center; Christoffer Johansen, Niels Kroman, Rigshospitalet; Lars V. Kessing, Psychiatric Center Copenhagen, University of Copenhagen; and Niels Kroman, Danish Breast Cancer Cooperative Group, Copenhagen, Denmark
| | - Susanne O Dalton
- Nis P. Suppli, Christoffer Johansen, Jane Christensen, Susanne O. Dalton, Danish Cancer Society Research Center; Christoffer Johansen, Niels Kroman, Rigshospitalet; Lars V. Kessing, Psychiatric Center Copenhagen, University of Copenhagen; and Niels Kroman, Danish Breast Cancer Cooperative Group, Copenhagen, Denmark
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Fang SY, Chang HT, Shu BC. Objectified Body Consciousness, Body Image Discomfort, and Depressive Symptoms Among Breast Cancer Survivors in Taiwan. PSYCHOLOGY OF WOMEN QUARTERLY 2014. [DOI: 10.1177/0361684314552652] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The literature comparing the effects of breast reconstructive surgery, breast-conserving surgery, and mastectomy on body image and mental health yields conflicting results. Objectified body consciousness may be a factor that influences the psychological well-being of breast cancer survivors. Women with average time of 19 months from breast cancer surgery were approached in outpatient clinics to participate in our study. Using structural equation modeling, we tested and verified a model that included self-reported objectified body consciousness, cancer-related body image discomfort, and depression among 193 breast cancer survivors in Taiwan. Our results provided support for the hypothesized indirect relation of objectified body consciousness with depression through the mediating role of cancer-related body image discomfort. Specifically, women with higher objectified body consciousness levels reported more cancer-related body image discomfort, which in turn was related to greater depression. Additionally, the degree of this mediation relationship across surgery types was different. These findings are significant to clinicians who should be cognizant of the potential role of objectified body consciousness in promoting cancer-related body image discomfort and depression in breast cancer survivors. Encouraging women to clarify their perceptions of their new bodies and providing care combined with psychological counseling after breast cancer surgery are critical.
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Affiliation(s)
- Su-Ying Fang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hong-Tai Chang
- Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Bih-Ching Shu
- Institute of Allied Health Sciences, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Hasson-Ohayon I, Goldzweig G, Dorfman C, Uziely B. Hope and social support utilisation among different age groups of women with breast cancer and their spouses. Psychol Health 2014; 29:1303-19. [DOI: 10.1080/08870446.2014.929686] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Tu CH, Hsu MC, Chi SC, Lin HY, Yen YC. Routine depression screening and diagnosing strategy for cancer inpatients. Psychooncology 2014; 23:1057-67. [PMID: 24798464 DOI: 10.1002/pon.3547] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Revised: 03/17/2014] [Accepted: 03/17/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND Clinical practice guidelines frequently recommend systematic screening for depression in cancer patients to improve recognition and prompt appropriate management. We aimed to screen major depressive disorder (MDD) in cancer inpatients using a structured tool and explore its applicability. METHODS Cancer inpatients were routinely screened by nurses using the Taiwanese Depression Questionnaire (TDQ), and for those screened positive, this was followed by a non-mandated referral to a psychiatrist for clinical evaluation and diagnosis. Patients who completed this two-stage procedure comprised the analysis sample. RESULTS Routine screening of 8800 patients in a period of 27 months yielded 1087 (26.9%) positive first-time screens. Of them, 298 (27.4%) completed the psychiatric consultation. Depressive disorders were diagnosed in 185 patients (62.1%), mainly adjustment disorder (23.8%) and MDD (21.5%). The estimated prevalence of MDD was 21.5%. Area under the curve was 0.72, a result produced by the receiver operating characteristic curve of the TDQ scores relative to the clinical psychiatric diagnoses of MDD. A TDQ cutoff score of ≧26 provided an optimal diagnostic accuracy for MDD. CONCLUSIONS This two-stage depression screening and diagnosing strategy is practical for improving recognition of MDD and other depressive disorders in cancer patients and could be routinely applied, rather than selectively, in a comprehensive cancer care system.
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Affiliation(s)
- Chun-Hsien Tu
- Department of Psychiatry, E-Da Hospital, Kaohsiung, Taiwan; Department of Nursing, College of Medicine, I-Shou University, Kaohsiung, Taiwan
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Tan SM, Beck KR, Li H, Lim ECL, Krishna LKR. Depression and anxiety in cancer patients in a Tertiary General Hospital in Singapore. Asian J Psychiatr 2014; 8:33-7. [PMID: 24655623 DOI: 10.1016/j.ajp.2013.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 09/23/2013] [Accepted: 10/06/2013] [Indexed: 01/06/2023]
Abstract
BACKGROUND Past research has indicated that distress, anxiety and depression may occur in cancer patients during the course of their illness and treatment. AIMS This study aims to establish the prevalence of anxiety and depression in cancer patients in a Singapore hospital. It also describes the clinical characteristics of these patients, and examines if cancer patients with a psychiatric diagnosis differ from those without. METHODS Cross-sectional anxiety and depression symptom data were collected using the MINI International Neuropsychiatric Interview generating DSM IV diagnoses from inpatients of an oncology ward in the tertiary hospital. RESULTS In all, 315 patients were interviewed. Fifty three (16.8%) were diagnosed with major depression, while 30 (9.5%) were found to have generalized anxiety disorder, three to ten times higher than their corresponding prevalence rates in the general population. Patients with depression or anxiety tend to be unemployed, in stage 4 cancer, who can develop these symptoms at any time from the onset of cancer diagnosis, even when perceived social support is strong. Oncology patients with depression were more likely to be in terminal stages of cancer and to correctly identify themselves to have mental health issues, than those without (p<0.01). CONCLUSIONS The psychological impact of cancer is appreciable. The lack of identifiable risk factors makes the task of diagnosing psychiatric conditions in cancer patients an onerous one. The psychiatrist involved may want to look beyond socio-demographic variables and consider biological factors in cancer to better help detect psychiatric morbidity in this group of patients.
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Affiliation(s)
- Shian Ming Tan
- Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
| | - Kevin Roy Beck
- Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
| | - Huihua Li
- Singapore General Hospital, Outram Road, Singapore 169608, Singapore.
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Relationship of oestrogen receptor status to depressive symptoms and quality of life in breast cancer patients. Acta Neuropsychiatr 2013; 25:283-8. [PMID: 25287728 DOI: 10.1017/neu.2013.5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE We investigated the relationship of oestrogen receptor (ER) status to the severity of depressive symptoms and quality of life (QOL) impairment in breast cancer patients. METHODS Seventy-seven breast cancer patients with comorbid depression were evaluated with the Hamilton Depression Rating Scale (HAMD), the Clinical Global Impression-Severity of Illness (CGI-S) for depression, and the Functional Assessment of Cancer Therapy-Breast (FACT-B). ER status was determined using immunohistochemical analysis. RESULTS The ER-positive group (n = 31) showed significantly higher scores compared with the ER-negative group (n = 46) on HAMD total (p = 0.04) and somatic anxiety factor (p = 0.004) scores as well as CGI-S score (p = 0.03). As for QOL measured with the FACT-B, a significantly higher score was found on the Functional Well-Being (FWB) subscale in the ER-positive group (p = 0.001). The relationships were further analysed using generalised linear models (GLM), after controlling for the influence of the current anti-oestrogen treatment. The analysis revealed that ER status was still significantly related to the FWB subscale score of the FACT-B (p = 0.04). However, the HAMD and CGI-S scores were no longer significantly related to ER status after the influence of anti-oestrogen treatment was controlled for. CONCLUSION These results suggest that ER status, which is a well-known biological prognostic factor in breast cancer, may be related to the severity of certain aspects of depressive symptoms or QOL impairment, implying a role of the ER in affective and behavioural regulation. However, anti-oestrogen treatments significantly influence these relationships.
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Reece JC, Chan YF, Herbert J, Gralow J, Fann JR. Course of depression, mental health service utilization and treatment preferences in women receiving chemotherapy for breast cancer. Gen Hosp Psychiatry 2013; 35:376-81. [PMID: 23642440 DOI: 10.1016/j.genhosppsych.2013.03.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 03/21/2013] [Accepted: 03/25/2013] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This prospective study aimed to estimate the prevalence and course of depression during chemotherapy in women with Stage I-III breast cancer, identify potential risk factors for depression and determine which treatments for depression were being used and which were most preferred. METHOD Thirty-two women were followed over consecutive chemotherapy infusions, with 289 assessments conducted altogether (mean, 9.0 assessments/subject). Current depression, anxiety, physical symptoms and mental health service use were recorded during each assessment. A linear mixed effects model was used to identify factors associated with depression. Patients also ranked depression treatment preferences. We referred patients with more severe depression for treatment. RESULTS Clinically significant depression was identified in 37.5% of patients. Depression severity tended to peak at 12-14 weeks and 32 or more weeks of chemotherapy. Depression severity was associated with anxiety severity, physical symptom burden, non-White race, receiving one's first chemotherapy regimen, Adriamycin-Cytoxan chemotherapy and chemotherapy duration. Most (65.5%) patients preferred evidence-based treatments for depression, and 66.7% of depressed patients were using such treatments. CONCLUSIONS Depression is common in women receiving chemotherapy for breast cancer. Most patients prefer evidence-based depression treatments. We recommend regular screening for depression during chemotherapy to ensure adequate detection and patient-centered treatment.
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Qiu J, Chen W, Gao X, Xu Y, Tong H, Yang M, Xiao Z, Yang M. A randomized controlled trial of group cognitive behavioral therapy for Chinese breast cancer patients with major depression. J Psychosom Obstet Gynaecol 2013; 34:60-7. [PMID: 23646866 DOI: 10.3109/0167482x.2013.766791] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study aims to evaluate the effects of Group Cognitive Behavioral Therapy (GCBT) in treating major depression in Chinese women with breast cancer. METHODS Sixty-two breast cancer patients diagnosed with major depression were randomly assigned to GCBT group (N = 31) or a waiting list control group provided with an educational booklet (N = 31). The primary outcome measure was the 17-Item Hamilton Depression Rating Scale (17-HAMD). The second outcome measures were Self-Rating Anxiety Scale, Functional Assessment of Cancer Therapy - Breast and Self-Esteem Scale (SES). Assessments were carried out at completion of the study and six-month afterwards. RESULTS Patients in the GCBT group had a significant reduction in the 17-HAMD mean score by 9 points (p < 0.001), more than any reduction among patients in the control group from baseline to the end of therapy and a significant 7 points (p < 0.001) more reduction from baseline to six-month follow-up. GCBT also yielded significantly greater improvement than the control group with regard to quality of life (QoL; p < 0.01) and self-esteem (p < 0.05). No significant differences were found between groups on improving anxiety (p > 0.05). CONCLUSION The results of this trial suggest that GCBT is effective for treating major depression, as well as for improving QoL and self-esteem in breast cancer patients. TRIAL REGISTRATION Chictr.org ChiCTR-TRC-11001689.
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Affiliation(s)
- Jianyin Qiu
- Department of Clinical Psychology, Shanghai Mental Health Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Hung YP, Liu CJ, Tsai CF, Hung MH, Tzeng CH, Liu CY, Chen TJ. Incidence and risk of mood disorders in patients with breast cancers in Taiwan: a nationwide population-based study. Psychooncology 2013; 22:2227-34. [PMID: 23463734 DOI: 10.1002/pon.3277] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Revised: 12/21/2012] [Accepted: 02/11/2013] [Indexed: 11/07/2022]
Abstract
OBJECTIVE The objective of this study is to assess the incidence and risk of mood disorders, including major depression, anxiety, and bipolar disorders, in Taiwanese patients after the diagnosis of breast cancer compared with a matched cohort. METHODS From January 2000 to December 2005, 26,629 newly diagnosed breast cancer patients were enrolled by the Taiwan National Health Insurance program database. The control cohort was selected randomly from 1,000,000 National Health Insurance beneficiaries from a population of 21,400,826 enrolled throughout Taiwan. Each patient was matched with one subject without breast cancer by age, sex, and presence of comorbidities with the same diagnosis index date. The diagnosis of mood disorders was defined by compatible International Classification of Diseases, 9th revision, clinical modification codes plus the prescription of antidepressants for at least 30 days. RESULTS The overall incidence rate ratio of mood disorders was 1.33 (95% CI 1.28-1.39, p < 0.001) in the breast cancer cohort compared with the matched cohort. The incidence rate ratios for specific mood disorders were 2.06 for bipolar disorder (95% CI 1.37-3.15 p = 0.0003), 1.94 for major depressive disorder (95% CI 1.76-2.13 p < 0.001), and 1.22 for anxiety (95% CI 1.16-1.27 p < 0.001). Independent risk factors for developing mood disorders included breast cancer, as well as age, hypertension, chronic obstructive pulmonary disease, autoimmune disease, ischemic heart disease, and cerebrovascular disease. CONCLUSIONS Breast cancer is a prominent risk factor for mood disorders, including major depressive disorder, anxiety, and bipolar disorder. The impact is most potent in the first year after diagnosis. Psychological support is a critical issue in these patients.
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Affiliation(s)
- Yi-Ping Hung
- Division of Haematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Jen Liu
- Division of Haematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Internal Medicine, National Yang-Ming University Hospital, Yilan, Taiwan
| | - Chia-Fen Tsai
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Man-Hsin Hung
- Division of Haematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Hwai Tzeng
- Division of Haematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chun-Yu Liu
- Division of Haematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Institute of Biopharmaceutical Sciences, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Institute of Biopharmaceutical Sciences, National Yang-Ming University, Taipei, Taiwan
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
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Zainal NZ, Nik-Jaafar NR, Baharudin A, Sabki ZA, Ng CG. Prevalence of depression in breast cancer survivors: a systematic review of observational studies. Asian Pac J Cancer Prev 2013; 14:2649-56. [PMID: 23725190 DOI: 10.7314/apjcp.2013.14.4.2649] [Citation(s) in RCA: 124] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Depression is common in breast cancer patients. The aim of this paper was to make a systematic review of its prevalence and associated factors oin breast cancer survivors. MATERIALS AND METHODS An extensive systematic electronic review (PUBMED, CINAHL, PsyINFO and Ovid) and handsearch were carried out to retrieve published articles up to November 2012, using Depression OR Dysthymia AND (Cancer OR Tumor OR Neoplasms as the keywords. Information about the design of the studies, measuring scale, characteristics of the participants, prevalence of depression and its associated factors from the included studies were extracted and summarized. RESULTS We identified 32 eligible studies that recruited 10,826 breast cancer survivors. Most were cross-sectional or prospective designed. The most frequent instrument used to screen depression was the Center for Epidemiological Studies for Depression (CES-D, n=11 studies) followed by the Beck Depression Inventory (BDI, n=6 studies) and the Hospital Anxiety and Depression Scale (HADS, n=6 studies). CES-D returned about similar prevalence of depression (median=22%, range=13-56%) with BDI (median=22%, range=17-48%) but higher than HADS (median=10%, range=1-22%). Depression was associated with several socio-demographic variables, cancer-related factors, treatment-related factors, subject psychological factors, lifestyle factors, social support and quality of life. CONCLUSIONS Breast cancer survivors are at risk for depression so that detection of associated factors is important in clinical practice.
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Affiliation(s)
- Nor Zuraida Zainal
- Psychological Medicine Research Group of University Malaya (PARADIGM), Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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DRAGOMIR BIANCAIASMINA, FODOREANU LIANA, RANCEA ALIN. The impact of depression and anxiety on the quality of life in nonmetastatic breast cancer patients in postoperative evaluation. CLUJUL MEDICAL (1957) 2013; 86:48-52. [PMID: 26527916 PMCID: PMC4462482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 01/03/2013] [Accepted: 01/04/2013] [Indexed: 11/12/2022]
Abstract
AIMS To evaluate the impact of psychiatric comorbidities on the quality of life of early stage breast cancer subjects, in the first post-surgery week, the prevalence of those psychiatric disorders in this group, the correlation between pain and adjustment disorders and between the STAI-X1 (State Trait Anxiety Inventory 1) and BDI (Beck Depression Inventory) scales and the psychopathological findings. PATIENTS AND METHODS We conducted a clinical study at the Ocological Institute "Ioan Chiricuţă" Cluj-Napoca on a group of 56 patients (mean age 53.51 years old) with nonmetastatic breast cancer, who underwent surgical intervention in the week prior to the psychiatric evaluation. Patients received a complete psychiatric evaluation during their hospitalization. The STAI-X1, BDI, Numeric Rating Scale and QLQ 30 (Quality of Life Questionnaire 30) plus BR 23 (Breast 23) questionnaires were administered. RESULTS The prevalence of adjustment disorders in the group was 28.58%. The psychiatric diagnosis significantly and inversely correlated with the emotional functioning, the cognitive functioning and future perspective. The existence of psychiatric disorders significantly and directly correlated with fatigue, pain, insomnia, appetite loss, constipation, arm symptoms and global health status. CONCLUSIONS Depression and anxiety have an important prevalence in the breast cancer population and they significantly alter the quality of life of these patients and caregivers by reducing their functional abilities and by generating a higher level of symptomatology and subjective sufferance.
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Affiliation(s)
- BIANCA-IASMINA DRAGOMIR
- Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania,Psychiatric I Emergency County Hospital, Cluj-Napoca, Romania,Adress for correspondence:
| | - LIANA FODOREANU
- Psychiatric I Emergency County Hospital, Cluj-Napoca, Romania
| | - ALIN RANCEA
- Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania,“Ioan Chiricuţă” Institute of Oncology, Cluj-Napoca, Romania
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Zainal NZ, Booth S, Huppert FA. The efficacy of mindfulness-based stress reduction on mental health of breast cancer patients: a meta-analysis. Psychooncology 2012; 22:1457-65. [DOI: 10.1002/pon.3171] [Citation(s) in RCA: 173] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 08/11/2012] [Accepted: 08/12/2012] [Indexed: 11/10/2022]
Affiliation(s)
- Nor Zuraida Zainal
- Department of Psychological Medicine, Faculty of Medicine; University of Malaya; Kuala Lumpur Malaysia
- Department of Psychiatry, School of Clinical Medicine; University of Cambridge; Cambridge UK
| | - Sara Booth
- Palliative Care Service; Addenbrooke's Hospital, University of Cambridge; Cambridge UK
| | - Felicia A. Huppert
- Department of Psychiatry, School of Clinical Medicine; University of Cambridge; Cambridge UK
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