Correlates of depressive symptomatology in African-American breast cancer patients

Abstract

Purpose This study assessed the levels of depressive symptomatology in African Americans women with breast cancer compared to those of women without breast cancer and examined demographic, psychosocial, and clinical factors were correlated with depression. Methods A total of 152 African American women were recruited from Washington DC and surrounding suburbs. Breast cancer patients (n=76 cases) were recruited from a healthcare center and women without cancer were recruited from health fairs (n=76 comparison). We assessed depression, psychosocial variables (ego strength and social support) and socio-demographic factors from in-person interviews. Stage and clinical factors were abstracted from medical records. Independent sample t-test, chi square test, ANOVA, and multiple regression models were used to identify differences in depression and correlates of depression among the cases and comparison groups. Results Women with breast cancer reported significantly greater levels of depression (m=11.5 SD=5.0) than women without breast cancer (m=3.9; SD=3.8) (p<.001). Higher cancer stage (beta=.91) and higher age (beta =.11) were associated with depression in the breast patients, explaining 84% of the variance. In the comparison group, ego strength and tangible support were inversely associated with depressive symptoms, accounting for 32% of the variance. Conclusions Women with more advanced disease may require interdisciplinary approaches to cancer care (i.e., caring for the whole person). Implications for cancer survivors Depression is often under-recognized and under-treated in African American breast cancer patients. Understanding the factors related to depression is necessary to integrate psychosocial needs to routine cancer care to improve survivors’ quality of life.

To be young, Black, and living with breast cancer: a systematic review of health-related quality of life in young Black breast cancer survivors

“…Moreover, one study documented lower psychological well-being among younger Black BC survivors relative to older Black survivors [57]. Similarly, another study found that young Black BC survivors were more likely to report depressive symptoms than young Black women with no BC history [58]. …”

“…Compared with older Black BC survivors and young Black women without BC, young Black BC survivors reported lower physical well-being and functioning [57, 58]. Issues related to infertility and sexual dysfunction (e.g., loss of sexual desire, vaginal dryness, pain during intercourse) were reported among young Black participants in one study [56].…”

“…With respect to psychological well-being, young Black women with BC reported greater fear of dying, but not fear of recurrence, compared with older Black women [55, 56]. They also reported greater depressive symptoms compared with young Black women without cancer [58]. Regarding social well-being, despite reporting greater social support than older Black women with BC, 30 % of young Black women expressed unmet social needs [58].…”

“…They also reported greater depressive symptoms compared with young Black women without cancer [58]. Regarding social well-being, despite reporting greater social support than older Black women with BC, 30 % of young Black women expressed unmet social needs [58]. Compared with young White women with BC, young Black women experienced greater financial distress [59].…”

Evaluating Survivorship Experiences and Needs Among Rural African American Breast Cancer Survivors

“…Previous investigators found that depression is underreported among AA-BCS. Further, measurements including self-report, used to identify depression, tend to be inadequate in identifying depressive symptomatology within this population [22][23][24]. For example, Zhang and Gary examined measurements to assess for depression and found that AA-BCS were less likely to say the word Bdepression^or discuss depressive symptoms compared to their Caucasian counterparts [22].…”