Course of depression, mental health service utilization and treatment preferences in women receiving chemotherapy for breast cancer

• Published in: General hospital psychiatry Vol. 35; no. 4; pp. 376 - 381
• Main Authors: Reece, Julia C., B.S, Chan, Ya-Fen, Ph.D, Herbert, Julia, B.A, Gralow, Julie, M.D, Fann, Jesse R., M.D., M.P.H
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.07.2013; Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Antidepressive Agents - therapeutic use; Antineoplastic Agents - therapeutic use; Anxiety; Anxiety Disorders - complications; Anxiety Disorders - psychology; Biological and medical sciences; Breast cancer; Breast Neoplasms - complications; Breast Neoplasms - drug therapy; Breast Neoplasms - psychology; Cohort Studies; Depression; Depressive Disorder - complications; Depressive Disorder - psychology; Depressive Disorder - therapy; Disease Progression; Fatigue - complications; Fatigue - psychology; Female; Gynecology. Andrology. Obstetrics; Health services; Humans; Mammary gland diseases; Medical sciences; Mental Health Services - utilization; Middle Aged; Mood disorders; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Patient Preference; Prospective Studies; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotherapy; Severity of Illness Index; Treatment; Tumors; Depression; Anxiety; Breast cancer; Treatment; Health services; Mood disorder; Human; Affect affectivity; Breast disease; Use; Mental health; Pharmacotherapy; Health service; Malignant tumor; Mammary gland diseases; Chemotherapy; Preference; Female; Woman; Public health; Cancer
• ISSN: 0163-8343; 1873-7714
• DOI: 10.1016/j.genhosppsych.2013.03.017

Abstract Objective This prospective study aimed to estimate the prevalence and course of depression during chemotherapy in women with Stage I–III breast cancer, identify potential risk factors for depression and determine which treatments for depression were being used and which were most preferred. Method Thirty-two women were followed over consecutive chemotherapy infusions, with 289 assessments conducted altogether (mean, 9.0 assessments/subject). Current depression, anxiety, physical symptoms and mental health service use were recorded during each assessment. A linear mixed effects model was used to identify factors associated with depression. Patients also ranked depression treatment preferences. We referred patients with more severe depression for treatment. Results Clinically significant depression was identified in 37.5% of patients. Depression severity tended to peak at 12–14 weeks and 32 or more weeks of chemotherapy. Depression severity was associated with anxiety severity, physical symptom burden, non-White race, receiving one's first chemotherapy regimen, Adriamycin-Cytoxan chemotherapy and chemotherapy duration. Most (65.5%) patients preferred evidence-based treatments for depression, and 66.7% of depressed patients were using such treatments. Conclusions Depression is common in women receiving chemotherapy for breast cancer. Most patients prefer evidence-based depression treatments. We recommend regular screening for depression during chemotherapy to ensure adequate detection and patient-centered treatment.