title: Predictors of depression and anxiety symptom trajectories in the 24 months following diagnosis of breast or gynaecologic cancer.
abstract: OBJECTIVE
  To identify predictors of anxiety and depression symptom trajectories, as distinct from general distress, in the 96 weeks following diagnosis of breast or gynaecologic cancer.
  
  
  METHODS
  Participants completed the Hospital Anxiety and Depression Scale anxiety subscale (HADS-A) and Centre for Epidemiological Studies Depression Scale (CES-D) at diagnosis and at 8-weekly intervals for 96 weeks. Linear mixed models were used to determine the effects of age, relationship status, tumour stream, cancer stage, living situation, residential area, educational status, current and previous anxiety/depression treatment and neuroticism on symptom trajectories.
  
  
  RESULTS
  Participants were 264 women with a mean (SD) age of 54 (12) years. Compared to non-treatment-receiving counterparts, women who received anxiety/depression treatment in the past had depression and anxiety symptom severity scores that were 4.58 and 1.24 higher, respectively. Women receiving such treatment at cancer diagnosis had depression and anxiety scores that were 4.34 and 2.35 points higher, respectively, than their counterparts. Compared to women with the lowest neuroticism scores, women with the highest scores scored 8.48 and 3.82 higher on the CES-D and HADS-A, respectively. Depressive severity remained stable but anxiety severity decreased as a function of neuroticism.
  
  
  CONCLUSIONS
  In settings with limited resources, women with high neuroticism or a depression/anxiety treatment history should be the initial target of psychological screening. Identification of women with these characteristics at the earliest point of entry into the oncology service followed by heightened surveillance and/or referral to psychosocial services may be useful to prevent chronic psychological morbidity.
authors.affiliation: Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Australia; Melbourne School of Psychological Sciences, University of Melbourne, Australia. Electronic address: Lesley.stafford@thewomens.org.au.
authors.forename: Lesley
authors.initials: L
authors.lastname: Stafford
authors.affiliation: Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Australia; Department of Psychiatry, University of Melbourne, Australia.
authors.forename: Angela
authors.initials: A
authors.lastname: Komiti
authors.affiliation: Department of Psychiatry, University of Melbourne, Australia; Department of General Practice, University of Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, University of Melbourne, Australia.
authors.forename: Chad
authors.initials: C
authors.lastname: Bousman
authors.affiliation: Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Australia; Department of Psychiatry, University of Melbourne, Australia.
authors.forename: Fiona
authors.initials: F
authors.lastname: Judd
authors.affiliation: Centre for Women's Mental Health, Royal Women's Hospital, Parkville, Australia.
authors.forename: Penny
authors.initials: P
authors.lastname: Gibson
authors.affiliation: The Breast Service, Royal Women's and Royal Melbourne Hospitals, Parkville, Australia; Department of Surgery, University of Melbourne, Australia.
authors.forename: G Bruce
authors.initials: GB
authors.lastname: Mann
authors.affiliation: Department of Obstetrics and Gynaecology, University of Melbourne, Australia; Oncology and Dysplasia Unit, Royal Women's Hospital, Parkville, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Quinn
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001007:Anxiety / Q000175:diagnosis / Q000209:etiology*; D001008:Anxiety Disorders / Q000523:psychology*; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology*; D003863:Depression / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology / Q000523:psychology*; D006801:Humans; D016014:Linear Models; D008875:Middle Aged; D009367:Neoplasm Staging; D000075384:Neuroticism; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Anxiety; Cancer; Depression; Distress; Oncology; Trajectory