Association of depression and anxiety disorder with the risk of mortality in breast cancer: A National Health Insurance Service study in Korea
Abstract
Purpose To examine whether depression, anxiety disorder, and their co-occurrence would increase the risk of mortality in patients with breast cancer, and whether antidepressant treatment would reduce the same.Methods Data were retrieved from the database of the Korean National Health Insurance Service. Of 145,251 patients diagnosed with breast cancer between 2007 and 2014, 20,870 patients diagnosed with depression or anxiety disorder one year before breast cancer diagnosis were excluded. Thus, data of 124,381 patients were included in this study.Results Depression and anxiety disorder were associated with an increased risk of mortality [Hazard Ratio (HR) 1.26, 95% CI 1.18-1.36; HR 1.14, 95% CI 1.08-1.22, respectively] and their co-occurrence further increased the risk (HR = 1.38, 95% CI 1.24-1.54). Antidepressant treatment was related to a reduced risk of mortality. Compared to patients without any psychiatric comorbidity with no antidepressant treatment, the mortality risk increased in patients with either psychiatric comorbidity or both, but the risk seemed to attenuate with antidepressant treatments.Conclusion The current findings suggest that psychiatric comorbidities are markers of increased mortality risk in patients with breast cancer, and antidepressant treatment may attenuate the risk. This underscores the need for screening and treating depression and anxiety disorders to improve survival in patients with breast cancer.
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These factors can have negative consequences for the disease course, including increased frequency and duration of hospital stays, lower adherence to treatment recommendations, difficulties coping, reduced quality of life, and increased mortality.
“These factors can have negative consequences for the disease course, including an increase in the frequency and duration of hospital stays, lower adherence to treatment recommendations, difficulties in coping with the disease, reduced quality of life and an increase in mortality [9–14].”
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- Authors
- Shim, E.-J., Lee, J. W., Cho, J., Jung, H. K., Kim, N. H., Lee, J. E., Min, J., Noh, W. C., Park, S.-H., & Kim, Y. S.
- Affiliations
- Pusan National University (KR)
- Seoul National University (KR)
- Keimyung University (KR)
- Kaywon University of Art & Design (KR)
- Korea Institute of Radiological and Medical Sciences (KR)
- Daegu Catholic University Medical Center (KR)
- Chosun University (KR)
- Corresponding author
- Kim, Yoo Seok
- Venue
- Breast Cancer Research and Treatment
- Published
- 2019-10-31
- Volume
- 179
- Issue
- 2
- Pages
- 491-498
- ISSN
- 0167-6806 (ISSN-L)
- 1573-7217
- OpenAlex
- W2986949204
- Cited by
- 67
- References
- 45
- Citations by year
- 2026: 2 · 2025: 15 · 2024: 10 · 2023: 8 · 2022: 14 · 2021: 8 · 2020: 9 · 2019: 1
- FWCI
- 3.34
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Breast Cancer Research and Treatment (publishedVersion)
- PubMed (publishedVersion)
- Seoul National University Open Repository (Seoul National University) (submittedVersion)
- Funders
- Korea Breast Cancer Society
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Psychiatry and Mental health › Cancer, Stress, Anesthesia, and Immune Response
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- breast cancer, depression, anxiety disorders, psychiatric comorbidity, mortality risk, antidepressant treatment, depression screening, cancer survival
- MeSH terms
- Antidepressive Agents, Anxiety Disorders, Breast Neoplasms, Depressive Disorder, Female, Humans, Prognosis, Registries, Risk Factors, Comorbidity, Proportional Hazards Models, Republic of Korea, Public Health Surveillance
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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