title: Anxiety and depression symptoms in the 2 years following diagnosis of breast or gynaecologic cancer: prevalence, course and determinants of outcome.
abstract: OBJECTIVE
  The purposes of this study are to examine the course and prevalence of anxiety and depression over 24 months in women with newly diagnosed breast and gynaecologic cancer and, controlling for demographic and clinical confounders, to test the role of neuroticism and psychiatric history in determining outcome 6, 12, 18 and 24 months post-diagnosis.
  
  
  METHODS
  Participants completed the Hospital Anxiety and Depression Scale-anxiety subscale and Centre for Epidemiological Studies Depression Scale on an 8-weekly basis from diagnosis until 96 weeks. Changes over time were analyzed with repeated measures ANOVA. Hierarchical linear regression, adjusted a priori for age, chemotherapy and radiation treatment, living alone, education and tumour stream were used to predict anxiety and depression.
  
  
  RESULTS
  Participants were 105 women (66 breast, 39 gynaecologic). Rates of anxiety (18.1 %) and depression (33.3 %) were highest at diagnosis. Average rates of anxiety and depression were 5.9 and 22.4 %, respectively. Average scores of anxiety and depression were highest at diagnosis, with improvement at 8 and 40 weeks, respectively, subsequently maintained. Morbidity at diagnosis was particularly acute among women with a treatment history of anxiety/depression or with high neuroticism. These three variables were the best and only predictors over 24 months.
  
  
  CONCLUSIONS
  Women are most vulnerable to anxiety and depression at diagnosis, with improvement over time. Morbidity rates are lower than reported elsewhere. Women with high neuroticism and a psychiatric history are at greatest risk for future morbidity after adjusting for confounders. Early identification of these women plus heightened surveillance or early referral to psychosocial services may protect against longer-term morbidity.
authors.affiliation: Centre for Women's Mental Health, Royal Women's Hospital, Locked Bag 300, Parkville, Victoria, 3052, Australia, lesley.stafford@thewomens.org.au.
authors.forename: Lesley
authors.initials: L
authors.lastname: Stafford
authors.forename: Fiona
authors.initials: F
authors.lastname: Judd
authors.forename: Penny
authors.initials: P
authors.lastname: Gibson
authors.forename: Angela
authors.initials: A
authors.lastname: Komiti
authors.forename: G Bruce
authors.initials: GB
authors.lastname: Mann
authors.forename: Michael
authors.initials: M
authors.lastname: Quinn
mesh_terms: D000223:Adaptation, Psychological; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D001315:Australia / Q000453:epidemiology; D001943:Breast Neoplasms / Q000453:epidemiology / Q000523:psychology*; D003863:Depression / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D005260:Female; D005833:Genital Neoplasms, Female / Q000453:epidemiology / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D015995:Prevalence; D011569:Psychiatric Status Rating Scales