Gwen W-J Lau, Allison M Deal, Annie B Page, Hyman B Muss, Zev M Nakamura
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引用次数: 0
Abstract
Objective: To characterize changes in depressive and anxiety symptoms during breast cancer chemotherapy and investigate how smoking, alcohol use, and physical activity impact these symptoms.
Methods: We conducted a secondary analysis of depressive and anxiety symptoms experienced by women with stage I-III breast cancer during the first 12 weeks of chemotherapy. Symptoms were evaluated using single-item measures (PRSM, PRO-CTCAE) at repeated timepoints. Generalized estimating equation methods estimated the odds of experiencing depressive or anxiety symptoms according to baseline smoking, alcohol use, and physical activity, adjusting for age, race, living alone, and chemotherapy regimen. Cochran Mantel Haenszel tests explored relationships between health behaviors and mental health symptom patterns.
Results: Among 330 participants, 74% were White, 77% had stage I or II breast cancer, and 41% received anthracycline-based regimens. At least moderately severe depressive and anxiety symptoms were reported by 27% and 38%, respectively, and were most prevalent during the first 3 weeks of chemotherapy. Participants who reported current smoking had higher odds of depressive symptoms compared to those who never smoked (aOR 3.17, 95% CI 1.27-7.96) and higher odds of anxiety symptoms compared to both participants who never (aOR 3.67, 95% CI 1.70-7.95) and previously smoked (aOR 3.03, 95% CI 1.5-6.79). Participants who reported current smoking were also more likely to experience delayed and persistent patterns of anxiety.
Conclusions: While depressive and anxiety symptoms declined over time, a substantial minority (≥ 27%) experienced at least moderately severe symptoms during chemotherapy. Patients who smoke may be at particularly elevated risk.
期刊介绍:
Psycho-Oncology is concerned with the psychological, social, behavioral, and ethical aspects of cancer. This subspeciality addresses the two major psychological dimensions of cancer: the psychological responses of patients to cancer at all stages of the disease, and that of their families and caretakers; and the psychological, behavioral and social factors that may influence the disease process. Psycho-oncology is an area of multi-disciplinary interest and has boundaries with the major specialities in oncology: the clinical disciplines (surgery, medicine, pediatrics, radiotherapy), epidemiology, immunology, endocrinology, biology, pathology, bioethics, palliative care, rehabilitation medicine, clinical trials research and decision making, as well as psychiatry and psychology.
This international journal is published twelve times a year and will consider contributions to research of clinical and theoretical interest. Topics covered are wide-ranging and relate to the psychosocial aspects of cancer and AIDS-related tumors, including: epidemiology, quality of life, palliative and supportive care, psychiatry, psychology, sociology, social work, nursing and educational issues.
Special reviews are offered from time to time. There is a section reviewing recently published books. A society news section is available for the dissemination of information relating to meetings, conferences and other society-related topics. Summary proceedings of important national and international symposia falling within the aims of the journal are presented.