Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Medical Center Blvd, Winston-Salem, NC 27157, USA.
Breast Cancer Res Treat. 2013 May;139(1):199-206. doi: 10.1007/s10549-013-2513-2. Epub 2013 Apr 16.
Younger women being treated for breast cancer consistently show greater depression shortly after diagnosis than older women. In this longitudinal study, we examine whether these age differences persist over the first 26 months following diagnosis and identify factors related to change in depressive symptoms. A total of 653 women within 8 months of a first time breast cancer diagnosis completed questionnaires at baseline and three additional timepoints (6, 12, and 18 months after baseline) on contextual/patient characteristics, symptoms, and psychosocial variables. Chart reviews provided cancer and treatment-related data. The primary outcome was depressive symptomatology assessed by the Beck Depression Inventory. Among women younger than age 65, depressive symptoms were highest soon after diagnosis and significantly decreased over time. Depressive symptoms remained stable and low for women aged 65 and older. Age was no longer significantly related to depressive symptoms in multivariable analyses controlling for a wide range of covariates. The primary factors related to levels of and declines in depressive symptomatology were the ability to pay for basics; completing chemotherapy with doxorubicin; and decreases in pain, vasomotor symptoms, illness intrusiveness, and passive coping. Increased sense of meaning/peace and social support were related to decreased depression. Interventions to reduce symptoms and illness intrusiveness, improve a sense of meaning and peace, and increase social support, may help reduce depression and such interventions may be especially relevant for younger women.
年轻女性在接受乳腺癌治疗后，其抑郁程度在诊断后短期内一直高于老年女性。在这项纵向研究中，我们考察了这些年龄差异是否会持续存在于诊断后的头 26 个月，并确定了与抑郁症状变化相关的因素。共有 653 名女性在首次确诊乳腺癌后 8 个月内完成了基线及另外 3 个时间点（基线后 6、12 和 18 个月）的问卷，内容涉及上下文/患者特征、症状和心理社会变量。病历审查提供了癌症和治疗相关的数据。主要结果是贝克抑郁量表评估的抑郁症状。在年龄小于 65 岁的女性中，抑郁症状在诊断后不久最高，并随着时间的推移显著下降。对于 65 岁及以上的女性，抑郁症状保持稳定且较低。在控制了广泛的协变量后，多变量分析中年龄与抑郁症状不再显著相关。与抑郁症状水平和下降相关的主要因素是支付基本生活费用的能力；完成包含阿霉素的化疗；疼痛、血管舒缩症状、疾病侵入性、被动应对能力下降。增加意义/平静感和社会支持与抑郁减少有关。减少症状和疾病侵入性、增加意义和平静感、增加社会支持的干预措施可能有助于减少抑郁，这些干预措施可能对年轻女性尤为重要。
