Profiles of depressive symptoms and the association with anxiety and quality of life in breast cancer survivors: a latent profile analysis
The aim of this study was to examine profiles of depressive symptoms and the association with anxiety and quality of life (QOL) in breast cancer survivors.
A cross-sectional multicenter survey involving 5 hospitals in Korea was implemented between February 2015 and January 2017. A self-report survey included the Patient Health Questionnaire-9, Short Form 36, and State and Trait Anxiety Scale. Data from 347 patients were analyzed.
Latent profile analysis identified five profiles of depressive symptoms: (1) “no depression” (63.98%); (2) “mild depression with sleep problems” (16.43%); (3) “mild depression” (8.65%); (4) “moderate depression with anhedonia” (7.78%); and (5) “moderately severe depression” (3.17%). Results from Fisher’s exact test and analysis of variance (ANOVA) to examine whether sociodemographic and clinical characteristics distinguish the classes indicated that marital status, income and education as well as C-reactive protein distinguished a few classes. Multivariate analysis of covariance and analysis of covariance results indicated that both types of anxiety as well as several dimensions of QOL differed between the identified classes.
The current results suggest that although identified classes were characterized overall by severity of depression, a few classes also reflected pronounced individual symptom patterns, warranting tailored interventions for these symptom patterns, along with overall severity of depression.
KeywordsAnxiety Breast cancer Depression Latent profile analysis Quality of life
This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2014R1A2A2A01007794).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Research involving human participants and/or animals
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.
- 3.Vodermaier, A., Linden, W., Rnic, K., Young, S. N., Ng, A., Ditsch, N., et al. (2014). Prospective associations of depression with survival: A population-based cohort study in patients with newly diagnosed breast cancer. Breast Cancer Research and Treatment, 143(2), 373–384.PubMedCrossRefGoogle Scholar
- 4.Andersen, B. L., DeRubeis, R. J., Berman, B. S., Gruman, J., Champion, V. L., Massie, M. J., et al. (2014). Screening, assessment, and care of anxiety and depressive symptoms in adults with cancer: An American Society of Clinical Oncology guideline adaptation. Journal of Clinical Oncology, 32(15), 1605–1619.PubMedPubMedCentralCrossRefGoogle Scholar
- 17.Han, C.-W., Lee, E.-J., Iwaya, T., Kataoka, H., & Kohzuki, M. (2004). Development of the Korean version of Short-Form 36-Item Health Survey: Health related QOL of healthy elderly people and elderly patients in Korea. The Tohoku Journal of Experimental Medicine, 203(3), 189–194.PubMedCrossRefGoogle Scholar
- 18.Hahn, D.-W. L., Lee, C.-H., & Chon, K.-K. (1996). Korean adaptation of spielberger’s STAI (K-STAI). Korean Journal of Health Psychology, 1(1), 1–14.Google Scholar
- 28.Mehnert, A., & Koch, U. (2008). Psychological comorbidity and health-related quality of life and its association with awareness, utilization, and need for psychosocial support in a cancer register-based sample of long-term breast cancer survivors. Journal of Psychosomatic Research, 64(4), 383–391.PubMedCrossRefGoogle Scholar
- 31.Pierce, B. L., Ballard-Barbash, R., Bernstein, L., Baumgartner, R. N., Neuhouser, M. L., Wener, M. H., et al. (2009). Elevated biomarkers of inflammation are associated with reduced survival among breast cancer patients. Journal of Clinical Oncology, 27(21), 3437.PubMedPubMedCentralCrossRefGoogle Scholar
- 34.Pelle, A. J., Pedersen, S. S., Erdman, R. A., Kazemier, M., Spiering, M., van Domburg, R. T., et al. (2011). Anhedonia is associated with poor health status and more somatic and cognitive symptoms in patients with coronary artery disease. Quality of Life Research, 20(5), 643–651.PubMedCrossRefGoogle Scholar
- 37.Brunault, P., Champagne, A. L., Huguet, G., Suzanne, I., Senon, J. L., Body, G., et al. (2016). Major depressive disorder, personality disorders, and coping strategies are independent risk factors for lower quality of life in non-metastatic breast cancer patients. Psycho-Oncology, 25(5), 513–520.PubMedCrossRefGoogle Scholar
- 39.Lengacher, C. A., Reich, R. R., Post-White, J., Moscoso, M., Shelton, M. M., Barta, M., et al. (2012). Mindfulness based stress reduction in post-treatment breast cancer patients: An examination of symptoms and symptom clusters. Journal of Behavioral Medicine, 35(1), 86–94.PubMedCrossRefGoogle Scholar
- 42.Reich, R. R., Lengacher, C. A., Alinat, C. B., Kip, K. E., Paterson, C., Ramesar, S., et al. (2017). Mindfulness-based stress reduction in post-treatment breast cancer patients: Immediate and sustained effects across multiple symptom clusters. Journal of Pain and Symptom Management, 53(1), 85–95.PubMedCrossRefGoogle Scholar
- 44.Gueorguieva, R. (2017). Statistical methods in psychiatry and related fields: Longitudinal, clustered, and other repeated measures data. London: Chapman and Hall/CRC.Google Scholar
- 46.Andersen, S. R., Würtzen, H., Steding-Jessen, M., Christensen, J., Andersen, K. K., Flyger, H., et al. (2013). Effect of mindfulness-based stress reduction on sleep quality: Results of a randomized trial among Danish breast cancer patients. Acta Oncologica, 52(2), 336–344.PubMedCrossRefGoogle Scholar
- 47.Hopko, D. R., Armento, M. E., Robertson, S., Ryba, M. M., Carvalho, J. P., Colman, L. K., et al. (2011). Brief behavioral activation and problem-solving therapy for depressed breast cancer patients: Randomized trial. Journal of Consulting and Clinical Psychology, 79(6), 834.PubMedCrossRefGoogle Scholar
- 49.Fairey, A. S., Courneya, K. S., Field, C. J., Bell, G. J., Jones, L. W., Martin, B. S., et al. (2005). Effect of exercise training on C-reactive protein in postmenopausal breast cancer survivors: A randomized controlled trial. Brain, Behavior, and Immunity, 19(5), 381–388.PubMedCrossRefGoogle Scholar