Association of Coping Style, Cognitive Errors and Cancer-related Variables with Depression in Women Treated for Breast Cancer

Abstract

Objective: The purpose of this study was to examine the correlation between depression levels with coping styles and cognitive errors in women treated for breast cancer. Methods: A total of 110 breast cancer outpatients who had had surgery at least 6 months previously, had completed adjuvant cancer treatment and had not experienced metastasis or recurrent lesions were evaluated. The Automatic Thoughts Questionnaire, Cognitive Errors Questionnaire, Mental Adjustment to Cancer Scale and Beck Depression Inventory were administered to all patients. Semi-structured interview forms were used to obtain medical and demographic data. All patients were categorized into depression and non-depression groups according to their Beck Depression Inventory scores. The study protocol was approved by the Medical Ethics Committee of Istanbul University Oncology Institute. Results: Higher cognitive errors and automatic thought scores were found in the depression group. Fighting spirit was found to be the primary coping style used in the non-depression group, while helplessness/hopelessness, anxious/preoccupation and fatalism were the coping styles used the most in the depression group. No association between depression and sociodemographic (except for educational level) and cancer-related variables was detected. However, it was found that automatic thoughts, cognitive errors, education level, fighting spirit and anxious/preoccupation are important indicators of depression in our sample. Conclusions: A causal relationship exists between depression and a patient's cognitive patterns and accompanying anxiety. The degree of depression is inversely related to both fighting spirit coping type and educational level. If clinicians take this into consideration, diagnosing and treating depression will be more effective.

Prevalence of Depression in Breast Cancer Survivors: a Systematic Review of Observational Studies

“…Depression was most frequently associated with fatigue (Bower et al, 2000;Den Oudsten et al, 2009;Vahdaninia et al, 2010) followed by lower income/poor financial status (Eversley et al, 2005;Morrill et al, 2008;Chen et al, 2009), low education (Mehnert and Koch, 2008;Morrill et al, 2008;Alcalar et al, 2012) and younger age (Broeckel et al, 2000;Mehnert and Koch, 2008). Regarding marital status, being unmarried (Broeckel et al, 2000;Morrill et al, 2008), widowed or divorced (Chen et al, 2009) were significantly associated with depression although in contrast with one study which found being married (Pumo et al, 2012) was associated with depression.…”

“…Most of the studies were conducted in USA (thirteen), followed by in Europe (five) and four studies from United Kingdom. Seven studies were conducted in Asian countries (Inagaki et al, 2004;Chen et al, 2009;Karakoyun-Celik et al, 2010;Vahdaninia et al, 2010;Alcalar et al, 2012;Hsiao et al, 2012;Jang et al, 2012). Nineteen of the studies were cross-sectional design and twelve prospective studies.…”

“…The prevalence of depression in breast cancer survivors varied greatly from as low as 1% (Watson et al, 1999) to as high as 56% (BegovicJuhant et al, 2012) as shown in Table 2. The prevalence of depression from the Asian studies (Inagaki et al, 2004;Karakoyun-Celik et al, 2010;Vahdaninia et al, 2010;Chen et al, 2009;Alcalar et al, 2012;Hsiao et al, 2012;Jang et al, 2012) reported a narrower range of 12.5-31% (median=19%). Studies which used CES-D reported about similar prevalence of depression (median=22%, range=13-56%) with BDI (median=22%, range=17-48%) but higher than HADS (median=10%, range=1-22%).…”

“…The subjects' psychological factors that were associated with depression were preoperative helplessness/ hopelessness (Schou et al, 2004), high anxiety levels (Deshields et al, 2006;Alcalar et al, 2012), higher neuroticism score, lower agreeableness score, more pre-operative depressive symptoms (Den Oudsten et al, 2009), poor body image, less attractiveness, less feminine (Begovic-Juhant et al, 2012), negative automatic thoughts, more cognitive errors, low fighting spirit (Alcalar et al, 2012) and lacking presence of the meaning of life (Hsiao et al, 2012).…”

Impact of Adjuvant Chemoradiotherapy for Rectal Cancer on the Long-Term Quality of Life and Late Side Effects: A Multicentric Clinical Evaluation by the Turkish Oncology Group

“…The patients with a fighting attitude may survive longer than patients who stoically accept their fate. This attitude has been dubbed by the experts the "Fighting Spirit" (Alcalar et al, 2012). The perception of the treatmentrelated (including surgery) adverse effects and their impact on QOL might have been affected by this spiritual attitude.…”