Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Germany.
Psychol Health Med. 2013;18(4):412-9. doi: 10.1080/13548506.2012.736624. Epub 2012 Nov 1.
Depression and anxiety are associated with a decline of health-related quality of life (QoL) in breast cancer patients, and the present study aims to investigate the longitudinal relationship of depression and anxiety with QoL in breast cancer patients. Depression and anxiety (HADS) as well as QoL (EORTC QLQ-C30) were assessed at baseline and six-month follow-up in 118 breast cancer patients and analysed using cross-lagged partial correlation analysis (CLPC). There were significant partial correlations between depression and anxiety at baseline and physical functioning, emotional functioning and "global health and QoL" at six-month follow-up (range of pr = -0.197 and -0.392; p < 0.05). "Global health and QoL" at baseline was significantly correlated with depression and anxiety at follow-up (pr = -0.207 and -0.327; p < 0.05). Cognitive functioning at baseline was significantly associated with anxiety at follow-up (pr = -0.248; p < 0.01). CLPC analysis of two models (depression and anxiety determining QoL vs. QoL determining depression and anxiety) did not show significant results. Hence, in breast cancer patients, depression and anxiety are closely related to QoL and the observed correlations suggest a complex interrelation in which depression and anxiety have to be regarded as indicators of QoL rather than determinants.
抑郁和焦虑与乳腺癌患者的健康相关生活质量（QoL）下降有关，本研究旨在探讨抑郁和焦虑与乳腺癌患者 QoL 的纵向关系。在 118 例乳腺癌患者中，在基线和 6 个月随访时评估抑郁和焦虑（HADS）以及 QoL（EORTC QLQ-C30），并使用交叉滞后部分相关分析（CLPC）进行分析。基线时抑郁和焦虑与 6 个月随访时的身体功能、情绪功能和“总体健康和 QoL”呈显著负相关（pr 值范围为-0.197 至-0.392；p 值均<0.05）。基线时的“总体健康和 QoL”与随访时的抑郁和焦虑呈显著负相关（pr 值范围为-0.207 至-0.327；p 值均<0.05）。基线时的认知功能与随访时的焦虑显著相关（pr=-0.248；p<0.01）。两个模型（抑郁和焦虑决定 QoL 与 QoL 决定抑郁和焦虑）的 CLPC 分析均未显示出显著结果。因此，在乳腺癌患者中，抑郁和焦虑与 QoL 密切相关，观察到的相关性表明，抑郁和焦虑之间存在复杂的相互关系，应将其视为 QoL 的指标，而不是决定因素。
