Psychosocial Resilience to Inflammation-Associated Depression: A Prospective Study of Breast-Cancer Survivors

Manigault, Andrew W.; Kuhlman, Kate R.; Irwin, Michael R.; Cole, Steve W.; Ganz, Patricia A.; Crespi, Catherine M.; Bower, Julienne E.

doi:10.1177/09567976221079633

Cited by 15 publications

(8 citation statements)

References 70 publications

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“…In breast cancer survivors one year post-radiotherapy, both depressive symptoms and higher inflammatory markers were independent risk factors of fatigue; however, the correlation between depressive symptoms and inflammatory markers was not statistically significant 49 , 50 . CRP was positively associated with depressive symptoms only among women who reported high levels of cancer-related stress in a longitudinal study of women with breast cancer 51 . Inflammation was positively correlated with depressive symptoms only in women who also reported high level of anxiety, perceived stress, negative affect, or sleep disturbance 52 .…”

Section: Discussionmentioning

confidence: 92%

Psychological measures of stress and biomarkers of inflammation, aging, and endothelial dysfunction in breast cancer survivors on aromatase inhibitors

Blaes

Nair

Everson‐Rose

et al. 2023

Sci Rep

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The use of aromatase inhibitors (AIs) is associated with higher rates of cardiovascular events and lower endothelial function in breast cancer survivors. Psychosocial stress is associated with higher levels of inflammatory and aging markers, and lower endothelial function in otherwise healthy subjects. These associations among breast cancer survivors on AIs are not well defined. A cross-sectional study of 30 breast cancer survivors on AIs was performed to assess the associations between self-reported scores of psychosocial measures of depression, anxiety, and stress assessed by validated questionnaires with markers of inflammation (CRP; IL-6; IL-18), aging (p16INK4a), and endothelial function (ICAM-1, EndoPAT ratio). Significant positive correlations were observed between psychosocial measures and inflammatory markers including CRP, IL-6, and ICAM-1. However, no psychosocial scores were related to endothelial function or gene expression of the aging biomarker p16INK4a. Overall, survivors had endothelial dysfunction with reduced EndoPAT ratios. Psychosocial stress is associated with greater inflammation in breast cancer survivors on AIs, corroborating previous studies in cancer-free populations. The lack of association between psychosocial stress and either endothelial function or aging biomarkers could be due to the already low endothelial function and accelerated aging in our cohort of breast cancer survivors on AIs, though our small sample size limits conclusions. Further work in a larger and more diverse cohort of patients is needed to further understand the relationships among inflammation, aging and endothelial function in breast cancer survivors.

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Section: Discussionmentioning

confidence: 92%

Psychological measures of stress and biomarkers of inflammation, aging, and endothelial dysfunction in breast cancer survivors on aromatase inhibitors

Blaes

Nair

Everson‐Rose

et al. 2023

Sci Rep

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“…This physiological process can assist the body in coping with systemic changes, such as in ammation and ischemia (34). Neuroin ammation and oxidative stress may mediate the pathogenesis of depression (35), and PUFAs show anti-in ammatory, anti-apoptotic, antioxidant, and neuroprotective properties; MUFAs also seem to reduce oxidative stress (36). IL-1, IL-6, and IFN-α can induce apoptosis and reduce neurogenesis, whereas PUFAs can reduce in ammation through lipoxygenase (LOX) and cytochrome P450 (CYP450) (37).…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between Different Fatty Acids Intake and the Presence of Depression: A Population-Based Study

Zheng

liu

Lin

et al. 2023

Preprint

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Background Depression is a common psychological disorder worldwide. Previous studies have explored the benefits of polyunsaturated fatty acids (PUFAs) in depression; however, few studies have focused on the association between different fatty acids and depression. Therefore, we explored the effect of the intake of different fatty acids on the risk of depression. Methods The study was based on the data from the 2005–2018 National Health and Nutrition Examination Survey (NHANES). We used a nutrient residual model and multivariate nutrient density model. We calculated the nutrient density and residual in men and women separately, and the fatty acid intake was divided into quartiles based on the sex distribution. The relationship between depression and different fatty acids was examined using logistic regression; furthermore, we explored the relationships in men and women. Results Monounsaturated fatty acids (MUFAs) and PUFAs, particularly n-3 and n-6 PUFAs, were associated with reduced odds ratios for depression, in contrast to total fatty acids (TFAs). The protective effect against depression of TFAs, MUFAs, PUFAs, and n-3 and n-6 PUFAs was stronger in women. Conclusion A higher intake of fatty acids, including MUFAs and PUFAs, may protect against depression, especially in women.

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“…As a consequence, resilience provides wide-ranging benefits when an individual faces challenging life events and suffering, such as severe illness. Interestingly, breast cancer survivors with higher resilience have been shown to exhibit weaker associations between stress and depressive symptoms, and weaker association between stress and inflammation-associated depressive symptoms, specifically [ 25 ]. The authors suggested that psychosocial resilience may play an important role in protecting individuals from inflammation-associated depressive symptoms under conditions of high stress [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, breast cancer survivors with higher resilience have been shown to exhibit weaker associations between stress and depressive symptoms, and weaker association between stress and inflammation-associated depressive symptoms, specifically [ 25 ]. The authors suggested that psychosocial resilience may play an important role in protecting individuals from inflammation-associated depressive symptoms under conditions of high stress [ 25 ]. In a biological level, psychosocial stressors have been shown to produce inflammation [ 44 ], which in turn elicits sickness behaviors that includes depressive symptoms [ 45 ]; likewise, resilience can be viewed as including complex processes that require integration of multiple central (such as hypothalamic–pituitary–adrenal-axis [HPA-axis]) and peripheral systems (such as immune system and gut microbiota) [ 46 ].…”

Section: Discussionmentioning

confidence: 99%

“…Yet alleviation of depression, anxiety, and related symptoms in this population including both those with and without increased depressive symptoms has been shown robustly [ 23 , 24 ]. In turn, there are few or no studies that examine resilience [ 25 ], mindfulness skills [ 26 ], and self-compassion, in women with breast cancer. Relatively little is also known about the relationship between mindfulness practice time and different outcomes in participants with or in recovery of cancer, or cancer survivors [ 27 ], and the same applies to mindfulness-based interventions and changes of objective markers of stress in breast-cancer survivors, particularly among those with depression [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

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Mindfulness is associated with improved psychological well-being but no change in stress biomarkers in breast cancer survivors with depression: a single group clinical pilot study

et al. 2022

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Background The aim of this clinical single group pilot study was to assess mental well-being, psychological symptoms, and a set of stress biomarkers among breast cancer survivors with high depressive symptoms undergoing the Mindfulness-Based Stress Reduction (MBSR) program. Methods Participants included 23 curatively treated breast cancer survivors from the Helsinki University Central Hospital with clinically significant symptoms of depression (Beck Depression Inventory > 13, and assessed by a psychiatrist), at 1-year post-operative follow-up. Mental wellbeing and psychological symptoms were assessed with self-reported questionnaires (Resilience Scale, Self-Compassion Scale, Five Facet Mindfulness Questionnaire, World Health Organization Quality of Life-questionnaire, Perceived Stress Scale, Beck Depression Inventory, Beck Anxiety Inventory, Insomnia Severity Index); in addition, stress response was assessed with biomarkers (cortisol, adrenocorticotropine, and high-sensitivity-CRP from blood; 24 h-cortisol from urine). All measures were addressed at baseline, mid-program (4 weeks after baseline) and at the completion of the 8-week MBSR program. Engagement to the independent mindfulness home practice was collected with a diary. Results From baseline to the completion of the 8-week MBSR program, we observed significant increases in resilience (d = 0.60, p = 0.005), and quality of life (d = 0.92, p = 0.002), and significant reductions in symptoms of depression (d = − 1.17, p < 0.0001), anxiety (d = − 0.87, p < 0.0001), insomnia (d = − 0.58, p = 0.006), and marginally significant reduction in perceived stress (d = − 0.40, p = 0.09). We found no changes in self-compassion or mindfulness skills, nor in the stress biomarkers during or at the completion of the program. There was no association between the engagement time to the independent mindfulness practice and any of the outcomes. Conclusions Attending the MBSR program was associated with increased wellbeing and reduced psychological symptoms in breast cancer survivors with clinically significant symptoms of depression. However, these favorably experienced changes did not transfer to the level of stress biomarkers during the 8-week program. Lack of association between the engagement in the mindfulness home practice and change in outcomes suggests that in the studied range of practice time, other qualities of MBSR despite the amount of independent practice may have a more important role for the improved wellbeing. Trial registration ISRCTN12326308 at 16/02/2021, retrospectively registered.

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Psychosocial Resilience to Inflammation-Associated Depression: A Prospective Study of Breast-Cancer Survivors

Cited by 15 publications

References 70 publications

Psychological measures of stress and biomarkers of inflammation, aging, and endothelial dysfunction in breast cancer survivors on aromatase inhibitors

Psychological measures of stress and biomarkers of inflammation, aging, and endothelial dysfunction in breast cancer survivors on aromatase inhibitors

The Relationship Between Different Fatty Acids Intake and the Presence of Depression: A Population-Based Study

Mindfulness is associated with improved psychological well-being but no change in stress biomarkers in breast cancer survivors with depression: a single group clinical pilot study

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