Depression, correlates of depression, and receipt of depression care among low-income women with breast or gynecologic cancer.
OBJECTIVE
To assess the prevalence of depression among low-income, ethnic minority women with breast or gynecologic cancer, receipt of antidepressant medications or counseling services, and correlates of depression.


METHODS
Study patients were 472 women receiving cancer care in an urban public medical center. Women had a primary diagnosis of breast (stage 0 to III) or gynecologic cancer (International Federation of Gynecology and Obstetrics stage 0 to IIIB). A diagnostic depression screen and baseline questionnaire were administered before or during active treatment or during active follow-up. Self-report data were collected on receipt of depression treatment, use of supportive counseling, pain and receipt of pain medication, functional status and well-being, and perceived barriers to cancer care.


RESULTS
Twenty-four percent of women reported moderate to severe levels of depressive disorder (30% of breast cancer patients and 17% of gynecologic cancer patients). Only 12% of women meeting criteria for major depression reported currently receiving medications for depression, and only 5% of women reported seeing a counselor or participating in a cancer support group. Neither cancer stage nor treatment status was correlated with depression. Primary diagnosis of breast cancer, younger age, greater functional impairment, poorer social and family well-being, anxiety, comorbid arthritis, and fears about treatment side effects were correlated with depression.


CONCLUSIONS
Findings indicate that depressive disorder among ethnic minority, low-income women with breast or gynecologic cancer is prevalent and is correlated with pain, anxiety, and health-related quality of life. Because these women are unlikely to receive depression treatment or supportive counseling, there is a need for routine screening, evaluation, and treatment in this population.
Ell
Kathleen
K
DSW, School of Social Work-0411, University of Southern California, University Park, Los Angeles, CA 90089, USA. e-mail: ell@usc.edu
Sanchez
Kathleen
K
Vourlekis
Betsy
B
Lee
Pey-Jiuan
PJ
Dwight-Johnson
Megan
M
Lagomasino
Isabel
I
Muderspach
Laila
L
Russell
Christy
C
D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000150:complications* / Q000523:psychology*; D019090:Case Management; D003376:Counseling; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D005006:Ethnicity; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications* / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D008913:Minority Groups; D011203:Poverty; D015995:Prevalence; D012720:Severity of Illness Index; D014505:Urban Population
D000928:Antidepressive Agents