title: The course of psychiatric co-morbidity in patients with breast cancer--results from the prospective multi-centre BRENDA II study.
abstract: OBJECTIVE
  This study examined the frequency of psychiatric co-morbidity in patients with breast cancer, its changes over time and predictors for these changes.
  
  
  METHODS
  In a prospective study with measurements before surgery (t1, baseline), 1 month (t2) and 8 months thereafter (t3) using the Patient Health Questionnaire, we examined the course of psychiatric co-morbidity in breast cancer patients. The co-morbidity courses were grouped into healthy (no co-morbidity during the study), acute (co-morbidity at t1 and/or t2, but not at t3), emerging (no co-morbidity at t1, but at t3) and chronic (co-morbidity at t1 and t3).
  
  
  RESULTS
  Of the 598 participants, 19% had acute, 10% emerging and 9% chronic psychiatric co-morbidity. Acute co-morbidity was more common in patients with poor quality of life (odds ratio (OR) 9.6, 95% confidence interval (CI) 4.4-20.8) and somatic co-morbidity (OR 3.8, CI 1.1-12.4). Patients who perceived support from their doctors had acute co-morbidity less frequently (OR 0.7, CI 0.5-1.0). Emerging co-morbidity occurred more often in younger patients (OR 2.4, CI 1.2-4.7) and in patients with another cancer in their own (OR 2.0, CI 1.1-3.9) or family (OR 2.1, CI 1.1-4.3) histories, less often in patients with support from doctors (OR 0.6, CI 0.4-1.0). Chronic co-morbidity was related to poor quality of life (OR 12.1, CI 3.6-39.9).
  
  
  CONCLUSIONS
  We found acute and emerging psychiatric co-morbidities less often in patients who reported having a supportive doctor-patient relationship. Patients that require psycho-oncological support often have poor quality of life and have experienced cancer before. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Singer
authors.affiliation: Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany.
authors.forename: Lukas
authors.initials: L
authors.lastname: Schwentner
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany.
authors.forename: Reyn
authors.initials: R
authors.lastname: van Ewijk
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University Mainz, Mainz, Germany.
authors.forename: Maria
authors.initials: M
authors.lastname: Blettner
authors.affiliation: Department of Gynaecology and Obstetrics, University of Würzburg, Würzburg, Germany.
authors.forename: Achim
authors.initials: A
authors.lastname: Wöckel
authors.affiliation: Department of Gynaecology and Obstetrics, Hospital Esslingen, Esslingen, Germany.
authors.forename: Thorsten
authors.initials: T
authors.lastname: Kühn
authors.affiliation: Department of Gynaecology and Obstetrics, Hospital Kempten, Kempten, Germany.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Felberbaum
authors.affiliation: Department of Gynaecology and Obstetrics, Hospital Memmingen, Memmingen, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Flock
authors.affiliation: Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Janni
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D008875:Middle Aged; D016017:Odds Ratio; D063868:Patient Outcome Assessment; D010817:Physician-Patient Relations; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology* / Q000523:psychology