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

Published online by Cambridge University Press:  14 October 2010

J. Hill ,
C. Holcombe ,
L. Clark ,
M. R. K. Boothby ,
A. Hincks ,
J. Fisher ,
S. Tufail  and
P. Salmon
J. Hill
Affiliation:
Child Psychiatry Research Group, The University of Manchester, Manchester, UK
C. Holcombe
Affiliation:
Breast Unit, Linda McCartney Centre, Royal Liverpool University Hospital, Liverpool, UK
L. Clark
Affiliation:
Division of Clinical Psychology, University of Liverpool, Liverpool, UK
M. R. K. Boothby
Affiliation:
Psychology Department, Istanbul Bilim University, Istanbul, Turkey
A. Hincks
Affiliation:
Division of Clinical Psychology, University of Liverpool, Liverpool, UK
J. Fisher
Affiliation:
Breast Unit, Linda McCartney Centre, Royal Liverpool University Hospital, Liverpool, UK
S. Tufail
Affiliation:
North Manchester General Hospital, Manchester, UK
P. Salmon*
Affiliation:
Division of Clinical Psychology, University of Liverpool, Liverpool, UK
*
*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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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.

Keywords

Anxietybreast cancerdepressiononset
Type
Original Articles
Information
Psychological Medicine , Volume 41 , Issue 7 , July 2011 , pp. 1429 - 1436
Copyright
Copyright © Cambridge University Press 2010

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References

Andrews, B (1995). Bodily shame as a mediator between abusive experiences and depression. Journal of Abnormal Psychology 104, 277–285.CrossRefGoogle ScholarPubMed
Baron, RM, Kenny, DA (1986). The moderator–mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology 51, 1173–1182.CrossRefGoogle ScholarPubMed
Bennett, KK, Compas, BE, Beckjord, E, Glinder, JG (2005). Self-blame and distress among women with newly diagnosed breast cancer. Journal of Behavioral Medicine 28, 313–323.CrossRefGoogle ScholarPubMed
Burgess, C, Cornelius, V, Love, S, Graham, J, Richards, M, Ramirez, A (2005). Depression and anxiety in women with early breast cancer: five year observational cohort study. British Medical Journal 330, 702.CrossRefGoogle ScholarPubMed
Dean, C (1987). Psychiatric morbidity following mastectomy: preoperative predictors and types of illness. Journal of Psychosomatic Research 31, 385–392.CrossRefGoogle ScholarPubMed
Gallagher, J, Parle, M, Cairns, D (2002). Appraisal and psychological distress six months after diagnosis of breast cancer. British Journal of Health Psychology 7, 365–376.Google Scholar
Gandubert, C, Carriere, I, Escot, C, Soulier, M, Hermes, A, Boulet, P, Ritchie, K, Chaudieu, I (2009). Onset and relapse of psychiatric disorders following early breast cancer: a case–control study. Psychooncology 18, 1029–1037.Google Scholar
Ganz, PA, Desmond, KA, Leedham, B, Rowland, JH, Meyerowitz, BE, Belin, TR (2002). Quality of life in long-term, disease-free survivors of breast cancer: a follow-up study. Journal of the National Cancer Institute 94, 39–49.CrossRefGoogle ScholarPubMed
Glinder, JG, Compas, BE (1999). Self-blame attributions in women with newly diagnosed breast cancer: a prospective study of psychological adjustment. Health Psychology 18, 475–481.Google Scholar
Gotlib, IH, Lewinsohn, PM, Seeley, JR (1998). Consequences of depression during adolescence: marital status and marital functioning in early adulthood. Journal of Abnormal Psychology 107, 686–690.Google Scholar
Grassi, L, Malacarne, P, Maestri, A, Ramelli, E (1997). Depression, psychosocial variables and occurrence of life events among patients with cancer. Journal of Affective Disorders 44, 21–30.CrossRefGoogle ScholarPubMed
Harrington, R, Hill, J, Rutter, M, John, K, Fudge, H, Zoccolillo, M, Weissman, M (1988). The assessment of lifetime psychopathology: a comparison of two interviewing styles. Psychological Medicine 18, 487–493.CrossRefGoogle ScholarPubMed
Helgeson, VS, Snyder, P, Seltman, H (2004). Psychological and physical adjustment to breast cancer over 4 years: identifying distinct trajectories of change. Health Psychology 23, 3–15.CrossRefGoogle ScholarPubMed
Hill, J, Davis, R, Byatt, M, Burnside, E, Rollinson, L, Fear, S (2000). Childhood sexual abuse and affective symptoms in women: a general population study. Psychological Medicine 30, 1283–1291.Google Scholar
Hill, J, Pickles, A, Burnside, E, Byatt, M, Rollinson, L, Davis, R, Harvey, K (2001). Child sexual abuse, poor parental care and adult depression: evidence for different mechanisms. British Journal of Psychiatry 179, 104–109.CrossRefGoogle ScholarPubMed
Hill, J, Pickles, A, Rollinson, L, Davies, R, Byatt, M (2004). Juvenile- versus adult-onset depression: multiple differences imply different pathways. Psychological Medicine 34, 1483–1493.Google Scholar
Jaffee, SR, Moffitt, TE, Caspi, A, Fombonne, E, Poulton, R, Martin, J (2002). Differences in early childhood risk factors for juvenile-onset and adult-onset depression. Archives of General Psychiatry 59, 215–222.CrossRefGoogle ScholarPubMed
Kessler, RC, McGonagle, KA, Zhao, S, Nelson, CB, Hughes, M, Eshleman, S, Wittchen, HU, Kendler, KS (1994). Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Archives of General Psychiatry 51, 8–19.Google Scholar
Lewinsohn, PM, Rohde, P, Seeley, JR, Klein, DN, Gotlib, IH (2003). Psychosocial functioning of young adults who have experienced and recovered from major depressive disorder during adolescence. Journal of Abnormal Psychology 112, 353–363.Google Scholar
Margolis, G, Goodman, RL, Rubin, A (1990). Psychological effects of breast-conserving cancer treatment and mastectomy. Psychosomatics 31, 33–39.CrossRefGoogle ScholarPubMed
Maunsell, E, Brisson, J, Deschenes, L (1992). Psychological distress after initial treatment of breast cancer. Assessment of potential risk factors. Cancer 70, 120–125.Google Scholar
Moorey, S, Greer, S (2002). Cognitive Behaviour Therapy for People with Cancer. Oxford University Press: Oxford.Google Scholar
Morasso, G, Costantini, M, Viterbori, P, Bonci, F, Del Mastro, L, Musso, M, Garrone, O, Venturini, M (2001). Predicting mood disorders in breast cancer patients. European Journal of Cancer 37, 216–223.Google Scholar
Pinder, KL, Ramirez, AJ, Black, ME, Richards, MA, Gregory, WM, Rubens, RD (1993). Psychiatric disorder in patients with advanced breast cancer: prevalence and associated factors. European Journal of Cancer 29A, 524–527.Google ScholarPubMed
Salmon, P, Hill, J, Krespi, R, Clark, L, Fisher, J, Holcombe, C (2006). The role of child abuse and age in vulnerability to emotional problems after surgery for breast cancer. European Journal of Cancer 42, 2517–2523.CrossRefGoogle ScholarPubMed
Sherbourne, CD, Hays, RD, Wells, KB (1995). Personal and psychosocial risk factors for physical and mental health outcomes and course of depression among depressed patients. Journal of Consulting and Clinical Psychology 63, 345–355.CrossRefGoogle ScholarPubMed
Sherbourne, CD, Stewart, AL (1991). The MOS social support survey. Social Science and Medicine 32, 705–714.CrossRefGoogle ScholarPubMed
Spitzer, RL, Endicott, J (1975). Schedule for Affective Disorders and Schizophrenia – Lifetime Version. Biometrics Research: New York.Google Scholar
Teasdale, JD, Cox, SG (2001). Dysphoria: self-devaluative and affective components in recovered depressed patients and never depressed controls. Psychological Medicine 31, 1311–1316.Google Scholar
Trunzo, JJ, Pinto, BM (2003). Social support as a mediator of optimism and distress in breast cancer survivors. Journal of Consulting and Clinical Psychology 71, 805–811.CrossRefGoogle ScholarPubMed
Whiffen, VE, Macintosh, HB (2005). Mediators of the link between childhood sexual abuse and emotional distress: a critical review. Trauma, Violence and Abuse 6, 24–39.CrossRefGoogle ScholarPubMed