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. 2022 Feb 9;22(1):101.
doi: 10.1186/s12888-022-03735-3.

Prevalence and determinants of anxiety and depression in long-term breast cancer survivors

Clara Breidenbach  1 , Paula Heidkamp  2 , Kati Hiltrop  3 , Holger Pfaff  4 , Anna Enders  5 , Nicole Ernstmann  3 , Christoph Kowalski  1
Affiliations

Prevalence and determinants of anxiety and depression in long-term breast cancer survivors

Clara Breidenbach et al. BMC Psychiatry. .

Abstract

Background: There is a significant number of long-term breast cancer survivors in Germany. However, research on the psychological challenges of cancer survivors is limited. This analysis describes prevalence, development and determinants of depression and anxiety 5 to 6 years after diagnosis and identifies predictors for an increase of anxiety and depression over time.

Methods: Data from 164 women was collected by survey and tumour documentation during post-operative hospital stay, 40 weeks and 5 to 6 years after diagnosis. Anxiety and depression were measured by the Hospital Anxiety and Depression Scale. Sankey-diagrams were created for visual presentation of prevalence over time. Logistic and linear regression models were calculated to identify determinants of anxiety and depression.

Results: Respondents had higher levels of depression and anxiety 5 to 6 years than 40 weeks after the diagnosis. Lower vocational status and having children were associated with depression, surgery type was correlated with anxiety, and age, as well as comorbidities, were predictors for both anxiety and depression 5 to 6 years after diagnosis. An increase of depression over time was more likely when having children and comorbidities. An increase in anxiety was less likely after cancer recurrence.

Conclusions: Findings highlight that anxiety and depression are relevant burdens for breast cancer survivors in Germany. Several sociodemographic and clinical predictors are identified. There is need for psychosocial support after acute treatment and in the long-term. Research on psychological burdens of long-term breast cancer survivors in the identified vulnerable groups is needed.

Keywords: Anxiety; Breast cancer; Cancer survivorship; Depression; Hospital anxiety and depression scale.

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Conflict of interest statement

Christoph Kowalski and Clara Breidenbach are employees of the German Cancer Society.

Figures

Fig. 1
Fig. 1
Sankey-diagram showing the respondents’ transfers between anxiety levels at T3 and T4 (n = 164); the thicker the grey line, the more patients
Fig. 2
Fig. 2
Sankey-diagram showing the respondents’ transfers between depression levels at T3 and T4 (n = 164); the thicker the grey line, the more patients
See this image and copyright information in PMC

References

    1. Robert Koch-Institut . Krebs in Deutschland für 2017/2018. 2021.
    1. Mehnert A. Employment and work-related issues in cancer survivors. Crit Rev Oncol Hematol. 2011;77:109–130. - PubMed
    1. Carreira H, Williams R, Müller M, Harewood R, Stanway S, Bhaskaran K. Associations between breast cancer survivorship and adverse mental health outcomes: a systematic review. J Natl Cancer Inst. 2018;110:1311–1327. - PMC - PubMed
    1. Firkins J, Hansen L, Driessnack M, Dieckmann N. Quality of life in “chronic” cancer survivors: a meta-analysis. J Cancer Surviv. 2020;14:1–14. - PubMed
    1. Koch L, Bertram H, Eberle A, Holleczek B, Schmid-Höpfner S, Waldmann A, et al. Fear of recurrence in long-term breast cancer survivors-still an issue. Results on prevalence, determinants, and the association with quality of life and depression from the Cancer survivorship-a multi-regional population-based study: fear of recurrence in long-term breast cancer survivors. Psychooncology. 2014;23:547–554. - PubMed

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