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      Anxiety, depression, perceived social support and quality of life in Malaysian breast cancer patients: a 1-year prospective study

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          Abstract

          Background

          Depression and anxiety are common psychiatric morbidity among breast cancer patient. There is a lack of study examining the correlation between depression, anxiety and quality of life (QoL) with perceived social support (PSS) among breast cancer patients. This study aims to study the level of depression, anxiety, QoL and PSS among Malaysian breast cancer women over a period of 12 months and their associations at baseline, 6 and 12 months.

          Methods

          It is a 12 months prospective cohort study. Two hundred and twenty one female patients were included in the study. They were assessed at the time of diagnosis, 6 months and 12 month using Hospital Anxiety and Depression Scale (HADS), Quality-of-Life Questionnaire (QLQ–C30), Version 3.0 of the EORTC Study Group and Multidimensional Scale of Perceived Social Support (MSPSS). The information of age, ethnicity, types of treatment, and staging of cancer were collected.

          Results

          The HADS anxiety and depression subscales scores of the subjects were relatively low. The level of anxiety reduced significantly at 6 and 12 months (Baseline – 6 months, p = 0.002; Baseline - 12 months, p < 0.001). There were no changes in the level of depression over the study period. The global status of QoL and MSPSS scores were relatively high. Correlation between the global status of QoL and MSPSS for the study subjects was positive (Spearman’s rho = 0.31–0.36). Global status of QoL and MSPSS scores were negatively correlated with anxiety and depression.

          Conclusion

          Malaysian breast cancer women had relatively better QoL with lower level of anxiety and depression. Perceived social support was an important factor for better QoL and low level of psychological distress. It reflects the importance of attention on activities that enhance and maintain the social support system for breast cancer patients.

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          Most cited references36

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          Stress, social support, and the buffering hypothesis.

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            Depression and anxiety in women with early breast cancer: five year observational cohort study.

            To examine the prevalence of, and risk factors for, depression and anxiety in women with early breast cancer in the five years after diagnosis. Observational cohort study. NHS breast clinic, London. 222 women with early breast cancer: 170 (77%) provided complete interview data up to either five years after diagnosis or recurrence. Prevalence of clinically important depression and anxiety (structured psychiatric interview with standardised diagnostic criteria) and clinical and patient risk factors, including stressful life experiences (Bedford College life events and difficulties schedule). Nearly 50% of the women with early breast cancer had depression, anxiety, or both in the year after diagnosis, 25% in the second, third, and fourth years, and 15% in the fifth year. Point prevalence was 33% at diagnosis, falling to 15% after one year. 45% of those with recurrence experienced depression, anxiety, or both within three months of the diagnosis. Previous psychological treatment predicted depression, anxiety, or both in the period around diagnosis (one month before diagnosis to four months after diagnosis). Longer term depression and anxiety, were associated with previous psychological treatment, lack of an intimate confiding relationship, younger age, and severely stressful non-cancer life experiences. Clinical factors were not associated with depression and anxiety, at any time. Lack of intimate confiding support also predicted more protracted episodes of depression and anxiety. Increased levels of depression, anxiety, or both in the first year after a diagnosis of early breast cancer highlight the need for dedicated service provision during this time. Psychological interventions for women with breast cancer who remain disease free should take account of the broader social context in which the cancer occurs, with a focus on improving social support.
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              Major depression after breast cancer: a review of epidemiology and treatment.

              While many breast cancer patients experience "normal" distress, there is a subset who experience clinically significant depression. We examined the current knowledge about the prevalence, impact and treatment of major depression in women with breast cancer. We reviewed the evidence for the prevalence of depression in women with breast cancer from the last 20 years and summarized the medical literature on the pharmacology and psychotherapy of depression in this population. Despite evidence that depression significantly impacts quality of life in breast cancer patients, few studies focus on the epidemiology and treatment of major depression. Treatment studies have focused on distress and mixed depressive states, with resulting lack of replicable studies showing treatment efficacy. Potential biological and psychosocial determinants of major depression following breast cancer are discussed in a proposed model. The need for further research on the epidemiology and treatment of major depression in this population is proposed. Major depression is a frequent but underrecognized and undertreated condition among breast cancer patients, which causes amplification of physical symptoms, increased functional impairment and poor treatment adherence. More research on the epidemiology and treatment of major depression in this population is needed.
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                Author and article information

                Contributors
                +60379492068 , chong_guan@um.edu.my
                Journal
                Health Qual Life Outcomes
                Health Qual Life Outcomes
                Health and Quality of Life Outcomes
                BioMed Central (London )
                1477-7525
                30 December 2015
                30 December 2015
                2015
                : 13
                : 205
                Affiliations
                [ ]Department of Psychological Medicine, Faculty of Medicine, University Malaya, Lembah Pantai, 50603 Kuala Lumpur, Malaysia
                [ ]Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Kuala Lumpur, Malaysia
                [ ]Department of Surgery, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
                [ ]Department of Social and Preventive Medicine, University of Malaya, Kuala Lumpur, Malaysia
                Article
                401
                10.1186/s12955-015-0401-7
                4696207
                26715073
                822fe233-dd4d-435a-ba24-6ca6f2148e68
                © Ng et al. 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 6 October 2015
                : 21 December 2015
                Funding
                Funded by: HIR grant (HIR Grant UM.C/HIR/MOHE/06) from the Ministry of Higher Education of Malaysia and joint grant from UM and Queen's University Belfast (UM-QUB3C-2011)
                Categories
                Research
                Custom metadata
                © The Author(s) 2015

                Health & Social care
                breast cancer,depression,anxiety,quality of life,social support,malaysia
                Health & Social care
                breast cancer, depression, anxiety, quality of life, social support, malaysia

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