Prevalence and Predictors of the Short-Term Trajectory of Anxiety and Depression in the First Year After a Cancer Diagnosis: A Population-Based Longitudinal Study

  • Allison W. Boyes
    Allison W. Boyes, Catherine A. D'Este, Alison C. Zucca, Mariko L. Carey, University of Newcastle and Hunter Medical Research Institute; Christophe Lecathelinais, Hunter New England Population Health, Newcastle; Afaf Girgis, Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, Australia.
  • Afaf Girgis
    Allison W. Boyes, Catherine A. D'Este, Alison C. Zucca, Mariko L. Carey, University of Newcastle and Hunter Medical Research Institute; Christophe Lecathelinais, Hunter New England Population Health, Newcastle; Afaf Girgis, Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, Australia.
  • Catherine A. D'Este
    Allison W. Boyes, Catherine A. D'Este, Alison C. Zucca, Mariko L. Carey, University of Newcastle and Hunter Medical Research Institute; Christophe Lecathelinais, Hunter New England Population Health, Newcastle; Afaf Girgis, Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, Australia.
  • Alison C. Zucca
    Allison W. Boyes, Catherine A. D'Este, Alison C. Zucca, Mariko L. Carey, University of Newcastle and Hunter Medical Research Institute; Christophe Lecathelinais, Hunter New England Population Health, Newcastle; Afaf Girgis, Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, Australia.
  • Christophe Lecathelinais
    Allison W. Boyes, Catherine A. D'Este, Alison C. Zucca, Mariko L. Carey, University of Newcastle and Hunter Medical Research Institute; Christophe Lecathelinais, Hunter New England Population Health, Newcastle; Afaf Girgis, Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, Australia.
  • Mariko L. Carey
    Allison W. Boyes, Catherine A. D'Este, Alison C. Zucca, Mariko L. Carey, University of Newcastle and Hunter Medical Research Institute; Christophe Lecathelinais, Hunter New England Population Health, Newcastle; Afaf Girgis, Ingham Institute for Applied Medical Research, University of New South Wales, Sydney, Australia.

説明

<jats:sec><jats:title>Purpose</jats:title><jats:p> Few studies have examined psychological adjustment for cancer survivors in late treatment and early survivorship stages. Our study investigated the prevalence and short-term trajectories of anxiety, depression, and comorbid anxiety-depression among adult cancer survivors, and identified the individual, disease, health behavior, psychological, and social predictors of chronic and late psychological morbidity. </jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p> A heterogeneous sample of adult cancer survivors was recruited from two state-based cancer registries. A total of 1,154 survivors completed self-report questionnaires at 6 (Time 1) and 12 months (Time 2) postdiagnosis. Anxiety and depression were assessed by the Hospital Anxiety and Depression Scale with cases identified by a subscale cutoff score ≥ 8. Logistic regression analyses identified Time 1 characteristics associated with anxiety and/or depression at Time 2. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> The point prevalence of anxiety (Time 1, 22%; Time 2, 21%), depression (13% at both timepoints) and comorbid anxiety-depression (9% at both timepoints) was similar at 6 and 12 months postdiagnosis. The most prevalent Time 1 to Time 2 trajectory was noncase for anxiety (70%), depression (82%), and comorbid anxiety-depression (87%). While psychological morbidity at Time 1 was the strongest predictor of psychological morbidity at Time 2, being diagnosed with lung cancer and health risk behaviors (smoking, insufficient physical activity) were also strong predictors. </jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p> Targeted psychological screening of vulnerable survivors and early intervention may prevent the onset and/or reduce the severity of psychological morbidity in early survivorship. Trials of risk reduction interventions targeting psychological functioning and health risk behaviors seem warranted. </jats:p></jats:sec>

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