Fatigue and Depression in Disease-Free Breast Cancer Survivors: Prevalence, Correlates, and Association with Quality of Life

• Published in: Journal of pain and symptom management Vol. 35; no. 6; pp. 644 - 655
• Main Authors: Kim, Soo Hyun, RN, MS, Son, Byung Ho, MD, Hwang, Sook Yeon, PhD, Han, Wonshik, MD, Yang, Jung-Hyun, MD, Lee, Seeyoun, MD, Yun, Young Ho, MD, PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.2008; Elsevier Science
• Subjects: Adult; Adult and adolescent clinical studies; Anesthesia & Perioperative Care; Biological and medical sciences; breast cancer; Breast Neoplasms - psychology; Data Collection; Depression; Depression - epidemiology; Depression - etiology; Fatigue; Fatigue - epidemiology; Fatigue - etiology; Female; Gynecology. Andrology. Obstetrics; Humans; Mammary gland diseases; Medical sciences; Middle Aged; Mood disorders; Pain Medicine; Pharmacology. Drug treatments; Psychiatric Status Rating Scales; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Quality of Life; survivors; Survivors - psychology; Tumors; Fatigue; breast cancer; depression; survivors; Mood disorder; Human; Breast disease; Prevalence; Survivor; Depression; Breast cancer; Malignant tumor; Epidemiology; Quality of life; Mammary gland diseases; Cancer
• DOI: 10.1016/j.jpainsymman.2007.08.012
• ISSN: 0885-3924

Abstract We performed this study to examine the prevalence and correlates of fatigue and depression, and their relevance to health-related quality of life in disease-free breast cancer survivors. A total of 1,933 breast cancer survivors recruited from five large hospitals in Korea completed a mailed survey, which included the Brief Fatigue Inventory, Beck Depression Inventory, European Organization for Research and Treatment of Cancer QLQ-C30, and QLQ-BR23. With a framework that included sociodemographic, clinical, and symptom characteristics, multivariate logistic regression models were used to identify factors associated with fatigue and depression. Among breast cancer survivors, 66.1% reported moderate to severe fatigue and 24.9% reported moderate to severe depression. Risk factors common to both fatigue and depression were lower income, dyspnea, insomnia, appetite loss, constipation, and arm symptoms. Risk factors for fatigue only included younger age, employment, presence of gastrointestinal disease, and pain. Having a musculoskeletal disease was identified as a risk factor for depression only. Both fatigue and depression were influenced by sociodemographic factors, comorbidity and symptom characteristics rather than cancer or treatment-related factors. Both fatigue and depression were negatively associated with survivors' health-related quality of life. However, the patterns of differences in health-related quality of life according to severity of fatigue or depression were similar. This concurrent examination of risk factors for fatigue and depression may be helpful in the development of clinical management strategies in disease-free breast cancer survivors.