Depression, Correlates of Depression, and Receipt of Depression Care Among Low-Income Women With Breast or Gynecologic Cancer

• Published in: Journal of clinical oncology Vol. 23; no. 13; pp. 3052 - 3060
• Main Authors: ELL, Kathleen, SANCHEZ, Kathleen, VOURLEKIS, Betsy, LEE, Pey-Jiuan, DWIGHT-JOHNSON, Megan, LAGOMASINO, Isabel, MUDERSPACH, Laila, RUSSELL, Christy
• Format: Journal Article
• Language: English
• Published: Baltimore, MD American Society of Clinical Oncology 01.05.2005; Lippincott Williams & Wilkins
• Subjects: Adult; Antidepressive Agents - therapeutic use; Biological and medical sciences; Breast Neoplasms - complications; Breast Neoplasms - psychology; Case Management; Counseling; Depression - diagnosis; Depression - epidemiology; Depression - therapy; Ethnicity; Female; Genital Neoplasms, Female - complications; Genital Neoplasms, Female - psychology; Humans; Medical sciences; Middle Aged; Minority Groups; Poverty; Prevalence; Severity of Illness Index; Tumors; Urban Population; Mood disorder; Human; Socioeconomic status; Depressions; Personal income; Depression; Breast cancer; Malignant tumor; Care; Mammary gland diseases; Cancerology; Adult; Female
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/JCO.2005.08.041

To assess the prevalence of depression among low-income, ethnic minority women with breast or gynecologic cancer, receipt of antidepressant medications or counseling services, and correlates of depression. Study patients were 472 women receiving cancer care in an urban public medical center. Women had a primary diagnosis of breast (stage 0 to III) or gynecologic cancer (International Federation of Gynecology and Obstetrics stage 0 to IIIB). A diagnostic depression screen and baseline questionnaire were administered before or during active treatment or during active follow-up. Self-report data were collected on receipt of depression treatment, use of supportive counseling, pain and receipt of pain medication, functional status and well-being, and perceived barriers to cancer care. Twenty-four percent of women reported moderate to severe levels of depressive disorder (30% of breast cancer patients and 17% of gynecologic cancer patients). Only 12% of women meeting criteria for major depression reported currently receiving medications for depression, and only 5% of women reported seeing a counselor or participating in a cancer support group. Neither cancer stage nor treatment status was correlated with depression. Primary diagnosis of breast cancer, younger age, greater functional impairment, poorer social and family well-being, anxiety, comorbid arthritis, and fears about treatment side effects were correlated with depression. Findings indicate that depressive disorder among ethnic minority, low-income women with breast or gynecologic cancer is prevalent and is correlated with pain, anxiety, and health-related quality of life. Because these women are unlikely to receive depression treatment or supportive counseling, there is a need for routine screening, evaluation, and treatment in this population.