Factors Affecting Anxiety and Depression in Patients with Breast Cancer during Child-rearing

<p>Background : Breast cancer often affects women in their 30s and 40s. Owing to the increase in maternal age in recent years, the timing and provision of treatment overlaps with the period of child-rearing in patients. Child-rearing patients with cancer likely experience significant psychological distress, but the impacts of child-rearing-related anxiety and depression in these patients have not been adequately investigated in Japan. The aims of this study were to determine the levels of anxiety and depression among child-rearing patients with cancer and to investigate impacts of child-rearing-related factors, including concerns about parental roles and parent-child relationships.</p><p>Subjects : Subjects were patients with breast cancer aged 20 years or older who were diagnosed within the past 10 years and who were living with at least one child aged 18 years or younger. All subjects were native Japanese speakers. Data were collected via self-administered questionnaires composed of the following items : general information about the subjects and their children ; basic clinical information ; an original scale on parental interactions with children ; and the FACT-G, BCWI, and HADS scales for assessing quality of life (QOL), concerns, anxiety, and depression. Between-group comparisons, multiple regression and factor analysis were used to model factors affecting anxiety and depression. This study was approved by the institutional review board at Tohoku University School of Medicine (2019-1-785). </p><p>Results : We obtained 63 valid responses. Compared with the low-anxiety group, the high-anxiety group showed significantly higher levels of concerns about the “future,” their “physical body,” and “interpersonal and societal relations” (all p<.001). Compared with low-anxiety and low-depression groups, “psychological aspects” and “functional aspects” of QOL were significantly lower in the respective high-anxiety (p<.001) and high-depression (p<.05) groups. “Societal and familial aspects” of QOL were also significantly lower in the high-depression group than in the low-depression group (p<.05). The following two items were identified as factors contributing to anxiety : “it’ s hard to talk about the future” and “my child and I understand each other’ s intentions and thoughts” (both p<.05). The following three items were identified as factors in depression : “presence or absence of recurrence,” “I tend to avoid topics related to my illness,” and “my child and I understand each other’ s intentions and thoughts” (all p<.01). Factor analysis revealed the following three factors as concerns related to the child-rearing : “fearing negative effects of my illness on my child,” “parent-child relationships,” and “hoping to be a good parent.” </p><p>Conclusion : In addition to their anxiety about their illness, child-rearing patients with breast cancer appeared to worry about their children as mothers, thereby affecting their overall levels of anxiety and depression. Greater understanding about the psychological support necessary for child-rearing patients with cancer is required to reduce their anxiety and provide appropriate care accordingly.</p>