Symptoms of Anxiety and Depression Among Slovenian Breast Cancer Survivors Post-Treatment During the COVID-19 Pandemic: A Cross-Sectional Study.

Background

Although anxiety and depression are important determinants of mental health, the literature in this area is sparse as most studies focus on the period during treatment. Mental health problems can affect cancer recovery as well as quality of life and survival. In this cross-sectional study, we investigated the prevalence of anxiety and depression in Slovenian cancer survivors after treatment and assessed the associated correlates during the COVID-19 pandemic.

Methods

From September 2021 to January 2022, we collected data from 430 breast cancer survivors one to five years after receiving post-local treatment and (neo)adjuvant chemotherapy. We used the Hospital Anxiety and Depression Scale (HADS) to measure anxiety and depression levels. Multivariate linear regression was used to identify factors associated with higher levels of anxiety and depression.

Results

Key findings from this study are increased levels of psychological distress and identification of relevant factors associated with those elevated levels. Approximately one-third of breast cancer survivors exhibited symptoms of elevated anxiety and depression, with one in eight meeting clinical thresholds. Multivariate linear regression revealed that age, lower quality of life, heightened fear of cancer recurrence (FCR), reduced resilience, limited social support, and unmet psychosocial and emotional needs correlated with increased anxiety symptoms. Additionally, lower quality of life, higher FCR, diminished resilience, and limited social support were associated with higher depression symptomatology.

Conclusions

Our study of Slovenian breast cancer survivors one to five years post-treatment observed a significant increase in anxiety and depression symptoms, possibly exacerbated by the COVID-19 pandemic. The demographic and psychosocial factors identified in this study offer valuable insights for future research. The study emphasises the importance of recognising and addressing the psychological needs of breast cancer survivors and the need to follow them throughout their cancer journey.

Uvod

Čeprav sta anksioznost in depresija pomembna dejavnika duševnega zdravja, ni veliko študij, ki bi se osredotočale na obdobje po koncu zdravljenja. Težave v duševnem zdravju lahko vplivajo na okrevanje po raku ter na kakovost življenja in preživetje. V tej presečni študiji smo preučevali prevalenco anksioznosti in depresije v času pandemije covida-19 pri slovenskih preživelih bolnicah z rakom dojke po koncu zdravljenja in ocenili z njima povezane korelacije.

Metode

Med septembrom 2021 in januarjem 2022 smo zbrali podatke 430 preživelih bolnic z rakom dojk, ki so bile 1–5 let po koncu zdravljenja in ki so prejele post-lokalno zdravljenje in (neo)adjuvantno kemoterapijo. Anksioznost in depresija sta bili merjeni z bolnišnično lestvico anksioznosti in depresije (HADS). Za ugotavljanje dejavnikov, povezanih z višjimi stopnjami anksioznosti in depresije, je bila uporabljena multivariatna linearna regresija.

Rezultati

Ključne ugotovitve te študije so visoka pojavnost simptomov psihološkega distresa in identifikacija spremenljivk povezanih z več simptomov psihološkega distresa. Približno tretjina preživelih bolnic z rakom dojke ima višje od normalnih ravni simptomov anksioznosti in depresije. Pri eni od osmih oseb ugotavljamo klinično pomembno anksioznost in depresijo. Z multivariatno linearno regresijo je bilo ugotovljeno, da so starost, slabša kakovost življenja, višja raven strahu pred ponovitvijo raka, manjša psihološka odpornost, manjša socialna podpora ter nezadovoljene potrebe po psihosocialni in čustveni podpori pomembni korelati simptomov anksioznosti. Poleg tega je bilo ugotovljeno, da so nižja kakovost življenja, višje ravni strahu pred ponovitvijo bolezni, nižja odpornost in nižja socialna podpora povezani z večjo simptomatiko depresije.

Zaključek

V našem vzorcu slovenskih preživelih bolnic z rakom dojk 1–5 let po zdravljenju je bila prevalenca simptomov anksioznosti in depresije visoka, kar bi lahko bilo povezano s pandemijo covida -19. Demografski in psihosocialni dejavniki, ugotovljeni v tej študiji, ponujajo obetavne usmeritve za prihodnje študije. Ključne ugotovitve študije so pomembnost prepoznavanja in obravnave psiholoških potreb preživelih bolnic z rakom dojke po končanem zdravljenju ter potreba po dolgoročnem spremljanju.

Informations de copyright

© 2024 Špela MIROŠEVIČ et al., published by Sciendo.

Déclaration de conflit d'intérêts

CONFLICTS OF INTEREST The authors have no conflicts of interest to declare.