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Depression as a prognostic factor for breast cancer mortality
Karen Hjerl1, Elisabeth W Andersen, Niels Keiding
1Center of Preventive Medicine, Glostrup University Hospital, Glostrup, Denmark. khjerl@dadlnet.dk
Psychosomatics
|January 8, 2003
Summary
Breast cancer patients with depression show a modestly increased mortality risk. This risk varies by cancer stage and timing of depression diagnosis, even after excluding unnatural deaths.
Area of Science:
- Oncology
- Psychiatry
- Epidemiology
Background:
- The impact of depression on breast cancer patient mortality remains unclear.
- Depression is a common comorbidity in cancer patients, potentially affecting outcomes.
Purpose of the Study:
- To investigate the association between depression and mortality risk in breast cancer patients.
- To analyze this association based on breast cancer stage and the timing of depression diagnosis.
Main Methods:
- Population-based, nationwide, retrospective cohort study in Denmark.
- Depression defined as psychiatric hospital admission for affective or anxiety disorders.
- Survival analysis using Cox's regression on data from three central registers, adjusted for somatic prognostic variables.
Main Results:
- Breast cancer patients with depression exhibited a significantly higher risk of mortality.
- The increased mortality risk was dependent on the stage of breast cancer and the time of depression diagnosis.
- This association persisted after censoring unnatural causes of death (e.g., suicide, accidents).
Conclusions:
- Depression is associated with an increased mortality risk in breast cancer patients.
- Clinical management of breast cancer should consider the impact of comorbid depression.
- Further research is warranted to explore the mechanisms underlying this association.