Differences in patterns of depression after treatment for breast cancer

Depression is a significant problem for some breast cancer survivors after the end of treatment. This study assessed depression using the CES‐D for 84 breast cancer patients at the conclusion of radiation treatment, and at 3 and 6 months post‐treatment. Based on the pattern of CES‐D scores, patients were divided into five groups: (1) Stay Depressed (scores above clinical cutoff for depression at all timepoints); (2) Recover (above threshold at baseline, but below at follow‐up); (3) Become Depressed (below threshold at baseline, but above at follow‐up); (4) Never Depressed (below threshold at all times); and (5) Vacillate (none of the above patterns). This study examined the relationships between depression groups and a variety of medical, demographic, and psychological measures, including anxiety and quality of life (QOL). Number of children at home significantly distinguished the groups, with the Become Depressed group having more children and the Vacillate group having fewer children. Anxiety levels were different among the groups, with Recover and Never Depressed groups having consistently lower anxiety scores. QOL scores also distinguished the groups in that Never Depressed patients demonstrated better QOL than all other groups. The findings have implications for understanding resilience in cancer patients. Copyright © 2005 John Wiley & Sons, Ltd.

[1]  J. Nanda,et al.  Pain, psychological distress, health status, and coping in patients with breast cancer scheduled for autotransplantation. , 1999, Oncology nursing forum.

[2]  M. Mishel,et al.  Depression burden, psychological adjustment, and quality of life in women with breast cancer: patterns over time. , 2004, Research in nursing & health.

[3]  J Brennan,et al.  Adjustment to cancer—coping or personal transition? , 2001, Psycho-oncology.

[4]  S. Stewart,et al.  Then and now: quality of life of young breast cancer survivors , 2004, Psycho-oncology.

[5]  H. P. Graversen,et al.  A comparative study of post-operative psychosocial function in women with primary operable breast cancer randomized to breast conservation therapy or mastectomy. , 1997, European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology.

[6]  R. Goodwin,et al.  Cancer and Mental Disorders in a National Community Sample: Findings from the National Comorbidity Survey , 2004, Psychotherapy and Psychosomatics.

[7]  G. Colditz,et al.  Functional impact of breast cancer by age at diagnosis. , 2004, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[8]  L. Radloff The CES-D Scale , 1977 .

[9]  D. Cella,et al.  Age‐related differences in the quality of life of breast carcinoma patients after treatment , 1999, Cancer.

[10]  Andrew H. Miller,et al.  Breast cancer and depression. , 2004, Oncology.

[11]  P. Jacobsen,et al.  Measurement of depressive symptoms in cancer patients: evaluation of the Center for Epidemiological Studies Depression Scale (CES-D). , 1999, Journal of psychosomatic research.

[12]  J. Costantino,et al.  Tamoxifen and depression: more evidence from the National Surgical Adjuvant Breast and Bowel Project's Breast Cancer Prevention (P-1) Randomized Study. , 2001, Journal of the National Cancer Institute.

[13]  C. Gotay,et al.  Quality of life in long-term survivors of adult-onset cancers. , 1998, Journal of the National Cancer Institute.

[14]  Howard Seltman,et al.  Psychological and physical adjustment to breast cancer over 4 years: identifying distinct trajectories of change. , 2004, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[15]  P. Ganz,et al.  Quality of life at the end of primary treatment of breast cancer: first results from the moving beyond cancer randomized trial. , 2004, Journal of the National Cancer Institute.

[16]  C. Clifford Attkisson,et al.  Screening for Depression in Primary Care Clinics: The CES-D and the BDI , 1990, International journal of psychiatry in medicine.

[17]  P. Ganz,et al.  Breast conservation versus mastectomy. Is there a difference in psychological adjustment or quality of life in the year after surgery? , 1992, Cancer.

[18]  M. Costantini,et al.  Predicting mood disorders in breast cancer patients. , 2001, European journal of cancer.

[19]  J. Horiguchi,et al.  Chilaiditi syndrome--associated schizophrenia: 3 case reports. , 2001, The Journal of clinical psychiatry.

[20]  G. Bonanno Loss, trauma, and human resilience: have we underestimated the human capacity to thrive after extremely aversive events? , 2008, The American psychologist.

[21]  B. Ferrell,et al.  An evaluation of the quality of life among long-term survivors of breast cancer , 2005, Breast Cancer Research and Treatment.

[22]  D S Tulsky,et al.  Reliability and validity of the Functional Assessment of Cancer Therapy-Breast quality-of-life instrument. , 1997, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.