Abstract
Depression is common in breast cancer patients. The aim of this paper was to make a systematic review of its prevalence and associated factors oin breast cancer survivors. An extensive systematic electronic review (PUBMED, CINAHL, PsyINFO and Ovid) and handsearch were carried out to retrieve published articles up to November 2012, using Depression OR Dysthymia AND (Cancer OR Tumor OR Neoplasms as the keywords. Information about the design of the studies, measuring scale, characteristics of the participants, prevalence of depression and its associated factors from the included studies were extracted and summarized. We identified 32 eligible studies that recruited 10,826 breast cancer survivors. Most were cross-sectional or prospective designed. The most frequent instrument used to screen depression was the Center for Epidemiological Studies for Depression (CES-D, n=11 studies) followed by the Beck Depression Inventory (BDI, n=6 studies) and the Hospital Anxiety and Depression Scale (HADS, n=6 studies). CES-D returned about similar prevalence of depression (median=22%, range=13-56%) with BDI (median=22%, range=17-48%) but higher than HADS (median=10%, range=1-22%). Depression was associated with several socio-demographic variables, cancer-related factors, treatment-related factors, subject psychological factors, lifestyle factors, social support and quality of life. Breast cancer survivors are at risk for depression so that detection of associated factors is important in clinical practice.
Highlights
Breast cancer has one of the highest five-year survival rates among female malignancies i.e. between 80% and 95% (Coleman et al, 2011)
Center for Epidemiological Studies – depression (CES-D) returned about similar prevalence of depression with Beck Depression Inventory (BDI) but higher than Hospital Anxiety and Depression Scale (HADS)
The prevalence of depression among breast cancer survivors varies across the extreme of 1-56% according to how it was defined
Summary
Breast cancer has one of the highest five-year survival rates among female malignancies i.e. between 80% and 95% (Coleman et al, 2011). A good review of this topic was conducted systematically (Fann et al, 2008) but did not focus on depression during survivorship; rather it looked at depression at no specific point of the disease These discrepancies emphasized the need to examine the current literature on depression among the breast cancer survivors. The focus on breast cancer survivors would provide a greater understanding of the frequency of depression and psychosocial characteristics of those in the period after going through a life threatening disease and its treatment. This paper aims to systematically review the medical literature which measured the prevalence of depression and examined the associated psychosocial and clinical factors of depression in breast cancer survivors.
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