The status and correlates of depression and anxiety among breast-cancer survivors in Eastern China: a population-based, cross-sectional case–control study

BMC Public Health

Zhigang Yu³  Qiang Zhang³  Dezong Gao³  Zhongbing Ma³  Fei Wang³  Liyuan Liu²  Jiajia Liu¹  Feng Wang³ 

[1] School of Nursing, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong 250012, P. R. China;School of Public Health, Shandong University, No. 44 Wenhua Xi Road, Jinan, Shandong 250012, P. R. China;Breast Disease Department, the Second Hospital of Shandong University, 247#, Beiyuan St, Tianqiao District, Jinan, Shandong 250033, P. R. China

关键词: Predictor;    Social support;    Coping style;    Anxiety;    Depression;    Breast cancer;   

Others  :  1131599
DOI  :  10.1186/1471-2458-14-326

 received in 2013-04-13, accepted in 2014-04-02,  发布年份 2014

【 摘 要 】

Background

Breast cancer presents specific challenges both physiologically and psychologically to women, and consequently affect the patients’ mental health. Psychosocial factors may play important roles in the symptoms and development of mental disorders among breast-cancer survivors. This study assesses the depression and anxiety status of breast-cancer survivors and further identifies the risk factors.

Methods

A 1:1 matched, case–control study was conducted with a total sample of 222 individuals. Participants were selected from a national epidemiological survey. The Center for Epidemiological Studies—Depression Scale and State-Trait Anxiety Inventory were used to assess depression and anxiety. The Social Support Rating Scale and Perceived Social Support Scale were used as measures of social support and perceived social support, and the Rosenberg Self-Esteem Scale as a measure of self-esteem. Coping style was assessed using the Simplified Coping Style Questionnaire. The predictive effect of these psychosocial factors for depression and anxiety was investigated with hierarchical linear regressions.

Results

Breast-cancer survivors experienced a high level of depressive and anxious symptoms. Multivariate analysis revealed that breast cancer functions as an independent but not a main risk factor of both depression and anxiety. Higher levels of depression and anxiety were positively associated with a higher level of passive coping style, and negatively with perceived social support, objective social support and an active coping style.

Conclusions

The mental health of breast-cancer survivors should be promoted through the transformation of coping styles and improvement of social support.

【 授权许可】

   
2014 Wang et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]WHO: The Global Burden of Disease 2004. Geneva, Switzerland: WHO press; 2010. http://www.who.int/healthinfo/global_burden_disease/2004_report_update/en/index.html webcite. Accessed Feb 10, 2010
• [2]Yang L, Li LD, Chen YD, Parkin DM: Time trends, estimates and projects for breast cancer incidence and mortality in China. Zhonghua Zhong Liu Za Zhi 2006, 28(6):438-440.
• [3]Zhang BN, Cao XC, Chen JY, Chen J, Fu L, Hu XC, Jiang ZF, Li HY, Liao N, Liu DG, Tao O, Shao ZM, Sun Q, Wang S, Wang YS, Xu BH, Zhang J: Guidelines on the diagnosis and treatment of breast cancer (2011 edition). Gland Surg 2012, 1(1):39-61.
• [4]Clarke DM: No cancer health without mental health. Med J Aust 2010, 193(5):S43.
• [5]Knobf M: Psychosocial Responses in Breast Cancer Survivors. Seminars in Oncology Nursing 2007, 23(1):71-83. Elsevier; 2007,
• [6]Helgeson VS, Snyder P, Seltman H: Psychological and physical adjustment to breast cancer over 4 years: identifying distinct trajectories of change. Health Psychol 2004, 23(1):3.
• [7]Lloyd-Williams M, Friedman T: Depression in palliative care patients–a prospective study. Eur J Cancer Care (Engl) 2001, 10(4):270-274.
• [8]Thewes B, Butow P, Girgis A, Pendlebury S: The psychosocial needs of breast cancer survivors; a qualitative study of the shared and unique needs of younger versus older survivors. Psycho-Oncology 2004, 13(3):177-189.
• [9]Wade TD, Lee C: Prospective predictors of mental health after the development of breast cancer in middle-aged women. Clin Psychol 2005, 9(2):64-69.
• [10]Bleiker E, Pouwer F, van der Ploeg HM, Leer J-WH, Adèr HJ: Psychological distress two years after diagnosis of breast cancer: frequency and prediction. Patient Educ Couns 2000, 40(3):209-217.
• [11]Segrin C, Badger TA: Psychological and physical distress are interdependent in breast cancer survivors and their partners. Psychol Health Med 2014, (ahead of print):1-8.
• [12]Tobiasz-Adamczyk B, Zawisza K, Florek M, Hodorowicz-Zaniewska D: Preoperative quality of life in women with pathological alteration in breast. Przeglad lekarski 2013, 70(4):180-186.
• [13]Deimling GT, Wagner LJ, Bowman KF, Sterns S, Kercher K, Kahana B: Coping among older‒adult, long‒term cancer survivors. Psycho-Oncology 2006, 15(2):143-159.
• [14]Pan XF, Fei MD, Zhang KY, Fan ZL, Fu FH, Fan JH: Psychopathological profile of women with breast cancer based on the symptom checklist-90-R. Asian Pac J Cancer Prev 2013, 14(11):6579-6584.
• [15]Yu Z-G, Jia C-X, Liu L-Y, Geng C-Z, Tang J-H, Zhang J, Zhang Q, Li Y-Y, Ma Z-B: The prevalence and correlates of breast cancer among women in Eastern China. PloS One 2012, 7(6):e37784.
• [16]Zhang J, Wu Z, Fang G, Li J, Han B, Chen Z: Development of the Chinese age norms of CES-D in urban area. Chin Ment Heal J 2010, 24(2):139-135.
• [17]Spielberger CD, Gorsuch RL: State-Trait Anxiety Inventory for Adults: Sampler set: Manual, Test, Scoring key. Mind Garden; 1983.
• [18]Xiangdong W: Social support rating scale (psychological health rating scale manual). Chin Ment Health J 1993, (supplement):42-46.
• [19]Sarason IG, Levine HM, Basham RB, Sarason BR: Assessing social support: the social support questionnaire. J Pers Soc Psychol 1983, 44(1):127.
• [20]Henderson S, Duncan-Jones P, Byrne D, Scott R: Measuring social relationships. The interview schedule for social interaction. Psychol Med 1980, 10(4):723-734.
• [21]Zimet GD, Dahlem NW, Zimet SG, Farley GK: The multidimensional scale of perceived social support. J Pers Assess 1988, 52(1):30-41.
• [22]Rosenberg M: Conceiving the Self. FL: Krieger Malabar; 1986.
• [23]Rosenberg M: Society and the Adolescent Self-Image (rev. Wesleyan University Press; 1989.
• [24]YN X: Simplified coping style questionnaire. Chin Ment Health J 1999, 13(Suppl):122-124.
• [25]Phillips-Salimi CR, Andrykowski MA: Physical and mental health status of female adolescent/young adult survivors of breast and gynecological cancer: a national, population-based, case–control study. Support Care Cancer 2013, 21(6):1597-1604.
• [26]Maly RC, Umezawa Y, Leake B, Silliman RA: Mental health outcomes in older women with breast cancer: impact of perceived family support and adjustment. Psycho-Oncology 2005, 14(7):535-545.
• [27]Badger T, Segrin C, Dorros SM, Meek P, Lopez AM: Depression and anxiety in women with breast cancer and their partners. Nursing Res 2007, 56(1):44-53.
• [28]Yh L h, Zhao S: Coping style, anxiety and depression in breast cancer postoperative survivors. Chin Ment Health J 2009, 23(3):173-176.
• [29]Schlegel RJ: Rural and Urban Breast Cancer Patients: Differential Relationships Between Coping Responses and Psychological Adjustment. Columbia: University of Missouri; 2007.
• [30]FU Lan LJ, Hong LI: Study on the relationship between social support and quality of life in cancer patients and nursing strategies. Chin J Nurs 2004, 39(1):9-11.
• [31]Yoo GJ, Levine EG, Aviv C, Ewing C, Au A: Older women, breast cancer, and social support. Support Care Cancer 2010, 18(12):1521-1530.
• [32]Wang X, Wang S-S, Peng R-J, Qin T, Shi Y-X, Teng X-Y, Liu D-G, Chen W-Q, Yuan Z-Y: Interaction of coping styles and psychological stress on anxious and depressive symptoms in chinese breast cancer patients. Asian Pac J Cancer Prev 2012, 13(4):1645.