Original articlePredictors of depression and anxiety symptom trajectories in the 24 months following diagnosis of breast or gynaecologic cancer
Section snippets
Background
Breast and gynaecologic cancers collectively account for the majority of cancer diagnoses among Australian women [1]. Cross-sectional studies show that 30–40% of these women report sufficient number or severity of anxiety or depressive symptoms to warrant clinical diagnosis [2], [3]. A key clinical imperative is to identify, as early as possible, those individual characteristics that predispose women to experience a poorer trajectory of psychological health. In doing so, women at greatest risk
Participants
The sample comprised women with newly diagnosed breast or gynaecologic cancer attending a specialist women's hospital in metropolitan Australia, with a stand-alone gynaecology oncology unit and a co-located breast oncology service shared with another major teaching hospital. Women excluded were those younger than 18 years of age, with ductal carcinoma in situ, previously diagnosed invasive carcinoma, cognitive impairment affecting ability to consent or participate, or poor English language
Study participation
During the recruitment period, 996 patients presented to the breast and gynaecologic units. Among these individuals, 609 were excluded due to language (n = 133), cognitive impairment (n = 24), non-invasive/benign pathology (n = 316), previous cancer diagnosis (n = 122) and for other reasons (e.g., male, overseas visitor, n = 14). Seventy-eight women declined participation. A total of 309 women consented to participate of whom 9 withdrew before baseline data were collected and a further 36 were
Discussion
We undertook a 2-year longitudinal study in a heterogeneous sample of women with newly diagnosed cancer, with 8-weekly measurement of anxiety and depression symptoms. We sought to identify, from a range of clinical, demographic and psychological characteristics that are available on entry to the oncology service, those variables that would predict poorer anxiety and depressive symptom experience. Consistent with our hypothesis, the psychological variables of neuroticism and past or pre-existing
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
Conflict of interest statement
The authors have no conflict of interest to declare.
Acknowledgements
This study was supported in part by funding from the Western and Central Melbourne Integrated Cancer Service (WCMICS). The Centre for Women's Mental Health is supported by the Pratt Foundation. The funding sources had no role in the study design, or collection, analysis and interpretation of data; or in the decision to submit the work for publication. The authors wish to thank the Breast Care Nurses Robyn Cordner, Monique Baldacchino, Kerry Shanahan, Bronwyn Flanagan and Claire Noonan for their
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