Prevalence of Depression in Breast Cancer Survivors: a Systematic Review of Observational Studies

“Common physical symptom in cancer patients such as fatigue which can be symptom of the disease progression but also the common adverse effects of radiotherapy or chemotherapy was frequently reported to be associated with depression (Bower et al., 2000; 2011; Den Oudsten et al., 2009; Vahdaninia et al., 2010).”

“Social support was examined in several studies which report a significant association with depression i.e. poor social support (Mehnert and Koch, 2008; Den Oudsten et al., 2009), being unaccompanied by spouse and requested for help from psychologist (Karakoyun-Celik et al., 2010).”

“This is also the period whereby survivors may be at risk of developing long-term physical and psychological complications of the disease and/ or its array of treatment including mastectomy, radiotherapy and chemotherapy (Howard-Anderson et al., 2012).”

“CES-D has been reported as a valid and reliable tool to screen depression in breast cancer patients (Hann et al., 1999) and demonstrates the same general structure of responses in different ethnic groups (Makambi et al.”

“Other illness-related factors included reduced chance of survival (Watson et al., 1999), increased cortisol level at 2100 hours (Hsiao et al., 2012) and high co-morbidity index (Chen et al., 2009).”

“A good review of this topic was conducted systematically (Fann et al., 2008) but did not focus on depression during survivorship; rather it looked at depression at no specific point of the disease.”

“Beside fatigue, other physical symptoms associated with depression were pain (Vahdaninia et al., 2010), sleep disturbance (Bower et al., 2011) and low sexual desire (Speer et al., 2005).”

“Social support was examined in several studies which report a significant association with depression i.e. poor social support (Mehnert and Koch, 2008; Den Oudsten et al., 2009), being unaccompanied by spouse and requested for help from psychologist (Karakoyun-Celik et al., 2010).”

“Similarly pain could predict depression in breast cancer survivors (Vahdaninia et al., 2010).”

“Long term effects associated with chemotherapy include infertility, sexual dysfunction, menopause-associated health problems e.g. osteoporosis and cardiovascular disease (Azim et al., 2011); all of which can be associated with depression.”

“, 2011) and/or psychological interventions (Zainal et al., 2012).”

“…(Bower et al., 2000; 2011; Den Oudsten et al., 2009; Vahdaninia et al., 2010) followed by lower income/poor financial status (Eversley et al., 2005; Morrill et al., 2008; Chen et al., 2009), low education (Mehnert and Koch, 2008; Morrill et al., 2008; Alcalar et al., 2012) and younger age…”

“Three studies found poor quality of life was significantly associated with depression (Deshields et al., 2006; Chen et al., 2009; Rabin et al., 2009) in which Rabin et al. (2009) found the significance was confined to the domains of physical, psychological and social relations (Rabin et al., 2009).”

“The subjects’ psychological factors that were associated with depression were preoperative helplessness/ hopelessness (Schou et al., 2004), high anxiety levels (Deshields et al., 2006; Alcalar et al., 2012), higher neuroticism score, lower agreeableness score, more pre-operative depressive symptoms…”

“…with fatigue (Bower et al., 2000; 2011; Den Oudsten et al., 2009; Vahdaninia et al., 2010) followed by lower income/poor financial status (Eversley et al., 2005; Morrill et al., 2008; Chen et al., 2009), low education (Mehnert and Koch, 2008; Morrill et al., 2008; Alcalar et al., 2012)…”

“, 2009) and shorter sleep duration (Carpenter et al., 2004).”

“Beside fatigue, other physical symptoms associated with depression were pain (Vahdaninia et al., 2010), sleep disturbance (Bower et al., 2011) and low sexual desire (Speer et al., 2005).”

“…lower agreeableness score, more pre-operative depressive symptoms (Den Oudsten et al., 2009), poor body image, less attractiveness, less feminine (Begovic-Juhant et al., 2012), negative automatic thoughts, more cognitive errors, low fighting spirit (Alcalar et al., 2012) and lacking presence of…”

“The period following completion of treatment and thereafter is also the transition time when women were transformed from the role of breast cancer ‘patients’ to become ‘survivors’ (Allen et al., 2009).”

“Social support was examined in several studies which report a significant association with depression i.e. poor social support (Mehnert and Koch, 2008; Den Oudsten et al., 2009), being unaccompanied by spouse and requested for help from psychologist (Karakoyun-Celik et al., 2010).”

“In terms of time since diagnosis, Broeckel et al. (2000) found more time elapsed since diagnosis to be associated with depression which contradicted with ‘recent diagnosis of breast cancer’ reported by another study (Khan et al., 2012).”

“In addition, tamoxifen, an anti-oestrogen for treatment and prophylaxis of hormone-sensitive breast cancer has also been associated with depression (Lorizio et al., 2012).”

“There may be a need for pharmacotherapy (Ng et al., 2011) and/or psychological interventions (Zainal et al., 2012).”

“In terms of time since diagnosis, Broeckel et al. (2000) found more time elapsed since diagnosis to be associated with depression which contradicted with ‘recent diagnosis of breast cancer’ reported by another study (Khan et al., 2012).”

“This is also the period whereby survivors may be at risk of developing long-term physical and psychological complications of the disease and/ or its array of treatment including mastectomy, radiotherapy and chemotherapy (Howard-Anderson et al., 2012).”

“Social support was examined in several studies which report a significant association with depression i.e. poor social support (Mehnert and Koch, 2008; Den Oudsten et al., 2009), being unaccompanied by spouse and requested for help from psychologist (Karakoyun-Celik et al., 2010).”

“Similarly BDI and HADS are other useful screening tools for depression in cancer patients (Wang et al., 2011; Warmenhoven et al., 2012).”

“Similarly BDI and HADS are other useful screening tools for depression in cancer patients (Wang et al., 2011; Warmenhoven et al., 2012).”

“, 2008), widowed or divorced (Chen et al., 2009) were significantly associated with depression although in contrast with one study which found being married (Pumo et al.”

“Asian Pacific Journal of Cancer Prevention, Vol 14, 2013 3398 psychological needs were often neglected (Park and Hwang, 2012).”

“The prevalence of depression from the Asian studies (Inagaki et al., 2004; Karakoyun-Celik et al., 2010; Vahdaninia et al., 2010; Chen et al., 2009; Alcalar et al., 2012; Hsiao et al., 2012; Jang et al., 2012) reported a narrower range of 12.”

“A main theme of depression among breast cancer survivors was the fear of breast cancer recurrence and metastasis (Pan et al., 2010).”

“, 1999) and demonstrates the same general structure of responses in different ethnic groups (Makambi et al., 2009).”

“Social support was examined in several studies which report a significant association with depression i.e. poor social support (Mehnert and Koch, 2008; Den Oudsten et al., 2009), being unaccompanied by spouse and requested for help from psychologist (Karakoyun-Celik et al., 2010).”

“Analysis of the items in HADS-depression used in cancer patients, combination of “feeling down, depressed or hopeless“ with “thoughts that would be better off dead, little interest or pleasure in doing things” gave high sensitivity but low specificity (Mitchell et al., 2012).”

“Seven studies were conducted in Asian countries (Inagaki et al., 2004; Chen et al., 2009; Karakoyun-Celik et al., 2010; Vahdaninia et al., 2010; Alcalar et al., 2012; Hsiao et al., 2012; Jang et al., 2012).”

“…depressive symptoms (Den Oudsten et al., 2009), poor body image, less attractiveness, less feminine (Begovic-Juhant et al., 2012), negative automatic thoughts, more cognitive errors, low fighting spirit (Alcalar et al., 2012) and lacking presence of the meaning of life (Hsiao et al., 2012).”

“Depression is often underestimated in breast cancer sufferers, with prevalence varied between 10% and 25% (Qiu et al., 2012; Popoola and Adewuya, 2012).”

“Regarding marital status, being unmarried (Broeckel et al., 2000; Morrill et al., 2008), widowed or divorced (Chen et al., 2009) were significantly associated with depression although in contrast with one study which found being married (Pumo et al., 2012) was associated with depression.”

“Three studies found poor quality of life was significantly associated with depression (Deshields et al., 2006; Chen et al., 2009; Rabin et al., 2009) in which Rabin et al.”

“One study found that depression was correlated with poor quality and dietary intakes (Tangney et al., 2002).”

“Depression is often underestimated in breast cancer sufferers, with prevalence varied between 10% and 25% (Qiu et al., 2012; Popoola and Adewuya, 2012).”

“The prevalence of depression from the Asian studies (Inagaki et al., 2004; Karakoyun-Celik et al., 2010; Vahdaninia et al., 2010; Chen et al., 2009; Alcalar et al., 2012; Hsiao et al., 2012; Jang et al., 2012) reported a narrower range of 12.”

“Early detection and treatment of depression in breast cancer sufferers not only significantly improved their quality of life but also increased their survival rates (Weinberger et al., 2010).”

“Other factors included having frequent cancer discussion and high level of detrimental interactions (Ullrich et al., 2008).”

“Depression is most commonly found in women with breast cancer [76].”

“In a systematic review of observational studies, the prevalence of depression and anxiety specifically among breast cancer survivors was 22% (range, 13%56%) using the Center for Epidemiological Studies for Depression, 22% (range, 17%-48%) using the Beck Depression Inventory, and 10% (range, 1%-22%) using the Hospital…”

“Other systematic reviews on the topic assessed the prevalence of anxiety and depressive symptoms in cancer survivors (11,116–118), including studies without a comparison group.”