title: Incidence and risk of mood disorders in patients with breast cancers in Taiwan: a nationwide population-based study.
abstract: OBJECTIVE
  The objective of this study is to assess the incidence and risk of mood disorders, including major depression, anxiety, and bipolar disorders, in Taiwanese patients after the diagnosis of breast cancer compared with a matched cohort.
  
  
  METHODS
  From January 2000 to December 2005, 26,629 newly diagnosed breast cancer patients were enrolled by the Taiwan National Health Insurance program database. The control cohort was selected randomly from 1,000,000 National Health Insurance beneficiaries from a population of 21,400,826 enrolled throughout Taiwan. Each patient was matched with one subject without breast cancer by age, sex, and presence of comorbidities with the same diagnosis index date. The diagnosis of mood disorders was defined by compatible International Classification of Diseases, 9th revision, clinical modification codes plus the prescription of antidepressants for at least 30 days.
  
  
  RESULTS
  The overall incidence rate ratio of mood disorders was 1.33 (95% CI 1.28-1.39, p < 0.001) in the breast cancer cohort compared with the matched cohort. The incidence rate ratios for specific mood disorders were 2.06 for bipolar disorder (95% CI 1.37-3.15 p = 0.0003), 1.94 for major depressive disorder (95% CI 1.76-2.13 p < 0.001), and 1.22 for anxiety (95% CI 1.16-1.27 p < 0.001). Independent risk factors for developing mood disorders included breast cancer, as well as age, hypertension, chronic obstructive pulmonary disease, autoimmune disease, ischemic heart disease, and cerebrovascular disease.
  
  
  CONCLUSIONS
  Breast cancer is a prominent risk factor for mood disorders, including major depressive disorder, anxiety, and bipolar disorder. The impact is most potent in the first year after diagnosis. Psychological support is a critical issue in these patients.
authors: Division of Haematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Yi-Ping
authors: YP
authors: Hung
authors: Division of Haematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.|School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Department of Internal Medicine, National Yang-Ming University Hospital, Yilan, Taiwan.
authors: Chia-Jen
authors: CJ
authors: Liu
authors: Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.|Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Chia-Fen
authors: CF
authors: Tsai
authors: Division of Haematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Man-Hsin
authors: MH
authors: Hung
authors: Division of Haematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors: Cheng-Hwai
authors: CH
authors: Tzeng
authors: Division of Haematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.|School of Medicine, National Yang-Ming University, Taipei, Taiwan.|Institute of Biopharmaceutical Sciences, National Yang-Ming University, Taipei, Taiwan.
authors: Chun-Yu
authors: CY
authors: Liu
authors: Institute of Biopharmaceutical Sciences, National Yang-Ming University, Taipei, Taiwan.|Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Tzeng-Ji
authors: TJ
authors: Chen
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology; D001327:Autoimmune Diseases / Q000453:epidemiology; D001714:Bipolar Disorder / Q000453:epidemiology* / Q000523:psychology; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000523:psychology; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000453:epidemiology; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: anxiety; bipolar disorders; breast cancer; major depression; mood disorders; psycho‐oncology