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. 2022 May;30(5):3933-3941.
doi: 10.1007/s00520-022-06827-8. Epub 2022 Jan 19.

Anticipating mental health needs after chemotherapy in early-stage breast cancer using patient-reported symptom screening

Zev M Nakamura  1   2 , Emily M Damone  3 , Hannah P Herrick  4 , Kirsten A Nyrop  5   6 , Allison M Deal  5 , A Tucker Brenizer  5 , Hyman B Muss  5   6
Affiliations

Anticipating mental health needs after chemotherapy in early-stage breast cancer using patient-reported symptom screening

Zev M Nakamura et al. Support Care Cancer. 2022 May.

Abstract

Purpose: Many patients with breast cancer experience depression and anxiety for years after completing systemic chemotherapy, which negatively impact overall symptom burden, quality of life, and treatment outcomes. The objective of this study was to examine the utility of patient-reported outcome (PRO) measures to predict mental health needs in patients with breast cancer during post-chemotherapy follow-up care.

Methods: In a sample of women with non-metastatic breast cancer, associations between patient-reported depression and anxiety at end of chemotherapy and post-chemotherapy mental health needs were evaluated using log-binomial regression adjusted for functional status, social activity limitations, and time from chemotherapy.

Results: In a sample of 149 women, 40% reported at least mild depressive symptoms and 52% reported at least mild anxiety at the end of chemotherapy. Over an average 3.2 years post-chemotherapy (range: 0.7-5.6 years), 23% received new psychiatric diagnoses, 21% engaged in mental health specialty care, and 62% were prescribed psychotropic medications. End of chemotherapy depression and anxiety were associated with future prescription of psychotropic medications (RR 1.52; 95% CI 1.14-2.03), as well as greater number of psychotropics. Associations were strongest with serotonin-norepinephrine reuptake inhibitors [(depression: RR 4.75; 95% CI 2.06-10.95); (anxiety: RR 3.68; 95% CI 1.62-8.36); (depression and anxiety: RR 2.98; 95% CI 1.65-5.36)].

Conclusion: Diagnosis of and treatment for depression and anxiety are common among women with breast cancer after completing chemotherapy. Prescriptions for psychotropic medications during the initial years after systemic chemotherapy can be anticipated by depression and anxiety screening at end of chemotherapy.

Keywords: Anxiety; Breast cancer; Cancer; Depression; Mental health; Patient-reported outcome measures.

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Conflict of interest statement

Conflict of interest The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Patient-reported depression and anxiety severity at end of chemotherapy
Fig. 2
Fig. 2
Number of psychotropic medications prescribed after chemotherapy by patient-reported depression and anxiety symptom status at end of chemotherapy
See this image and copyright information in PMC

References

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