Trajectories of distress, anxiety, and depression among women with breast cancer: Looking beyond the mean

Bidstrup, Pernille Envold; Christensen, Jane; Mertz, Birgitte Goldschmidt; Rottmann, Nina; Dalton, Susanne Oksbjerg; Johansen, Christoffer

doi:10.3109/0284186x.2014.1002571

Cited by 99Cancer survivorship and careWomen's cancer prevention and managementFamily Support in Illness

Trajectories of distress, anxiety, and depression among women with breast cancer: Looking beyond the mean

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Bidstrup, Pernille Envold, Christensen, Jane, Mertz, Birgitte Goldschmidt, Rottmann, Nina, Dalton, Susanne Oksbjerg, Johansen, Christoffer·2015·Acta Oncologica

DOI 10.3109/0284186x.2014.1002571

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Abstract

OBJECTIVE: Little is known about the development of psychological wellbeing over time among women who have been treated for breast cancer. The aim of this study was to identify distinct patterns of distress, anxiety, and depression in such women. METHODS: We invited 426 consecutive women with newly diagnosed primary breast cancer to participate in this study, and 323 (76%) provided information on distress ('distress thermometer') and on symptoms of anxiety and depression ('hospital anxiety and depression scale'). Semiparametric group-based mixture modeling was used to identify distinct trajectories of distress, anxiety, and depressive symptoms assessed the week before surgery and four and eight months later. Logistic regression analysis was used to evaluate the characteristics of women in the distinct groups. RESULTS: Although no sub-group of women with chronic severe anxiety or depressive symptoms was found, we did identify a sub-group of 8% of the women who experienced continuously severe distress. Young age, having a partner, shorter education, and receiving chemotherapy but not radiotherapy might characterize women whose psychological symptoms remain strong eight months after diagnosis. CONCLUSION: By looking beyond the mean, we found that 8% of the women experienced chronic severe distress; no sub-groups with chronic severe anxiety or depression were identified. Several socio-demographic and treatment factors characterized the women whose distress level remained severe eight months after diagnosis. The results suggest that support could be focused on relatively small groups of patients most in need.

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Distress is most common during active treatment.
“While an estimated 35–45% of cancer patients report psychological distress [1, 12], distress is most common during active treatment [13, 14].”
From Being present: A single-arm feasibility study of audio-based mindfulness meditation for colorectal cancer patients and caregivers (2018) · cites this paper as [14]
The Depression section reports that distress symptoms generally decreased from before surgery to four and eight months afterward, consistent with greater distress earlier in the breast-cancer course. But the study does not establish that distress is most common specifically during active treatment: its first assessment was before surgery, and it does not compare active-treatment and post-treatment prevalence across cancer patients. (LLM, conf=0.82)
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Self-citation

Authors: Bidstrup, P. E., Christensen, J., Mertz, B. G., Rottmann, N., Dalton, S. O., & Johansen, C.
Affiliations: Danish Cancer Society (DK)
Copenhagen University Hospital (DK)
University of Southern Denmark (DK)
Corresponding author: Bidstrup, Pernille Envold
ORCID: Bidstrup, Pernille Envold
Christensen, Jane
Mertz, Birgitte Goldschmidt
Rottmann, Nina
Dalton, Susanne Oksbjerg
Johansen, Christoffer
Venue: Acta Oncologica
Publisher: MJS Publishing, Medical Journals Sweden AB
Published: 2015-03-11
Volume: 54
Issue: 5
Pages: 789-796
ISSN: 0284-186X (ISSN-L)
1651-226X
DOI: 10.3109/0284186x.2014.1002571
OpenAlex: W2134128362
Cited by: 99
References: 32
Citations by year: 2026: 8 · 2025: 9 · 2024: 9 · 2023: 8 · 2022: 13 · 2021: 8 · 2020: 9 · 2019: 6 · 2018: 11 · 2017: 4 · 2016: 12 · 2015: 2
FWCI: 4.22
Type: journal article
Language: en
Open access: diamond
doi.org
Locations: Acta Oncologica (publishedVersion)
PubMed (publishedVersion)
University of Southern Denmark Research Portal (University of Southern Denmark) (publishedVersion)
Funders: Kræftens Bekæmpelse
Topics: Health Sciences › Medicine › Oncology › Cancer survivorship and care
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
Social Sciences › Sociology and Political Science › Family Support in Illness
Keywords: breast cancer, psychological distress, anxiety, depression, depressive symptoms, longitudinal trajectories, newly diagnosed breast cancer, chemotherapy, radiotherapy, sociodemographic factors, psychological well-being
MeSH terms: Adaptation, Psychological, Adult, Aged, Aged, 80 and over, Antineoplastic Agents, Anxiety, Breast Neoplasms, Denmark, Depression, Educational Status, Female, Humans, Middle Aged, Postoperative Period, Surveys and Questionnaires, Radiotherapy, Referral and Consultation, Regression Analysis, Social Support, Stress, Psychological, Marital Status, Preoperative Period

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Trajectories of distress, anxiety, and depression among women with breast cancer: Looking beyond the mean

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