Predictors of depressive symptoms among breast cancer patients during the first year post diagnosis

Abstract

It is important to identify predictors of psychological health among breast cancer patients that can be relatively easily identified by medical care providers. This article investigates the role of one class of such potential predictors: easily identified demographics that have potential social and/or practical implications. Specifically, we examined whether income, marital status, presence of children in the home, education, travel distance, age and rurality interact with time to predict psychological health over the first year post diagnosis. Two hundred and twenty five breast cancer patients receiving radiation treatment completed four surveys over the course of 13 months that included measures of both their physical health and depressive symptoms. The results revealed that women who were not married had children living in the home or had to travel long distances to receive radiation treatment reported higher levels of depressive symptoms across the entire study. Women with lower incomes reported increased depressive symptoms, but only after the completion of treatment. Younger women reported elevated depressive symptoms during initial treatment, but this effect dissipated after the completion of treatment. The current results suggest that demographic patient characteristics may indeed be useful in identifying both when and for whom depressive symptoms are particularly likely to be problematic.

Keywords:

• breast cancer
• depression
• income
• marital status
• distance
• children

Acknowledgements

Data collection and manuscript preparation were supported by a grant from the National Cancer Institute (CA97916-01). We gratefully acknowledge the assistance of the staff at the Radiation Oncology Clinics, especially Linda Robb. This study was conducted in accord with APA ethical guidelines and was approved by the institutional review board of the University of Missouri.

Notes

Notes

1. One notable exception can be found in an empirical study by Helgeson et al. (2004), who examined age and education (in addition to disease variables and several psychosocial variables such as social support) as predictors of psychological and physical adjustment in a longitudinal study. This study differs from this report however in that we take a different analytic approach by allowing our predictors to potentially interact with time. This approach allows for a more nuanced view of when depressive symptoms are likely to be elevated for different patients.

2. It is worth noting that it is unlikely that actual cancer recurrence in the sample explains the current results. The Wave 4 survey included a question about cancer recurrence and 10 women indicated that their cancer had either recurred or spread to another site by that time. As such, we re-ran the baseline model to assess whether these 10 women were possibly driving the quadratic effect of time. The results revealed that the quadratic effect of time remained significant when these women were not included in the analysis (b = 0.02, p < 0.05).