Post-surgical depressive symptoms and long-term survival in non-metastatic breast cancer patients at 11-year follow-up

Michael H Antoni, Jamie M. Jacobs, Laura C. Bouchard, Suzanne C Lechner, Devika R. Jutagir, Lisa M. Gudenkauf, Bonnie B Blomberg, Stefan Glück, Charles S Carver

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background Mild to moderate depressive symptoms are common during treatment for non-metastatic breast cancer. The goal of this secondary analysis was to determine if depressive symptoms predict clinical outcomes at long-term follow-up. Methods From 1998 to 2005, we interviewed 231 women with the Hamilton Rating Scale for Depression who were participating in a psychosocial study 2–10 weeks post-surgery for non-metastatic breast cancer (Stage 0-IIIb). We conducted Kaplan Meier (K-M) curves and Cox proportional hazards (PH) models to examine associations between depressive symptoms, overall survival, and disease-free survival at 8–15-year follow-up. Results A total of 95 women (41.1%) scored in the mild-moderately depressed range. Non-depressed women had longer overall survival (M = 13.56 years; SE = 0.26) than those in the mild/moderate depressed group (M = 11.45 years; SE = 0.40), Log-rank χ2(1) = 4.41, p = 0.036. Cox PH models, adjusting for covariates, showed comparable results: mild/moderate depressive symptoms hazard ratio = 2.56, [95% CI, 1.11 to 5.91], p = 0.027. Similar results were observed in a subsample with invasive disease (n = 191). Depression category did not predict disease-free survival in the overall or invasive sample. Conclusions Screening and referrals for treatment of depressive symptoms, even at subclinical levels, is important early in treatment. A randomized trial is warranted to determine effects of depressive symptoms on clinical outcomes.

Original languageEnglish (US)
Pages (from-to)16-21
Number of pages6
JournalGeneral Hospital Psychiatry
Volume44
DOIs
StatePublished - Jan 1 2017

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Depression
Breast Neoplasms
Survival
Proportional Hazards Models
Disease-Free Survival
Therapeutics
Referral and Consultation

Keywords

  • Breast neoplasms
  • Depressive symptoms
  • Follow-up study
  • Recurrence
  • Survival

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Post-surgical depressive symptoms and long-term survival in non-metastatic breast cancer patients at 11-year follow-up. / Antoni, Michael H; Jacobs, Jamie M.; Bouchard, Laura C.; Lechner, Suzanne C; Jutagir, Devika R.; Gudenkauf, Lisa M.; Blomberg, Bonnie B; Glück, Stefan; Carver, Charles S.

In: General Hospital Psychiatry, Vol. 44, 01.01.2017, p. 16-21.

Research output: Contribution to journalArticle

Antoni, Michael H ; Jacobs, Jamie M. ; Bouchard, Laura C. ; Lechner, Suzanne C ; Jutagir, Devika R. ; Gudenkauf, Lisa M. ; Blomberg, Bonnie B ; Glück, Stefan ; Carver, Charles S. / Post-surgical depressive symptoms and long-term survival in non-metastatic breast cancer patients at 11-year follow-up. In: General Hospital Psychiatry. 2017 ; Vol. 44. pp. 16-21.
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abstract = "Background Mild to moderate depressive symptoms are common during treatment for non-metastatic breast cancer. The goal of this secondary analysis was to determine if depressive symptoms predict clinical outcomes at long-term follow-up. Methods From 1998 to 2005, we interviewed 231 women with the Hamilton Rating Scale for Depression who were participating in a psychosocial study 2–10 weeks post-surgery for non-metastatic breast cancer (Stage 0-IIIb). We conducted Kaplan Meier (K-M) curves and Cox proportional hazards (PH) models to examine associations between depressive symptoms, overall survival, and disease-free survival at 8–15-year follow-up. Results A total of 95 women (41.1{\%}) scored in the mild-moderately depressed range. Non-depressed women had longer overall survival (M = 13.56 years; SE = 0.26) than those in the mild/moderate depressed group (M = 11.45 years; SE = 0.40), Log-rank χ2(1) = 4.41, p = 0.036. Cox PH models, adjusting for covariates, showed comparable results: mild/moderate depressive symptoms hazard ratio = 2.56, [95{\%} CI, 1.11 to 5.91], p = 0.027. Similar results were observed in a subsample with invasive disease (n = 191). Depression category did not predict disease-free survival in the overall or invasive sample. Conclusions Screening and referrals for treatment of depressive symptoms, even at subclinical levels, is important early in treatment. A randomized trial is warranted to determine effects of depressive symptoms on clinical outcomes.",
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AU - Antoni, Michael H

AU - Jacobs, Jamie M.

AU - Bouchard, Laura C.

AU - Lechner, Suzanne C

AU - Jutagir, Devika R.

AU - Gudenkauf, Lisa M.

AU - Blomberg, Bonnie B

AU - Glück, Stefan

AU - Carver, Charles S

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N2 - Background Mild to moderate depressive symptoms are common during treatment for non-metastatic breast cancer. The goal of this secondary analysis was to determine if depressive symptoms predict clinical outcomes at long-term follow-up. Methods From 1998 to 2005, we interviewed 231 women with the Hamilton Rating Scale for Depression who were participating in a psychosocial study 2–10 weeks post-surgery for non-metastatic breast cancer (Stage 0-IIIb). We conducted Kaplan Meier (K-M) curves and Cox proportional hazards (PH) models to examine associations between depressive symptoms, overall survival, and disease-free survival at 8–15-year follow-up. Results A total of 95 women (41.1%) scored in the mild-moderately depressed range. Non-depressed women had longer overall survival (M = 13.56 years; SE = 0.26) than those in the mild/moderate depressed group (M = 11.45 years; SE = 0.40), Log-rank χ2(1) = 4.41, p = 0.036. Cox PH models, adjusting for covariates, showed comparable results: mild/moderate depressive symptoms hazard ratio = 2.56, [95% CI, 1.11 to 5.91], p = 0.027. Similar results were observed in a subsample with invasive disease (n = 191). Depression category did not predict disease-free survival in the overall or invasive sample. Conclusions Screening and referrals for treatment of depressive symptoms, even at subclinical levels, is important early in treatment. A randomized trial is warranted to determine effects of depressive symptoms on clinical outcomes.

AB - Background Mild to moderate depressive symptoms are common during treatment for non-metastatic breast cancer. The goal of this secondary analysis was to determine if depressive symptoms predict clinical outcomes at long-term follow-up. Methods From 1998 to 2005, we interviewed 231 women with the Hamilton Rating Scale for Depression who were participating in a psychosocial study 2–10 weeks post-surgery for non-metastatic breast cancer (Stage 0-IIIb). We conducted Kaplan Meier (K-M) curves and Cox proportional hazards (PH) models to examine associations between depressive symptoms, overall survival, and disease-free survival at 8–15-year follow-up. Results A total of 95 women (41.1%) scored in the mild-moderately depressed range. Non-depressed women had longer overall survival (M = 13.56 years; SE = 0.26) than those in the mild/moderate depressed group (M = 11.45 years; SE = 0.40), Log-rank χ2(1) = 4.41, p = 0.036. Cox PH models, adjusting for covariates, showed comparable results: mild/moderate depressive symptoms hazard ratio = 2.56, [95% CI, 1.11 to 5.91], p = 0.027. Similar results were observed in a subsample with invasive disease (n = 191). Depression category did not predict disease-free survival in the overall or invasive sample. Conclusions Screening and referrals for treatment of depressive symptoms, even at subclinical levels, is important early in treatment. A randomized trial is warranted to determine effects of depressive symptoms on clinical outcomes.

KW - Breast neoplasms

KW - Depressive symptoms

KW - Follow-up study

KW - Recurrence

KW - Survival

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