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Variations in the Co-occurrence of Anxiety and Depressive Symptoms and its Impact on Quality of Life in Women Following Breast Cancer Surgery


Purpose: Little is known about the prevalence of combined anxiety and depressive symptoms (CADS) in patients with breast cancer. The purpose of this study was to evaluate for differences in demographic and clinical characteristics, as well as quality of life (QOL) outcomes prior to breast cancer surgery among women classified into one of four distinct groups with and without CADS.

Methods: A total of 410 patients completed a demographic questionnaire and self-report measures of performance status, comorbidity, anxiety, depression, and QOL prior to and monthly for 6 months following breast cancer surgery. Growth mixture modelling (GMM) was used to identify subgroups of women with distinct trajectories of anxiety and depressive symptoms. Results of these analyses were used to create four groups of patients with and without CADS. Differences in demographic, clinical, and symptom characteristics, among the four groups of women were evaluated using analyses of variance and Chi square analyses.

Results: Women with CADS were younger, non-white, had lower performance status, received neoadjuvant or adjuvant chemotherapy, had greater difficulty dealing with their disease and treatment, and reported less support from others to meet their needs. In addition, these women had lower physical, psychological, social well-being, and total QOL scores. Higher levels of anxiety with or without subsyndromal depressive symptoms were associated with fears of recurrence, hopelessness, uncertainty, loss of control, and a decrease in life satisfaction.

Conclusion: Findings from this study suggest that CADS occurs in a high percentage of women following breast cancer surgery and results in a poorer QOL.

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