Clinical and genetic factors associated with anxiety and depression in breast cancer patients: a cross-sectional study

BMC Cancer

Fady NASR¹  Georges CHAHINE¹  Joseph KATTAN¹  Fadi EL KARAK¹  Souheil HALLIT²  Aline HAJJ³  Roula HACHEM³  Lydia RABBAA KHABBAZ³  Rita KHOURY³  Bashar ElJEBBAWI³ 

[1]Department of Hemato-Oncology, Hôtel-Dieu de France Hospital, Faculty of Medicine, Saint-Joseph University of Beirut, Beirut, Lebanon

[2]Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik (USEK), Jounieh, Lebanon

[3]INSPECT-LB (Institut National de Santé Publique d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut, Lebanon

[4]Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon

[5]Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon

[6]Laboratoire de Pharmacologie, Pharmacie Clinique et Contrôle de Qualité des Médicaments, Faculté de pharmacie, Saint-Joseph University, Beirut, Lebanon

关键词: Anxiety;    Breast cancer;    COMT;    Depression;    HADS;    PER2;    Pharmacogenetics;   

DOI  :  10.1186/s12885-021-08615-9

来源: Springer

【 摘 要 】

BackgroundDespite the progress in assessment and treatment of breast cancer, being diagnosed with it or receiving chemotherapy treatment is still conceived as a traumatic experience. Women develop negative thoughts about life and death with detrimental effects on their daily physical functioning/activities, emotional state and overall quality of life. The aim of our study was to evaluate the level of anxiety and depression among breast cancer patients receiving chemotherapy and explore the correlation between these psychological disorders, clinical, sociodemographic and genetic factors.MethodsA cross-sectional study was conducted among breast cancer patients undergoing intravenous chemotherapy at the oncology outpatient unit of Hôtel-Dieu de France hospital (November 2017–June 2019; Ethical approval number: CEHDF1016). All patients gave their written informed consent and completed several validated scales, including the Hospital Anxiety and Depression scale (HADS) for the assessment of anxiety and depression. Sleep quality, insomnia, cognitive function, fatigue and pain were also evaluated. Genotyping for certain gene polymorphisms (CLOCK, PER2, CRY2, OPRM1, ABCB1, COMT, DRD2) was performed using the Lightcycler® (Roche).ResultsA total of 112 women was included. The prevalence of depression was 43.4%, and 56.2% of the patients reported anxiety (based on the HADS classification). Multivariable analysis showed that higher cognitive scores and taking fosaprepitant were significantly associated with lower depression and anxiety scores. Moreover, being married compared to single was also associated with lower depression scores, whereas higher PSQI scores (worse sleep quality) and having the PER2 AA variant genotype compared to GG were significantly associated with higher depression scores. Finally, reporting a more severe insomnia and having the COMT Met/Met genotype were significantly associated with a higher anxiety score.ConclusionsOur study demonstrated a strong relationship between depression scores and cognitive impairment, sleep quality, marital status, fosaprepitant intake, and PER2 polymorphism, while anxiety scores were correlated to cognitive impairment, insomnia severity, fosaprepitant intake, and COMT polymorphism. The association with PER polymorphism was not previously reported. Identification of genetic and clinical risk factors for anxiety and depression would help clinicians implement an individualized management therapy aiming at preventing and alleviating the burden of these symptoms in breast cancer patients, hence improving their overall quality of life.

【 授权许可】

CC BY