[Improvement of anxiety and depression in women with breast cancer during inpatient oncological rehabilitation-- results of a prospective study].
OBJECTIVE
Investigation of the influence of an oncological inpatient rehabilitation programme on anxiety and depression in women with breast cancer.


METHODS
198 women with breast cancer, aged 25 to 75 years, filled in the Hospital Anxiety and Depression Scale (HADS) German version at the beginning and end of inpatient rehabilitation. Focus was set on the frequency of anxiety and depression. Therefore proportions with 95 % confidence intervals (CI) were built. The before-after comparison of HADS-scores was made using the signed rank test with two-sided level of significance of alpha = 5 %. In addition effect sizes were calculated. Possible relations between the scores at the beginning of rehabilitation and the patients' age or the interval since diagnosis were analysed by calculating correlation coefficients.


RESULTS
At the beginning of rehabilitation a state of anxiety was probable in 23.2 % (CI [17.3 %; 29.1 %] of the women and one of depression in 9.1 % (CI [5.8 %; 13.9 %]). In other words, they reached a level of >or= 11 score points on each scale. No correlation was found with the age of the patients or the time interval since diagnosis (|r| <or= 0.192). At the end of rehabilitation 67.5 % (CI [61.0 %; 74.0 %]) and 60.9 % (CI [54.1 %; 67.7 %]), respectively, of the women showed an improvement of anxiety and depression. The before-after difference was a median + 2 points (anxiety) and + 1 point (depression), resp., with a positive value representing an improvement. The changes after rehabilitation were statistically significant with p < 0.0001. The effect sizes ranged from 0.37 to 0.50.


CONCLUSIONS
After the end of primary therapy, women with breast cancer frequently suffer from anxiety or depressive disorders, with no correlation to the patients' age or time since diagnosis. By an inpatient oncological rehabilitation programme both anxiety and depression can be improved very successfully. Whether these results represent a long-term effect is currently being evaluated in a randomised prospective study.
Reha-Klinik Am Kurpark, Fachklinik für Onkologie und Rheumatologie, Bad Kissingen.
U
U
Hartmann
A
A
Kluge
C
C
Ring
M
M
Reuss-Borst
D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D005858:Germany; D006801:Humans; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D010555:Personality Inventory; D011446:Prospective Studies; D012047:Rehabilitation Centers