Trajectories of distress, anxiety, and depression among women with breast cancer: Looking beyond the mean

Figures & data

Table I. Demographic and clinical characteristics of 323 women with newly diagnosed breast cancer.

Variable	No. of patients (%)
Age (years)	Mean, 61; SD, 11
Partner^1
Yes	217 (67)
No	106 (33)
Support beyond the family^a
Yes	280 (87)
No	42 (13)
Wish for referral for psychological support^a
Yes	39 (12)
Perhaps, but not now	182 (56)
No	102 (32)
Education (years)^a
< 13^b	196 (61)
≥ 13	127 (39)
Chemotherapy
Yes	130 (40)
No	193 (60)
Endocrine treatment
Yes	179 (55)
No	144 (45)
Radiotherapy
Yes	256 (79)
No	67 (21)

^aMeasured at baseline; ^bIncludes unknown length of education.

Figure 1. Mean severity of distress at breast cancer diagnosis and 4 and 8 months later according to the five groups identified in the TRAJ models for all women (n = 323).

Figure 2. Mean severity of anxiety at breast cancer diagnosis and 4 and 8 months later according to the five groups identified in the TRAJ models for all women (n = 323).

Figure 3. Mean severity of depression at breast cancer diagnosis and 4 and 8 months later according to the five groups identified in the TRAJ models for all women (n = 323).

Table II. Model selection results for distress, anxiety, and depression for 323 women with newly diagnosed breast cancer.

			Estimated probability (% in each group)
No. of groups	BIC	AIC	1	2	3	4	5
Distress
1	− 2565	− 2557	100
2	− 2481	− 2466	35	65
3	− 2464	− 2441	9	28	63
4	− 2415	− 2385	9	28	56	8
5	− 2367	− 2329	9	8	24	51	8
Anxiety
1	− 2220	− 2212	100
2	− 1988	− 1973	24	76
3	− 2000	− 1977	24	18	58
4	− 1776	− 1796	4	14	75	7
5	− 1888	− 1850	7	17	16	59	1
Depression
1	− 2371	− 2304	100
2	− 2217	− 2202	23	77
3	− 2142	− 2120	21	12	67
4	− 2154	− 2124	21	12	61	6
5	− 2027	− 1989	13	10	10	64	3

AIC, Akaike information criterion; BIC, Bayesian information criterion.

Table III. Odds ratios (ORs) and 95% confidence intervals (CIs) for mutually adjusted associations between characteristics and trajectories of high distress (reference group 5), anxiety symptoms (reference group 2), and depressive symptoms (reference group 3), respectively (N = 323).

Characteristic	Group 1 OR [95% CI]	Group 2 OR [95% CI]	Group 3 OR [95% CI]	Group 4 OR [95% CI]
Distress
Age (continuous)	1.20 [0.84–1.71]	1.58 [1.04–2.41]*	0.97 [0.74–1.29]	1.01 [0.79–1.29]
Partner (no)^a	1.25 [0.38–4.10]	2.17 [0.61–7.75]	3.17 [1.11–9.03]*	2.37 [0.95–5.93]
Support beyond family (yes)^a	0.21 [0.04–1.26]	0.42 [0.08–2.07]	0.46 [0.13–1.60]	0.49 [0.16–1.50]
Education (short or unknown)^a	1.64 [0.46–5.92]	6.44 [1.67–24.82]*	1.54 [0.52–4.58]	1.99 [0.74–5.36]
Chemotherapy (yes)	1.05 [0.28–3.96]	9.06 [0.94–87.15]	3.60 [1.17–11.07]*	0.77 [0.29–2.02]
Endocrine treatment (yes)	0.53 [0.16–1.77]	0.76 [0.21–2.70]	1.54 [0.57–4.13]	0.88 [0.36–2.17]
Radiotherapy (yes)	0.55 [0.15–2.01]	0.15 [0.03–0.80]*	0.43 [0.14–1.28]	0.37 [0.14–0.98]*
Referral for support [no (reference) vs. yes]^a	–	0.32 [0.04–2.79]	0.11 [0.02–0.71]	0.62 [0.15–2.50]
Referral for support [maybe (reference) vs. yes]^a	0.72 [0.21–2.51]	0.70 [0.18–2.75]	0.86 [0.28–2.62]	1.55 [0.53–4.47]
Anxiety
Age (continuous)	1.05 [0.88–1.26]
Partner (no)^a	0.69 [0.37–1.28]
Support beyond family (yes)^a	0.39 [0.15–1.03]
Education (short or unknown)^a	0.93 [0.51–1.69]
Chemotherapy (yes)	1.47 [0.74–2.91]
Endocrine treatment (yes)	1.00 [0.57–1.77]
Radiotherapy (yes)	1.16 [0.57–2.36]
Referral for support [no (reference) vs. yes]^a	–
Referral for support [no (reference) vs. maybe]^a	0.40 [0.22–0.71]*
Depression
Age (continuous)	0.93 [0.77–1.12]	0.86 [0.68–1.09]
Partner (no)^a	1.11 [0.58–2.12]	1.52 [0.63–3.67]
Support beyond family (yes)^a	0.43 [0.16–1.14]	0.27 [0.06–1.25]
Education (short or unknown)^a	0.99 [0.54–1.83]	1.32 [0.60–2.87]
Chemotherapy (yes)	2.25 [1.10–4.63]*	5.79 [1.97–16.97]*
Endocrine treatment (yes)	1.12 [0.62–2.01]	1.66 [0.74–3.71]
Radiotherapy (yes)	0.73 [0.33–1.59]	1.02 [0.39–2.63]
Referral for support [no (reference) vs. yes]^a	–	0.31 [0.07–1.42]
Referral for support [maybe (reference) vs. yes]^a	0.58 [0.32–1.06]	0.62 [0.27–1.41]

^aMeasured at baseline; *Significant association.