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Annals of Behavioral Medicine
Published in: Annals of Behavioral Medicine 3/2014

01-06-2014 | Original Article

Depressive Symptom Trajectories During and After Adjuvant Treatment for Breast Cancer

Authors: Kristine A. Donovan, Ph.D., Brian D. Gonzalez, Ph.D., Brent J. Small, Ph.D., Michael A. Andrykowski, Ph.D., Paul B. Jacobsen, Ph.D.

Published in: Annals of Behavioral Medicine | Issue 3/2014

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Abstract

Background

The course of depressive symptoms during and after breast cancer treatment is not well understood.

Purpose

We identified patient subgroups based on distinct trajectories of depressive symptoms and determined whether subgroups could be distinguished by personal characteristics and coping strategies.

Methods

Breast cancer patients completed the Center for Epidemiologic Studies–Depression Scale on clinically meaningful occasions and during the posttreatment period. The Illness Management Questionnaire was completed prior to treatment.

Results

A three-class mixture model provided the best fit to the data. Subgroup membership was significantly (p < .05) associated with marital status, history of depression, and focusing on symptoms. In multivariate analysis, marital status and focusing on symptoms remained significant (p < .05) predictors of subgroup membership.

Conclusions

Distinct trajectories can be identified during and after adjuvant breast cancer therapy. Predictors of these trajectories have implications for addressing depressive symptoms in this clinical population and for future research.
Footnotes
1
Following a reviewer's suggestion, we reran the three class model constraining the intercept and slope covariance to zero for all three classes and allowing the intercept and slope variance in each class to be freely estimated. Unfortunately, the convergence problem was not remedied and the slope variance for the highest depressive symptom class was negative. Moreover, the fit of the model with the covariances constrained was not appreciably better than the three class model that we originally reported (−2ll = 2,611.93, df = 17, AIC = 5,257.85, BIC = 5,308.69). As such, we have retained the three class model.
 
Literature
1.
Deshields T, Tibbs T, Fan MY, Taylor M. Differences in patterns of depression after treatment for breast cancer. Psycho-Oncology. 2006; 15: 398-406.PubMedCrossRef
2.
Ganz PA, Kwan L, Stanton AL, et al. Quality of life at the end of primary treatment of breast cancer: First results from the Moving Beyond Cancer randomized trial. JNCI. 2004; 96: 376-387.PubMedCrossRef
3.
Christensen S, Zachariae R, Jensen AB, et al. Prevalence and risk of depressive symptoms 3–4 months postsurgery in a nationwide cohort study of Danish women treated for early stage breast cancer. Breast Cancer Res Treat. 2009; 113: 339-355.PubMedCrossRef
4.
Luutonen S, Vahlberg T, Eloranta S, Hyvari H, Salminen E. Breast cancer patients receiving postoperative radiotherapy: distress, depressive symptoms, and unmet needs of psychosocial support. Rad Onc. 2011; 100: 299-303.CrossRef
5.
Hopwood P, Howell A, Maguire P. Psychiatric morbidity in patients with advanced cancer of the breast; prevalence measured by two self-rating questionnaires. British J Cancer. 1991; 64: 349-352.CrossRef
6.
Cantarero-Villanueva I, Fernandez-Lao D. Associations among musculoskeletal impairments, depression, body image and fatigue in breast cancer survivors within the first year after treatment. Eur J Cancer. 2011; 20: 632-639.CrossRef
7.
Meyer L, Aspergren K. Long-term psychological sequelae of mastectomy and breast conserving treatment for breast cancer. Acta Onc. 1989; 28: 13-18.CrossRef
8.
Den Oudsten BL, Van Heck GL, Van der Steeg AF, Roukema JA, De Vries J. Predictors of depressive symptoms 12 months after surgical treatment of early-stage breast cancer. Psycho-Oncology. 2009; 18: 1230-1237.CrossRef
9.
Hill J, Holcombe C, Clark L, et al. Predictors of onset of depression and anxiety in the year after diagnosis of breast cancer. Psychol Med. 2011; 41: 1429-1436.PubMedCrossRef
10.
Costanzo ES, Lutgendorf SK, Mattes ML, et al. Adjusting to life after treatment: distress and quality of life following treatment for breast cancer. British J Cancer. 2007; 97: 1625-1631.CrossRef
11.
Burgess C, Cornelius V, Love S, et al. Depression and anxiety in women with early breast cancer: 5 year observational cohort study. BMJ. 2005; 330: 702.PubMedCentralPubMedCrossRef
12.
Schlegel RJ, Manning MA, Molix LA, Talley AE, Bettencourt BA. Predictors of depressive symptoms among breast cancer patients during the first year post diagnosis. Psychol Health. 2012; 27: 277-293.PubMedCrossRef
13.
Carragher N, Adamson G, Bunting B, McCann S. Subtypes of depression in a nationally representative sample. J Affect Dis. 2009; 113: 88-99.PubMedCrossRef
14.
Colman I, Ploubidis GB, Wadsworth ME, Jones PB, Croudace TJ. A longitudinal typology of symptoms of depression and anxiety over the life course. Bio Psychiatry. 2007; 62: 1265-1271.CrossRef
15.
Norton S, Sacker A, Young A, Done J. Distinct psychological distress trajectories in rheumatoid arthritis: findings from an inception cohort. J Psychosom Res. 2011; 71: 290-295.PubMedCrossRef
16.
Murphy BM, Elliott PC, Higgins RO, et al. Anxiety and depression after coronary artery bypass graft surgery: Most get better, some get worse. Eur J Cardio PreventRehab. 2008; 15: 434-440.CrossRef
17.
Helgeson VS, Snyder P, Seltman H. Psychological and physical adjustment to breast cancer over 4 years: Identifying distinct trajectories of change. Health Psychol. 2004; 23: 3-15.PubMedCrossRef
18.
Henselmans I, Helgeson VS, Seltman H, et al. Identification and prediction of distress trajectories in the first year after a breast cancer diagnosis. Health Psychol. 2010; 29: 160-168.PubMedCrossRef
19.
Dunn LB, Cooper BA, Neuhaus J, et al. Identification of distinct depressive symptom trajectories in women following surgery for breast cancer. Health Psychol. 2011; 30: 683-692.PubMedCentralPubMedCrossRef
20.
Radloff LS. A self-report depression scale for research in the general population. App Psychol Measure. 1977; 1: 385-401.CrossRef
21.
Nesselroade JR, Baltes PB. Longitudinal Research in the Study of Behavior and Development. New York: Academic; 1979.
22.
Jim HS, Small BJ, Minton S, Andrykowski M, Jacobsen PB. History of major depressive disorder prospectively predicts worse quality of life in women with breast cancer. Ann Behav Med. 2012; 43: 402-408.PubMedCentralPubMedCrossRef
23.
ten Doesschate MC, Bockting CL, Koeter MW, Schene AH. Prediction of recurrence in recurrent depression: A 5.5-year prospective study. J Clin Psychiatry. 2010; 71: 984-991.PubMedCrossRef
24.
Bockting CL, Spinhoven P, Koeter MW, Wouters LF, Schene AH. Prediction of recurrence in recurrent depression and the influence of consecutive episodes on vulnerability for depression: A 2-year prospective study. J Clin Psychiatry. 2006; 67: 747-755.PubMedCrossRef
25.
Solomon DA, Keller MB, Leon AC, et al. Multiple recurrences of major depressive disorder. AmerJ Psychiatry. 2000; 157: 229-233.
26.
Belsher G, Costello CG. Relapse after recovery from unipolar depression: a critical review. Psychol Bull. 1988; 104: 84-96.PubMedCrossRef
27.
Keller MB, Lavori PW, Lewis CE, Klerman GL. Predictors of relapse in major depressive disorder. JAMA. 1983; 250: 3299-3304.PubMedCrossRef
28.
Conradi HJ, de Jonge P, Ormel J. Prediction of the three-year course of recurrent depression in primary care patients: different risk factors for different outcomes. J Affect Disorders. 2008; 105: 267-271.PubMedCrossRef
29.
Kuehner C, Weber I. Responses to depression in unipolar depressed patients: An investigation of Nolen-Hoeksema's response styles theory. Psychol Med. 1999; 29: 1323-1333.PubMedCrossRef
30.
Blalock JA, Joiner TE Jr. Interaction of cognitive avoidance coping and stress in predicting depression and anxiety: Gender differences. Cog TherRes. 2000; 24: 47-65.CrossRef
31.
Ray C, Weir W, Stewart D, Miller P, Hyde G. Ways of coping with chronic fatigue syndrome: Development of an illness management questionnaire. Soc Sci Med. 1993; 37: 385-391.PubMedCrossRef
32.
Kraemer LM, Stanton AL, Meyerowitz BE, Rowland JH, Ganz PA. A longitudinal examination for couples' coping strategies as predictors of adjustment to breast cancer. J Fam Psychol. 2011; 25: 963-972.PubMedCentralPubMedCrossRef
33.
Low CA, Stanton AL, Thompson N, Kwan L, Ganz PA. Contextual life stress and coping strategies as predictors of adjustment to breast cancer survivorship. Ann Beh Med. 2006; 32: 235-244.CrossRef
34.
Stanton AL, Danoff-Burg S, Huggins ME. The first year after breast cancer diagnosis: hope and coping strategies as predictors of adjustment. Psycho-Oncology. 2002; 11: 93-102.PubMedCrossRef
35.
Ransom S, Jacobsen PB, Schmidt JE, Andrykowski MA. Relationship of problem-focused coping strategies to changes in quality of life following treatment for early stage breast cancer. J Pain Symptom Manage. 2005; 30: 243-253.PubMedCrossRef
36.
Andrykowski MA, Donovan KA, Laronga C, Jacobsen PB. Prevalence, predictors, and characteristics of off-treatment fatigue in breast cancer survivors: A longitudinal, multisite study. Cancer. 2010; 116: 5740-5748.PubMedCrossRef
37.
Andrykowski MA, Schmidt JE, Salsman JM, Beacham AO, Jacobsen PB. Use of a case definition approach to identifying cancer-related fatigue in women undergoing adjuvant therapy for breast cancer. J Clin Onc. 2005; 23: 6613-6622.CrossRef
38.
Jones BL, Nagin DS, Roeder K. A SAS procedure based on mixture models for estimating developmental trajectories. Sociol Methods Res. 2001; 29: 374-393.CrossRef
39.
Muthen BO. Latent variable analysis. Growth mixture modeling and related techniques. In: Kapland D, ed. Handbook of Quantitative Methodology for the Social Sciences. Newbury Park, CA: Sage; 2004: 345-369.
40.
Donovan KA, Small BJ, Andrykowski MA, Munster P, Jacobsen PB. Utility of a cognitive–behavioral model to predict fatigue following breast cancer treatment. Health Psychol. 2007; 26: 464-472.PubMedCentralPubMedCrossRef
41.
Jacobsen PB, Donovan KA, Small BJ, et al. Fatigue after treatment for early stage breast cancer: A controlled comparison. Cancer. 2007; 110: 1851-1859.PubMedCentralPubMedCrossRef
42.
Katz JN, Chang LC, Sangha O, Fossel AH, Bates DW. Can comorbidity be measured by questionnaire rather than medical record review? Med Care. 1996; 34: 73-84.PubMedCrossRef
43.
Ray C, Jefferies S, Weir W. Coping with chronic fatigue syndrome: illness responses and their relationship with fatigue, functional impairment, and emotional status. Psychol Med. 1995; 25: 937-945.PubMedCrossRef
44.
Ray C, Jefferies S, Weir WR. Coping and other predictors of outcome in chronic fatigue syndrome: A 1-year follow-up. J Psychosom Res. 1997; 43: 405-415.PubMedCrossRef
45.
First MB, Gibbons M, Spitzer RL. User's Guide for the Structured Clinical Interview for DSM-IV Axis I Disorders: Research Version. New York: Biometrics Research; 1996.
46.
Beeber LS, McCorkle R. The Center for Epidemiologic Studies Depression Scale as a measure of depressive symptoms in newly diagnosed patients. J Psychosoc Onc. 1998; 16: 1-20.CrossRef
47.
Hann D, Winter K, Jacobsen P. Measurement of depressive symptoms in cancer patients: Evaluation of the Center for Epidemiological Studies Depression Scale (CES-D). J Psychosom Res. 1999; 46: 437-443.PubMedCrossRef
48.
Littell RC, Milliken GA, Stroup WW, Wolfinger RD, Schabenberger O. SAS for Mixed Models. 2nd ed. Cary, NC: SAS Press; 2006.
49.
Ram N, Grimm KJ. Methods and measures: Growth mixture modeling: a method for identifying differences in longitudinal change among unobserved groups. Internat J Behav Dev. 2009; 33: 565-576.CrossRef
50.
Lo Y, Mendell NRR, DB: Testing the number of components in a normal mixture. Biometrika. 2001; 88:767–778
51.
Jedidi K, Ramaswamy VV, Desarbo WS. A maximum likelihood method for latent class regression involving a censored dependent variable. Psychometrika. 1993; 358: 373-394.
52.
Greenbaum PE, Del Boca FK, Darkes J, Wang CP, Goldman MS. Variation in the drinking trajectories of freshmen college students. J Consul Clin Psychol. 2005; 73: 229-238.CrossRef
53.
54.
Dy SM, Lorenz KA, Naeim A, et al. Evidence-based recommendations for cancer fatigue, anorexia, depression, and dyspnea. J ClinOnc. 2008; 26: 3886-3895.CrossRef
55.
Jacobsen PB, Wagner LI. A new quality standard: The integration of psychosocial care into routine cancer care. J Clin Onc. 2012; 30: 1151-1153.CrossRef
56.
Velikova G. Patient benefits from psychosocial care: Screening for distress and models of care. J Clin Onc. 2010; 28: 4871-4872.CrossRef
57.
Gielissen MFM, Verhagen S, Witjes F, Bleijenberg G. Effects of cognitive behavior therapy in severely fatigued disease-free cancer patients compared with patients waiting for cognitive behavior therapy: A randomized controlled trial. J Clin Onc. 2006; 24: 4882-4887.CrossRef
Metadata
Title
Depressive Symptom Trajectories During and After Adjuvant Treatment for Breast Cancer
Authors
Kristine A. Donovan, Ph.D.
Brian D. Gonzalez, Ph.D.
Brent J. Small, Ph.D.
Michael A. Andrykowski, Ph.D.
Paul B. Jacobsen, Ph.D.
Publication date
01-06-2014
Publisher
Springer US
Published in
Annals of Behavioral Medicine / Issue 3/2014
Print ISSN: 0883-6612
Electronic ISSN: 1532-4796
DOI
https://doi.org/10.1007/s12160-013-9550-2

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