Dataset Information

Depression and anxiety in women with early breast cancer: five year observational cohort study.

ABSTRACT:

Objective

To examine the prevalence of, and risk factors for, depression and anxiety in women with early breast cancer in the five years after diagnosis.

Design

Observational cohort study.

Setting

NHS breast clinic, London.

Participants

222 women with early breast cancer: 170 (77%) provided complete interview data up to either five years after diagnosis or recurrence.

Main outcome measures

Prevalence of clinically important depression and anxiety (structured psychiatric interview with standardised diagnostic criteria) and clinical and patient risk factors, including stressful life experiences (Bedford College life events and difficulties schedule).

Results

Nearly 50% of the women with early breast cancer had depression, anxiety, or both in the year after diagnosis, 25% in the second, third, and fourth years, and 15% in the fifth year. Point prevalence was 33% at diagnosis, falling to 15% after one year. 45% of those with recurrence experienced depression, anxiety, or both within three months of the diagnosis. Previous psychological treatment predicted depression, anxiety, or both in the period around diagnosis (one month before diagnosis to four months after diagnosis). Longer term depression and anxiety, were associated with previous psychological treatment, lack of an intimate confiding relationship, younger age, and severely stressful non-cancer life experiences. Clinical factors were not associated with depression and anxiety, at any time. Lack of intimate confiding support also predicted more protracted episodes of depression and anxiety.

Conclusion

Increased levels of depression, anxiety, or both in the first year after a diagnosis of early breast cancer highlight the need for dedicated service provision during this time. Psychological interventions for women with breast cancer who remain disease free should take account of the broader social context in which the cancer occurs, with a focus on improving social support.

SUBMITTER: Burgess C

PROVIDER: S-EPMC555631 | biostudies-literature | 2005 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Depression and anxiety in women with early breast cancer: five year observational cohort study.

Burgess Caroline C Cornelius Victoria V Love Sharon S Graham Jill J Richards Michael M Ramirez Amanda A

BMJ (Clinical research ed.) 20050204 7493

<h4>Objective</h4>To examine the prevalence of, and risk factors for, depression and anxiety in women with early breast cancer in the five years after diagnosis.<h4>Design</h4>Observational cohort study.<h4>Setting</h4>NHS breast clinic, London.<h4>Participants</h4>222 women with early breast cancer: 170 (77%) provided complete interview data up to either five years after diagnosis or recurrence.<h4>Main outcome measures</h4>Prevalence of clinically important depression and anxiety (structured p ...[more]

PMID: 15695497

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Project description:To test the hypothesis that postmenopausal women who increase their alcohol intake over a five year period have a higher risk of breast cancer and a lower risk of coronary heart disease compared with stable alcohol intake.Prospective cohort study.Denmark, 1993-2012.21?523 postmenopausal women who participated in the Diet, Cancer, and Health Study in two consecutive examinations in 1993-98 and 1999-2003. Information on alcohol intake was obtained from questionnaires completed by participants.Incidence of breast cancer, coronary heart disease, and all cause mortality during 11 years of follow-up. Information was obtained from the Danish Cancer Register, Danish Hospital Discharge Register, Danish Register of Causes of Death, and National Central Person Register. We estimated hazard ratios according to five year change in alcohol intake using Cox proportional hazards models.During the study, 1054, 1750, and 2080 cases of breast cancer, coronary heart disease, and mortality occurred, respectively. Analyses modelling five year change in alcohol intake with cubic splines showed that women who increased their alcohol intake over the five year period had a higher risk of breast cancer and a lower risk of coronary heart disease than women with a stable alcohol intake. For instance, women who increased their alcohol intake by seven or 14 drinks per week (corresponding to one or two drinks more per day) had hazard ratios of breast cancer of 1.13 (95% confidence interval 1.03 to 1.23) and 1.29 (1.07 to 1.55), respectively, compared to women with stable intake, and adjusted for age, education, body mass index, smoking, Mediterranean diet score, parity, number of births, and hormone replacement therapy. For coronary heart disease, corresponding hazard ratios were 0.89 (0.81 to 0.97) and 0.78 (0.64 to 0.95), respectively, adjusted for age, education, body mass index, Mediterranean diet score, smoking, physical activity, hypertension, elevated cholesterol, and diabetes. Results among women who reduced their alcohol intake over the five year period were not significantly associated with risk of breast cancer or coronary heart disease. Analyses of all cause mortality showed that women who increased their alcohol intake from a high intake (?14 drinks per week) to an even higher intake had a higher mortality risk that women with a stable high intake.In this study of postmenopausal women over a five year period, results support the hypotheses that alcohol intake is associated with increased risk of breast cancer and decreased risk of coronary heart disease.

Project description:BACKGROUND:Young women with breast cancer tend to report lower quality of life and higher levels of stress than older women with breast cancer, and this may have implications for other psychosocial factors including finances. We sought to determine if stress, anxiety, and depression at diagnosis were associated with changes in household income over 12-months in young women with breast cancer in the United States. METHODS:This study was a prospective, longitudinal cohort study comprised of women enrolled in the Young and Strong trial. Of the 467 women aged 18-45 newly diagnosed with early-stage breast cancer enrolled in the Young and Strong trial from 2012 to 2013, 356 (76%) answered income questions. Change in household income from baseline to 12?months was assessed and women were categorized as having lost, gained, maintained the same household income <$100,000, or maintained household income ?$100,000. Patient-reported stress, anxiety, and depression were assessed close to diagnosis at trial enrollment. Adjusted multinomial logistic regression models were used to compare women who lost, gained, or maintained household income ?$100,000 to women who maintained the same household income <$100,000. RESULTS:Although most women maintained household income ?$100,000 (37.1%) or the same household income <$100,000 (32.3%), 15.4% lost household income and 15.2% gained household income. Stress, anxiety, and depression were not associated with gaining or losing household income compared to women maintaining household incomes <$100,000. Women with household incomes <$50,000 had a higher risk of losing household income compared to women with household incomes ?$50,000. Women who maintained household incomes ?$100,000 were less likely to report financial or insurance problems. Among women who lost household income, 56% reported financial problems and 20% reported insurance problems at 12?months. CONCLUSIONS:Baseline stress, anxiety, and depression were not associated with household income changes for young women with breast cancer. However, lower baseline household income was associated with losing household income. Some young survivors encounter financial and insurance problems in the first year after diagnosis, and further support for these women should be considered. TRIAL REGISTRATION:Clinicaltrials.gov , NCT01647607 ; date registered: July 23, 2012.

Dataset Information

Depression and anxiety in women with early breast cancer: five year observational cohort study.

Objective

Design

Setting

Participants

Main outcome measures

Results

Conclusion

Publications

Depression and anxiety in women with early breast cancer: five year observational cohort study.

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