title: Relationship between anxiety disorders and domains of health related quality of life among Nigerians with breast cancer.
abstract: OBJECTIVE
  Health Related Quality of life (HRQoL) is increasingly recognised as an important indicator of outcome and well-being in oncology care. We set out in this study to evaluate whether significant association exists between anxiety disorders (ADs) and HRQoL in breast cancer, such that any intervention addressing ADs would potentially improve HRQoL.
  
  
  METHODS
  A cross sectional evaluation of 200 attendees of an oncology clinic was done using designed questionnaire to gather socio-demographic and clinical data. Subsequently, the Schedule for clinical Assessment in Neuropsychiatry was used to ascertain ADs and the European Organization for Research and Treatment of Cancer QOL Questionnaire (THE EORTC QLQ-C30) Version 3 with its breast specific supplement (QLQ-BR-23) was used to profile HRQoL in participants.
  
  
  RESULTS
  The mean age of participants was 49.6(±11.2) years, and 54% of participants had stage III and IV breast cancer. Findings on EORTC QLQ-C30 following univariate analyses showed association between ADs and poorer mean scores on global health status, functional domains including physical, emotional, social, and cognitive functions (p < 0.05). On the symptom scale, those with ADs had higher symptom load including fatigue, pain, insomnia, appetite loss, diarrhoea and financial difficulties (p < 0.05). Similarly, the QLQ-BR-23 showed correlation between ADs and poorer mean scores on breast cancer specific issues like body image, future perspectives, sexual functioning, sexual enjoyment, systemic therapy side-effects, upset by hair loss and breast symptoms (p < 0.05). Findings after controlling for age, treatment, cancer duration, recurrence and stage showed the same pattern of relationship between ADs and HRQoL; however, the global health status, cognition, sexual functioning, and higher symptom load with respect to appetite loss and financial difficulties were not independently related with ADs.
  
  
  CONCLUSIONS
  Scaling up of oncological services, supportive care and targeted psychosocial interventions are indicated for optimal outcome of breast cancer. Longitudinal research with focus on the complex relationship between HRQoL and ADs along with their modifiable determinants across the trajectories of breast cancer is warranted.
authors.affiliation: Federal Neuropsychiatric Hospital, PMB 2008, Yaba, Lagos, Nigeria; Department of Psychiatry, Lagos University Teaching Hospital, PMB 12003, Lagos, Nigeria.
authors.forename: Olamijulo Adedeji
authors.initials: OA
authors.lastname: Fatiregun
authors.affiliation: Department of Psychiatry, College of Medicine, University of Lagos, PMB 12003, Lagos, Nigeria; Department of Psychiatry, Lagos University Teaching Hospital, PMB 12003, Lagos, Nigeria. Electronic address: aolagunju@unilag.edu.ng.
authors.forename: Andrew Toyin
authors.initials: AT
authors.lastname: Olagunju
authors.affiliation: Department of Psychiatry, College of Medicine, University of Lagos, PMB 12003, Lagos, Nigeria; Department of Psychiatry, Lagos University Teaching Hospital, PMB 12003, Lagos, Nigeria.
authors.forename: Adebayo Rasheed
authors.initials: AR
authors.lastname: Erinfolami
authors.affiliation: Population Council, Lagos, Nigeria.
authors.forename: Olubunmi Ayodele
authors.initials: OA
authors.lastname: Arogunmati
authors.affiliation: Lagos State University Teaching Hospital, Ikeja, Nigeria.
authors.forename: Omolara Amina
authors.initials: OA
authors.lastname: Fatiregun
authors.affiliation: Department of Psychiatry, College of Medicine, University of Lagos, PMB 12003, Lagos, Nigeria; Department of Psychiatry, Lagos University Teaching Hospital, PMB 12003, Lagos, Nigeria.
authors.forename: Joseph Dada
authors.initials: JD
authors.lastname: Adeyemi
mesh_terms: D000328:Adult; D000505:Alopecia / Q000523:psychology; D001008:Anxiety Disorders / Q000523:psychology*; D001066:Appetite; D001828:Body Image / Q000523:psychology; D001943:Breast Neoplasms / Q000523:psychology* / Q000628:therapy; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000523:psychology; D005221:Fatigue / Q000523:psychology; D006801:Humans; D008875:Middle Aged; D009549:Nigeria; D010146:Pain / Q000523:psychology; D011788:Quality of Life / Q000523:psychology*; D019529:Sexuality / Q000523:psychology; D007319:Sleep Initiation and Maintenance Disorders / Q000523:psychology; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Africa; Anxiety disorders; Breast cancer; Health related quality of life; Symptoms