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. 2016 Feb:20:97-105.
doi: 10.1016/j.ejon.2015.06.003. Epub 2015 Jul 15.

Co-occurrence of anxiety and depressive symptoms following breast cancer surgery and its impact on quality of life

Marshall Gold  1 , Laura B Dunn  2 , Bethany Phoenix  1 , Steven M Paul  1 , Deborah Hamolsky  1 , Jon D Levine  2 , Christine Miaskowski  3
Affiliations

Co-occurrence of anxiety and depressive symptoms following breast cancer surgery and its impact on quality of life

Marshall Gold et al. Eur J Oncol Nurs. 2016 Feb.

Abstract

Purpose: Little is known about the prevalence of combined anxiety and depressive symptoms (CADS) in breast cancer patients. Purpose was to evaluate for differences in demographic and clinical characteristics and quality of life (QOL) prior to breast cancer surgery among women classified into one of four distinct anxiety and/or depressive symptom groups.

Methods: A total of 335 patients completed measures of anxiety and depressive symptoms and QOL prior to and for 6 months following breast cancer surgery. Growth Mixture Modelling (GMM) was used to identify subgroups of women with distinct trajectories of anxiety and depressive symptoms. These results were used to create four distinct anxiety and/or depressive symptom groups. Differences in demographic, clinical, and symptom characteristics, among these groups were evaluated using analyses of variance and Chi square analyses.

Results: A total of 44.5% of patients were categorized with CADS. Women with CADS were younger, non-white, had lower performance status, received neoadjuvant or adjuvant chemotherapy, had greater difficulty dealing with their disease and treatment, and reported less support from others to meet their needs. These women had lower physical, psychological, social well-being, and total QOL scores. Higher levels of anxiety with or without subsyndromal depressive symptoms were associated with increased fears of recurrence, hopelessness, uncertainty, loss of control, and a decrease in life satisfaction.

Conclusions: Findings suggest that CADS occurs in a high percentage of women following breast cancer surgery and results in a poorer QOL. Assessments of anxiety and depressive symptoms are warranted prior to surgery for breast cancer.

Keywords: Anxiety; Breast cancer; Depression; Quality of life; Subsyndromal depression; Surgery.

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Figures

Figure 1
Figure 1
Differences among the four anxiety and depressive symptom groups in Center for Epidemiological Studies Scale (CES-D) scores (A) and Trait and State Anxiety scores (B) at enrollment. All values are plotted as means ± standard deviations. For CES-D scores, post hoc contrasts revealed that group 0
Figure 2
Figure 2
Differences among the four anxiety and depressive symptom groups in physical, psychological, social, spiritual, and total quality of life (QOL) scores at enrollment. All values are plotted as means ± standard deviations. For the physical well-being subscale, post hoc contrasts revealed that group 0 > 1 and 3 (both p ≤.003) and that group 2 > 3 (p = .018). For the psychological well-being subscale, post hoc contrasts revealed that group 0 > 1, 2, and 3 (all p≤.028) and that groups 1 and 2 > 3 (both p≤.002). For the social well-being subscale, groups 0, 1, and 2 > 3 (all p≤.002). For the total QOL score, groups 0, 1, and 2 > 3 (all p<.0001>
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References

    1. Alacacioglu A, Binicier O, Gungor O, Oztop I, Dirioz M, Yilmaz U. Quality of life, anxiety, and depression in Turkish colorectal cancer patients. Supportive Care in Cancer. 2010;18:417–421. - PubMed
    1. Alfaro E, Dhruva A, Langford DJ, Koetters T, Merriman JD, West C, Dunn LB, Paul SM, Cooper B, Cataldo J, Hamolsky D, Elboim C, Kober K, Aouizerat BE, Miaskowski C. Associations between cytokine gene variations and self-reported sleep disturbance in women following breast cancer surgery. European Journal of Oncology Nursing. 2014;18:85–93. - PMC - PubMed
    1. Barez M, Blasco T, Fernandez-Castro J, Viladrich C. A structural model of the relationships between perceived control and adaptation to illness in women with breast cancer. Journal of Psychosocial Oncology. 2007;25:21–43. - PubMed
    1. Benight CC, Bandura A. Social cognitive theory of posttraumatic recovery: the role of perceived self-efficacy. Behavioral Research and Therapy. 2004;42:1129–1148. - PubMed
    1. Brintzenhofe-Szoc KM, Levin TT, Li Y, Kissane DW, Zabora JR. Mixed anxiety/depression symptoms in a large cancer cohort: prevalence by cancer type. Psychosomatics. 2009;50:383–391. - PubMed

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