title: Predictors of initial levels and trajectories of depressive symptoms in women with breast cancer undergoing radiation therapy.
abstract: BACKGROUND
  Women with breast cancer undergoing radiation therapy (RT) are at increased risk for depressive symptoms. However, only 4 studies specifically evaluated changes in and predictors of depressive symptoms in these patients.
  
  
  OBJECTIVE
  This study evaluated changes in depressive symptoms from the initiation of and through 6 months following RT and investigated whether specific demographic, clinical, symptom, and psychological adjustment characteristics predicted initial levels and trajectories of depressive symptoms.
  
  
  METHODS
  A total of 184 women with breast cancer completed the Center for Epidemiologic Studies-Depression Scale that evaluated depressive symptoms prior to and approximately 1, 2, 3, and 6 months after the initiation of RT. Hierarchical linear modeling was used for these analyses.
  
  
  RESULTS
  Approximately one-fourth of patients had clinically meaningful levels of depressive symptoms prior to RT, but the trajectory of depressive symptoms improved over time. Women with less education, children living at home, a higher level of sleep disturbance, worry about disease outcome, less meaning in life, and less support from family and friends had higher levels of depressive symptoms prior to RT.
  
  
  CONCLUSIONS
  Some women with breast cancer experience depressive symptoms prior to, during, and after RT, and specific demographic, clinical, symptom, and psychological adjustment characteristics identified women at higher risk for depressive symptoms.
  
  
  CONCLUSIONS
  Nurses could use knowledge of the predictors to identify patients at risk for depressive symptoms and to educate patients about how depressive symptoms may change during and following RT for breast cancer.
authors.affiliation: Author Affiliations: Faculty of Medicine, University of Oslo, and Oslo University Hospital, Norwegian Radium Hospital, Norway (Ms Lindviksmoen); School of Nursing, University of California, San Francisco (Drs Paul and Miaskowski); Oslo University Hospital, Ullevål, and Lovisenberg Diaconal University College, Oslo, Norway (Dr Rustøen); and Centre for Shared Decision Making and Collaborative Research, Oslo University Hospital, Rikshospitalet, Norway (Ms Hofsø).
authors.forename: Guro
authors.initials: G
authors.lastname: Lindviksmoen
authors.forename: Kristin
authors.initials: K
authors.lastname: Hofsø
authors.forename: Steven M
authors.initials: SM
authors.lastname: Paul
authors.forename: Christine
authors.initials: C
authors.lastname: Miaskowski
authors.forename: Tone
authors.initials: T
authors.lastname: Rustøen
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology; D001943:Breast Neoplasms / Q000150:complications* / Q000523:psychology / Q000532:radiotherapy*; D003863:Depression / Q000209:etiology* / Q000523:psychology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology; D011795:Surveys and Questionnaires