title: The relationship between depressive symptoms and shoulder mobility among older women: assessment at one year after breast cancer diagnosis.
abstract: OBJECTIVE
  To examine the association between depressive symptoms and shoulder range of motion at one year after breast cancer diagnosis, controlling for patient characteristics, tumour stage and cancer therapy (surgery, axillary node dissection and radiation).
  
  
  METHODS
  Prospective trial of nurse case management involving 187 older women with complete data, age 60 years and older, newly diagnosed with breast cancer, from 1 November, 1993 to 31 October, 1996 in south-eastern Texas. Depressive symptoms, sociodemographic characteristics and breast cancer treatment were measured at two months and shoulder range of motion at 12 months. The relationship among the variables was evaluated with bivariate chi-square statistics and logistic regression analysis. All logistic models also included a variable indicating whether or not the woman received nurse case management, to control for intervention status.
  
  
  RESULTS
  Increasing depressive symptoms at baseline were associated with lower arm mobility at 12 months following breast cancer diagnosis. Each unit increase in depressive symptoms at baseline was associated with an 8% decreased odds of having full range of motion of the shoulder (odds ratio (OR) 0.92, 95% confidence interval (CI) 0.87, 0.97), after controlling for relevant patient and treatment factors.
  
  
  CONCLUSIONS
  Older women with depressive symptoms have an elevated risk of not fully recovering shoulder mobility after being treated for breast cancer. Future studies are needed to assess benefits from early intervention with psychological and or physical interventions in the presence of depressive symptoms on shoulder mobility.
authors.affiliation: Department of Orthopedics and Rehabilitation, Route 0165, University of Texas Medical Branch, Galveston, TX 77555, USA. macabon@utmb.edu
authors.forename: Mabel E
authors.initials: ME
authors.lastname: Caban
authors.forename: Jean L
authors.initials: JL
authors.lastname: Freeman
authors.forename: Dong D
authors.initials: DD
authors.lastname: Zhang
authors.forename: Caroline
authors.initials: C
authors.lastname: Jansen
authors.forename: Glenn
authors.initials: G
authors.lastname: Ostir
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Hatch
authors.forename: James S
authors.initials: JS
authors.lastname: Goodwin
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D001365:Axilla; D001943:Breast Neoplasms / Q000150:complications / Q000523:psychology* / Q000628:therapy; D003863:Depression / Q000209:etiology*; D005260:Female; D006801:Humans; D007592:Joint Diseases / Q000209:etiology / Q000523:psychology*; D008197:Lymph Node Excision / Q000009:adverse effects; D008875:Middle Aged; D011446:Prospective Studies; D011878:Radiotherapy / Q000009:adverse effects; D016059:Range of Motion, Articular; D012785:Shoulder Joint