Background: The prevalence of psychological distress among breast cancer patients is high, and they are at higher risk of developing severe anxiety, depression and potential mood disorders. In the present study, we conducted prospective study to determine the socioeconomic factors associated with anxiety and depression among breast cancer patients and to access the changes of psychological distress after the completion of treatment at 1 year of follow-up.
Methods: This study was conducted among breast cancer patients enrolled in the Department of General Surgery, Sir Sunderlal Hospital, Banaras Hindu University, Varanasi, India. A total of 200 patients who were diagnosed from January, 2013 to December, 2014 were interviewed using the questionnaires of Hospital Anxiety and Depression (HADS). The HADS was administered at two time points: at time of diagnosis and 12 months after completion of treatment. The associated factors investigated concerned socio-demographics, socio-economic background and the cancer stage.
Results: Prevalence of anxiety and depression among the breast cancer patients was 37.0% (n=74) and 28.0% (n=56) respectively. We found strong association of anxiety with age group (p=0.014), educational level (p=0.034), monthly income (p=0.001) and financial support (p=0.041). However, marital status (p=0.014), monthly income (p=0.017), accompanying person (p=0.005) and financial support (p=0.002) were significantly associated with depression. Binary logistic regression analysis shows age younger than 50 years old, those earned less income, illiterate or low level of education, being single and receiving less financial support are more likely to have anxiety. For depression, those earned less income, being single and receiving lesless financial support are more likely to have depression. At the 12 month follow-up, 184 breast cancer patients were re-interviewed. We found significant improvement (P<0.001) after 12 month follow-up in both anxiety and depression level (mean anxiety level improved from 11.14 ? 4.23 to 8.64 ? 3.63 and mean depression score improved from 6.87 ? 3.11 to 5.13 ? 4.51.
Conclusion: Study clearly shows that younger age group, low monthly income, having less financial support, low education level and being single were associated with anxiety and depression. For managing breast cancer patients, more care or support should be given to this type of patients as they are at high risk of anxiety and depression.
Vivek Srivastava, Mumtaz Ahmad Ansari, Anand Kumar, Agni Gautam Shah, Rakesh Kumar Meena, Prasant Sevach and Om Prakash Singh
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