title: Depressive symptom trajectories in women affected by breast cancer and their male partners: a nationwide prospective cohort study.
abstract: The purpose of this study was to identify subgroups of breast cancer patients and their partners based on distinct trajectories of depressive symptoms, to examine how relationship quality and medical and sociodemographic factors were associated with these trajectories, and to explore whether patients and partners had similar trajectories.
  
  
  
  A nationwide, population-based cohort of couples dealing with breast cancer was established in Denmark. Participants completed the Center for Epidemiologic Studies-Depression Scale at baseline and 5 and 12 months later. Sociodemographic and medical characteristics were retrieved from registers. A trajectory finite mixture model was used to identify trajectories.
  
  
  
  The trajectories of depressive symptoms over time were analyzed in 546 patients and 508 partners. Among patients, 13 % had a high stable trajectory, 38 % an intermediate decreasing trajectory, and 49 % a low trajectory. Similar trajectories were found for partners (11, 22, and 67 %, respectively). Compared to the low trajectory, trajectories with higher depressive symptoms were associated with poorer relationship quality and previous use of antidepressants for patients and partners and with younger age, comorbidity, basic education, and chemotherapy for patients. The trajectories of patients and their partners were weakly correlated.
  
  
  
  A considerable minority of patients and partners had a persistently high level of depressive symptoms. Poorer relationship quality and previous antidepressant use most consistently characterized patients and partners with higher depressive symptom trajectories.
  
  
  
  In clinical practice, attention to differences in depressive symptom trajectories is important to identify and target patients and partners who might need support.
authors.affiliation: National Research Centre for Cancer Rehabilitation, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, 5000, Odense C, Denmark. nrottmann@health.sdu.dk.|Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark. nrottmann@health.sdu.dk.
authors.forename: Nina
authors.initials: N
authors.lastname: Rottmann
authors.affiliation: National Research Centre for Cancer Rehabilitation, Research Unit of General Practice, Department of Public Health, University of Southern Denmark, J.B. Winsløws Vej 9, 5000, Odense C, Denmark.
authors.forename: Dorte Gilså
authors.initials: DG
authors.lastname: Hansen
authors.affiliation: Health Sciences/Health Psychology, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
authors.forename: Mariët
authors.initials: M
authors.lastname: Hagedoorn
authors.affiliation: Center for Clinical Epidemiology, Odense University Hospital, Sdr. Boulevard 29, 5000, Odense C, Denmark.|Research Unit of Clinical Epidemiology, Institute of Clinical Research, University of Southern Denmark, Sdr. Boulevard 29, 5000, Odense C, Denmark.
authors.forename: Pia Veldt
authors.initials: PV
authors.lastname: Larsen
authors.affiliation: Center for Quality, Region of Southern Denmark, P.V. Tuxensvej 5, 5500, Middelfart, Denmark.
authors.forename: Anne
authors.initials: A
authors.lastname: Nicolaisen
authors.affiliation: Unit of Survivorship, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen Ø, Denmark.
authors.forename: Pernille Envold
authors.initials: PE
authors.lastname: Bidstrup
authors.affiliation: Multidisciplinary Pain Center, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
authors.forename: Hanne
authors.initials: H
authors.lastname: Würtzen
authors.affiliation: Department of Breast Surgery, Herlev Hospital, University of Copenhagen, Herlev Ringvej 75, 2730, Herlev, Denmark.
authors.forename: Henrik
authors.initials: H
authors.lastname: Flyger
authors.affiliation: Department of Breast Surgery, PBB, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.|Danish Breast Cancer Cooperative Group, Rigshospitalet, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
authors.forename: Niels
authors.initials: N
authors.lastname: Kroman
authors.affiliation: Unit of Survivorship, Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen Ø, Denmark.|Oncology Department, Finsen Center, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, 2100, Copenhagen Ø, Denmark.
authors.forename: Christoffer
authors.initials: C
authors.lastname: Johansen
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology* / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000523:psychology* / Q000556:secondary / Q000628:therapy; D003131:Combined Modality Therapy; D003718:Denmark; D003863:Depression / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011379:Prognosis; D011446:Prospective Studies; D012747:Sexual Partners / Q000523:psychology*; D015996:Survival Rate; D017741:Survivors / Q000523:psychology*
keywords: Breast cancer; Cohort study; Couples; Depressive symptoms; Partner