title: The course of anxiety and depression over 5 years of follow-up and risk factors in women with early breast cancer: results from the UK Standardisation of Radiotherapy Trials (START).
abstract: Prospective data are limited on the course of anxiety and depression and their determinants in women with early breast cancer. These parameters were assessed before adjuvant radiotherapy (RT) and over 5 years follow-up. Of 2208 women recruited to the START QOL study, 35% reported clinically relevant levels of anxiety and/or depression pre-RT; there was no significant change in these proportions over time. However, 75% women with high baseline anxiety recorded further high scores over time whilst one in six had high scores at every follow-up point. Depression showed a similar pattern with lower frequencies at all time points; very few with initial normal scores developed clinically relevant anxiety or depression over time. Lower educational level predicted worse anxiety and depression over time; younger age predicted worse anxiety and chemotherapy predicted worse depression. Scores in the borderline or case range for anxiety or depression at baseline were both significantly associated with worse mood states over 5 years. These findings indicate the course of anxiety and depression in women with specific risk factors. This subgroup of patients requires greater clinical attention.
authors.affiliation: ICR Clinical Trials and Statistics Unit (ICR-CTSU), Section of Clinical Trials, The Institute of Cancer Research, Sir Richard Doll Building, Cotswold Road, Sutton, Surrey SM2 5NG, UK.
authors.forename: Penelope
authors.initials: P
authors.lastname: Hopwood
authors.forename: Georges
authors.initials: G
authors.lastname: Sumo
authors.forename: Judith
authors.initials: J
authors.lastname: Mills
authors.forename: Joanne
authors.initials: J
authors.lastname: Haviland
authors.forename: Judith M
authors.initials: JM
authors.lastname: Bliss
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology*; D001943:Breast Neoplasms / Q000523:psychology* / Q000532:radiotherapy; D003863:Depression / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant / Q000523:psychology*; D012307:Risk Factors; D006113:United Kingdom