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Predictors of onset of depression and anxiety in the year after diagnosis of breast cancer

  • J. Hill (a1), C. Holcombe (a2), L. Clark (a3), M. R. K. Boothby (a4), A. Hincks (a3), J. Fisher (a2), S. Tufail (a5) and P. Salmon (a3)...

Abstract

Background

Depression and anxiety are common after diagnosis of breast cancer. We examined to what extent these are recurrences of previous disorder and, controlling for this, whether shame, self-blame and low social support after diagnosis predicted onset of depression and anxiety subsequently.

Method

Women with primary breast cancer who had been treated surgically self-reported shame, self-blame, social support and emotional distress post-operatively. Psychiatric interview 12 months later identified those with adult lifetime episodes of major depression (MD) or generalized anxiety disorder (GAD) before diagnosis and onset over the subsequent year. Statistical analysis examined predictors of each disorder in that year.

Results

Of the patients, two-thirds with episodes of MD and 40% with episodes of GAD during the year after diagnosis were experiencing recurrence of previous disorder. Although low social support, self-blame and shame were each associated with both MD and GAD after diagnosis, they did not mediate the relationship of disorder after diagnosis with previous disorder. Low social support, but not shame or self-blame, predicted recurrence after controlling for previous disorder.

Conclusions

Anxiety and depression during the first year after diagnosis of breast cancer are often the recurrence of previous disorder. In predicting disorder following diagnosis, self-blame and shame are merely markers of previous disorder. Low social support is an independent predictor and therefore may have a causal role.

Copyright

Corresponding author

*Address for correspondence: P. Salmon, D.Phil., Division of Clinical Psychology, University of Liverpool, Whelan Building, Brownlow Hill, Liverpool L69 3GB, UK. (Email: psalmon@liv.ac.uk)

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Predictors of onset of depression and anxiety in the year after diagnosis of breast cancer

  • J. Hill (a1), C. Holcombe (a2), L. Clark (a3), M. R. K. Boothby (a4), A. Hincks (a3), J. Fisher (a2), S. Tufail (a5) and P. Salmon (a3)...

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