The association of mood disorders with breast cancer survival: an investigation of linked cancer registration and hospital admission data for South East England

Abstract

BackgroundData linkage studies find that depression before or after a breast cancer diagnosis predicts reduced survival. This study aimed to determine whether depression or bipolar recorded in routine hospital admission data independently predicts survival in English breast cancer patients and whether onset in relation to cancer diagnosis is significant.MethodsData on 77 173 women diagnosed with breast cancer (ICD‐10 C50) in South East England, 2000–2009, were included. Of these, 131 women had a diagnosis of bipolar affective disorder (ICD‐10 F31) and 955 of depression (either depressive episodes (ICD‐10 F32) or depressive disorder (ICD‐10 F33)) recorded in Hospital Episode Statistics between 3 years before and a year following cancer diagnosis. Kaplan–Meier plots were used to examine overall survival. Cox regression analyses were carried out overall and separately for mood disorder diagnoses before and after the cancer diagnosis and adjusted for confounding variables.ResultsA record of depression was a predictor of worse overall survival in breast cancer patients (adjusted HR = 1.33, 95% CI: 1.20–1.48, p < 0.001), while the effect of bipolar was not statistically significant (adjusted HR = 1.33, 95% CI: 0.97–1.82, p = 0.079). New recordings of depression and bipolar diagnoses following a cancer diagnosis appeared better predictors of overall survival than a prior history of either.ConclusionsThere is evidence that English breast cancer patients with depression and bipolar recorded in routine hospital data have worse overall survival than those without these mood disorders. Further work exploring the concordance of records within administrative health data with clinical diagnosis and cause‐specific death within these patient groups is needed. © 2015 The Authors. Psycho‐Oncology Published by John Wiley & Sons Ltd.

Post-surgical depressive symptoms and long-term survival in non-metastatic breast cancer patients at 11-year follow-up

“…Results are consistent with studies showing that depressive symptoms predict mortality in breast cancer, as demonstrated in samples of non-metastatic [10,11] and metastatic breast cancer [9], and in a study combining all breast cancer stages [12]. Findings are in line with meta- analyses showing that higher levels of depressive symptoms predict elevated mortality in cancer patients [6,7] and in breast cancer patients specifically [4].…”

“…Estimates of prevalence of depression in women with breast cancer range as high as 37% [8]. Some individual studies [9-12] and meta-analyses [4,6,7] conclude that depressive symptoms predict higher all-cause mortality, though not breast cancer recurrence [6]. Other studies show no relationship between depressive symptoms and survival among breast cancer patients [13,14].…”

Family resilience and psychological well-being among Chinese breast cancer survivors and their caregivers

“…Previous studies have analysed the negative psychological reactions of survivors of breast cancer to their diagnoses and have found associations with sleep disturbances, fatigue, mood disorders and depression (Ancoli‐Israel et al, ; Di Giacomo et al, ; Kanani, Davies, Hanchett, & Jack, ). However, there has been a growing interest in patients' positive psychological functioning during their experiences with cancer, such as optimism, hope, resilience and post‐traumatic growth (Casellas‐Grau, Vives, Font, & Ochoa, ; Tedeschi & Calhoun, ).…”

Self-Compassion and Breast Cancer in 23 Cancer Respondents: Is the Way You Relate to Yourself a Factor in Disease Onset and Progress?

“…We do know that emotions affect outcomes in breast cancer via mood states such as depression (Kanani, Davies, Hanchett, & Jack, 2016) and that in general health terms studies in related fields such as prostate cancer (Sharp, O'Leary, Kinnear, Gavin, & Drummond, 2015) have recommended interventions aimed at decreasing depression, anxiety and stress levels in cancer patients. However, little attention has been given to emotion regulation strategies such as self-compassion as an intervention that may influence how individuals with cancer manage stress and the subsequent physiological hyper-arousal responses that can affect immune system functioning.…”