title: Cancer-related fatigue and depression in breast cancer patients postchemotherapy: Different associations with optimism and stress appraisals.
abstract: Symptoms of depression and cancer-related fatigue (CRF) are common among breast cancer patients postchemotherapy and may seriously impair quality of life (QoL). This study aimed to assess the relationship between depression and CRF in breast cancer patients postchemotherapy and to examine their relationships to optimism and to threat and challenge appraisals.
  
  
  
  Participants included 95 breast cancer patients (stages 1-3) 1 to 6 months after completion of chemotherapy. Patients submitted personal and medical details and completed the following: physical symptom questionnaires (EORTC QLQ-C30, and QLQ-BR23), a symptoms of depression questionnaire (CES-D), the Fatigue Symptom Inventory (FSI), the Life Orientation Test (LOT-R), and a stress appraisals questionnaire.
  
  
  
  We found levels of depression, CRF, and appraisals of cancer as a threat to bemoderate and levels of optimism and appraisals of cancer as a challenge to be high. Depression and CRF were positively associated. A multivariate regression analysis revealed that 51% of the CRF variancewas explained; physical symptoms and threat appraisal were significantly associated with CRF. A 67% of the CRF variance of depression was explained; challenge and threat appraisals were significantly associated with depression [corrected].
  
  
  
  Although CRF and depression were often experienced simultaneously and both were found to be higher among individuals who gave higher appraisals of cancer as a threat, only depression was related to optimism and challenge appraisals, while CRF was related mainly to intensity of physical symptoms. The different pattern of associations between optimism and appraisals warrants further clinical attention as well as future study.
authors.affiliation: Department of Gerontology,Faculty of Social Welfare and Health Sciences,University of Haifa,Haifa,Israel.
authors.forename: Inbar
authors.initials: I
authors.lastname: Levkovich
authors.affiliation: Department of Gerontology and School of Social Work,Faculty of Social Welfare and Health Sciences,University of Haifa,Haifa,Israel.
authors.forename: Miri
authors.initials: M
authors.lastname: Cohen
authors.affiliation: Institute of Clinical Immunology,Allergy and AIDS,Rambam Health Care Campus,Haifa,Israel.
authors.forename: Shimon
authors.initials: S
authors.lastname: Pollack
authors.affiliation: Oncology Unit,Rambam Health Care Campus,Haifa,Israel.
authors.forename: Karen
authors.initials: K
authors.lastname: Drumea
authors.affiliation: Oncology Unit,Rambam Health Care Campus,Haifa,Israel.
authors.forename: Georgeta
authors.initials: G
authors.lastname: Fried
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000150:complications / Q000523:psychology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology / Q000523:psychology*; D005221:Fatigue / Q000150:complications / Q000209:etiology / Q000523:psychology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D008960:Models, Psychological; D000067656:Optimism / Q000523:psychology; D011788:Quality of Life; D012044:Regression Analysis; D018434:Sickness Impact Profile; D013315:Stress, Psychological / Q000209:etiology / Q000523:psychology*; D017741:Survivors / Q000523:psychology*
keywords: Breast cancer; Depression; Fatigue; Optimism; Stress appraisals