Depression and Resilience in Breast Cancer Patients

Gordana Ristevska-DimitrÐ¾vska; Petar Stefanovski; Snezhana Smichkoska; Marija Raleva; Beti Dejanova

doi:10.3889/oamjms.2015.119

Authors

Gordana Ristevska-DimitrÐ¾vska University St. Kliment Ohridski Bitola, Higher Medical School Bitola, Bitola
Petar Stefanovski Clinical Hospital Dr. Trifun Panovski, Department of Oncology, Bitola
Snezhana Smichkoska University Clinic for Radiotherapy and Oncology, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje
Marija Raleva University Clinic of Psychiatry, Faculty of Medicine, Ss Cyril and Methodius University of Skopje, Skopje
Beti Dejanova Department of Medical and Experimental Physiology with Anthropology, Medical Faculty, Ss Cyril and Methodius University of Skopje, Skopje

DOI:

https://doi.org/10.3889/oamjms.2015.119

Keywords:

Connor Davidson Resilience Scale, Hospital Anxiety Depression Scale, depression, resilience, breast cancer

Abstract

OBJECTIVE: A significant number of breast cancer patients, during their life with the diagnosis, experience emotional distress in the form of depression and anxiety. Psychological resilience is the ability of a person to protect his/her mental health when faced with adverse circumstances such as the cancer diagnosis. This study aims to assess the resilience in breast cancer patients and to explore whether depression affects the resilience.

MATERIAL AND METHODS: Two hundred eighteen (218) women, treated for early breast cancer responded to Connor - Davidson Resilience Scale and Hospital Depression and Anxiety Scale, in order to assess the level of psychological resilience and the level of depression.

RESULTS: There is a significant negative correlation between depression and resilience in our sample (r = - 0.562, p < 0.001). Individuals with higher levels of depression have lower levels of psychological resilience. There is no statistically significant correlation between the ages of the participants; time passed since diagnosis, cancer stage and resilience levels.

CONCLUSION: This study shows that patients who are less depressed have higher levels of resilience and that psychological resilience may independently contribute to lower levels of depression among breast cancer patients. The level of psychological resilience may be a protective factor for depression and psychological distress.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Kroll J. Posttraumatic symptoms and the complexity of responses to trauma. JAMA. 2003;290:267270.

http://dx.doi.org/10.1001/jama.290.5.667 DOI: https://doi.org/10.1001/jama.290.5.667

PMid:12902373

Brintzenhofe-Szoc KM, Levin TT, Li Y, et al. Mixed anxiety/depression symptoms in a large cancer cohort: prevalence by cancer type. Psychosomatics. 2009;50:383-391.

http://dx.doi.org/10.1176/appi.psy.50.4.383 DOI: https://doi.org/10.1176/appi.psy.50.4.383

Rodin G, Zimmermann C, Rydall A, et al. The desire for hastened death in patients with metastatic cancer. J Pain Symptom Manage. 2007;33:661-675.

http://dx.doi.org/10.1016/j.jpainsymman.2006.09.034 DOI: https://doi.org/10.1016/j.jpainsymman.2006.09.034

PMid:17531909

Pirl WF. Evidence report on the occurrence, assessment, and treatment of depression in cancer patients. J Natl Cancer Inst Monogr. 2004;32:32-39.

http://dx.doi.org/10.1093/jncimonographs/lgh026 DOI: https://doi.org/10.1093/jncimonographs/lgh026

PMid:15263039

Lo C, Zimmermann C, Rydall A, et al. Longitudinal study of depressive symptoms in patients with metastatic gastrointestinal and lung cancer. J Clin Oncol. 2010;28:3084-3089.

http://dx.doi.org/10.1200/JCO.2009.26.9712 DOI: https://doi.org/10.1200/JCO.2009.26.9712

PMid:20479397

Benton T, Staab J, Evans DL. Medical comorbidity in depressive disorders. Ann Clin Psychiatry. 2007;19:289-303.

http://dx.doi.org/10.1080/10401230701653542 DOI: https://doi.org/10.1080/10401230701653542

PMid:18058286

Clarke DM, Currie KC. Depression, anxiety and their relationship with chronic diseases: a review of the epidemiology, risk and treatment evidence. Med J Aust. 2009;190:S54-S60. DOI: https://doi.org/10.5694/j.1326-5377.2009.tb02471.x

PMid:19351294

Kessler RC, Berglund P, Demler O, et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003;289:3095-3105.

http://dx.doi.org/10.1001/jama.289.23.3095 DOI: https://doi.org/10.1001/jama.289.23.3095

PMid:12813115

Zainal NZ, Nik-Jaafar NR, Baharudin A, Sabki ZA, Ng CG.: Prevalence of depression in breast cancer survivors: a systematic review of observational studies. Asian Pac J Cancer Prev. 2013;14(4):2649-56.

http://dx.doi.org/10.7314/APJCP.2013.14.4.2649 DOI: https://doi.org/10.7314/APJCP.2013.14.4.2649

PMid:23725190

Grassi L, Indelli M, Marzola M, et al. Depressive symptoms and quality of life in home-care-assisted cancer patients. J Pain Symptom Man-age. 1996;12:300-307.

http://dx.doi.org/10.1016/S0885-3924(96)00181-9 DOI: https://doi.org/10.1016/S0885-3924(96)00181-9

Chochinov HM, Wilson KG, Enns M, et al. Depression, hopelessness, and suicidal ideation. Psychosomatics. 1998;39:366-370.

http://dx.doi.org/10.1016/S0033-3182(98)71325-8 DOI: https://doi.org/10.1016/S0033-3182(98)71325-8

Colleoni M, Mandala M, Peruzzotti G, et al. Depression and degree of acceptance of adjuvant cytotoxic drugs. Lancet. 2000;356:1326-1327.

http://dx.doi.org/10.1016/S0140-6736(00)02821-X DOI: https://doi.org/10.1016/S0140-6736(00)02821-X

Chen ML, Chang HK. Physical symptom profiles of depressed and nondepressed patients with cancer. Palliat Med. 2004;18:712-718.

http://dx.doi.org/10.1191/0269216304pm950oa DOI: https://doi.org/10.1191/0269216304pm950oa

Prieto JM, Blanch J, Atala J, et al. Psychiatric morbidity and impact on hospital length of stay among hematologic cancer patients receiving stem-cell transplantation. J Clin Oncol. 2002;20:1907-1917.

http://dx.doi.org/10.1200/JCO.2002.07.101 DOI: https://doi.org/10.1200/JCO.2002.07.101

PMid:11919251

Pinquart M, Duberstein PR. Depression and cancer mortality: a meta-analysis. Psychol Med. 2010;40:1797-1810.

http://dx.doi.org/10.1017/S0033291709992285 DOI: https://doi.org/10.1017/S0033291709992285

PMid:20085667 PMCid:PMC2935927

Satin JR, Linden W, Phillips MJ. Depression as a predictor of disease progression and mortality in cancer patients: a meta-analysis. Cancer. 2009;115:5349-5361

http://dx.doi.org/10.1002/cncr.24561 DOI: https://doi.org/10.1002/cncr.24561

PMid:19753617

Lloyd-Williams M, Shiels C, Taylor F, et al. De-pressionâ€”an independent predictor of early death in patients with advanced cancer. J Affect Disord. 2009;113:127-132.

http://dx.doi.org/10.1016/j.jad.2008.04.002 DOI: https://doi.org/10.1016/j.jad.2008.04.002

PMid:18558439

Iosifescu DV. Treating depression in the medically ill. Psychiatr Clin North Am. 2007;30:77-90.

http://dx.doi.org/10.1016/j.psc.2006.12.008 DOI: https://doi.org/10.1016/j.psc.2006.12.008

PMid:17362805

Lo C, Li M, Rodin G. The assessment and treatment of distress in cancer patients: overview and future directions. Minerva Psichiatr. 2008;49:129-143.

Coleman MP, Forman D, Bryant H, et al. Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 1995â€“2007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data. Lancet. 2011;377:127-38.

http://dx.doi.org/10.1016/S0140-6736(10)62231-3 DOI: https://doi.org/10.1016/S0140-6736(10)62231-3

Weinberger T, Forrester A, Markov D, et al. Women at a dangerous intersection: diagnosis and treatment of depression and related disorders in patients with breast cancer. Psychiatr Clin North America. 2010;33:409-22.

http://dx.doi.org/10.1016/j.psc.2010.01.005 DOI: https://doi.org/10.1016/j.psc.2010.01.005

PMid:20385344

Allen JD, Savadatti S, Levy AG. The transition from breast cancer 'patient' to 'survivor'. Psychooncology. 2009;18:71-8.

http://dx.doi.org/10.1002/pon.1380 DOI: https://doi.org/10.1002/pon.1380

PMid:18613299

Qiu J, Yang M, Chen W et al. Prevalence and correlates of major depressive disorder in breast cancer survivors in Shanghai, China. Psychooncology. 2012;21:1331-7.

http://dx.doi.org/10.1002/pon.2075 DOI: https://doi.org/10.1002/pon.2075

PMid:21983854

Popoola AO, Adewuya AO. Prevalence and correlates of depressive disorders in outpatients with breast cancer in Lagos, Nigeria. Psychooncology. 2012;21:675-9.

http://dx.doi.org/10.1002/pon.1968 DOI: https://doi.org/10.1002/pon.1968

PMid:21462281

Park BW, Hwang SY. Unmet needs of breast cancer patients relative to survival duration. Yonsei Med J. 2012;53:118-25.

http://dx.doi.org/10.3349/ymj.2012.53.1.118 DOI: https://doi.org/10.3349/ymj.2012.53.1.118

PMid:22187241 PMCid:PMC3250332

Pan L, Han Y, Sun X, et al. FDG-PET and other imaging modalities for the evaluation of breast cancer recurrence and metastases: a meta-analysis. J Cancer Res Clin Oncol. 2010;136:1007-22.

http://dx.doi.org/10.1007/s00432-009-0746-6 DOI: https://doi.org/10.1007/s00432-009-0746-6

PMid:20091186 PMCid:PMC2874488

Luthar SS, Cicchetti D, Becker B. The construct of resilience: a critical evaluation and guidelines for future work. Child Dev. 2000;71(3):543-62.

http://dx.doi.org/10.1111/1467-8624.00164 DOI: https://doi.org/10.1111/1467-8624.00164

PMid:10953923 PMCid:PMC1885202

Gotay CC, Isaacs P, Pagano I. Quality of life in patients who survive a dire prognosis compared to control cancer survivors. Psychooncology. 2004;13(12):882-92.

http://dx.doi.org/10.1002/pon.808 DOI: https://doi.org/10.1002/pon.808

PMid:15386789

Connor KM, Davidson JR. Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003;18(2):76-82.

http://dx.doi.org/10.1002/da.10113 DOI: https://doi.org/10.1002/da.10113

PMid:12964174

Windle G, Bennett KM, Noyes J. A methodological review of resilience measurement scales. Health Qual Life Outcomes. 2011;9:8.

http://dx.doi.org/10.1186/1477-7525-9-8 DOI: https://doi.org/10.1186/1477-7525-9-8

PMid:21294858 PMCid:PMC3042897

Zigmond, AS; Snaith, RP. The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica. 1983;67(6):361â€“370.

http://dx.doi.org/10.1111/j.1600-0447.1983.tb09716.x DOI: https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

PMid:6880820

Vodermaier A, Millman RD. Accuracy of the Hospital Anxiety and Depression Scale as a screening tool in cancer patients: a systematic review and meta-analysis. Support Care Cancer 2011;19(12):1899-908.

http://dx.doi.org/10.1007/s00520-011-1251-4 DOI: https://doi.org/10.1007/s00520-011-1251-4

PMid:21898134

Singer S, Kuhnt S, GÃ¶tze H, Hauss J, Hinz A, Liebmann A, Krauss O, Lehmann A, Schwarz R. Hospital anxiety and depression scale cutoff scores for cancer patients in acute care. Br J Cancer 2009;100(6):908-12.

http://dx.doi.org/10.1038/sj.bjc.6604952 DOI: https://doi.org/10.1038/sj.bjc.6604952

PMid:19240713 PMCid:PMC2661775

Min JA1, Yoon S, Lee CU, Chae JH, Lee C, Song KY, Kim TS. Psychological resilience contributes to low emotional distress in cancer patients. Sup-port Care Cancer. 2013;21(9):2469-76.

http://dx.doi.org/10.1007/s00520-013-1807-6 DOI: https://doi.org/10.1007/s00520-013-1807-6

PMid:23604453

Steinhardt M, Dolbier C. Evaluation of a resilience intervention to enhance coping strategies and protective factors and decrease symptomatology. J Am Coll Health. 2008;56(4):445-53.

http://dx.doi.org/10.3200/JACH.56.44.445-454 DOI: https://doi.org/10.3200/JACH.56.44.445-454

PMid:18316290