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01-08-2006 | Original Research

Correlates of Depressive Symptoms Among Women Seeking Cancer Genetic Counseling and Risk Assessment at a High-Risk Cancer Clinic

Authors: Molly Middlecamp Kodl, Judith W. Lee, Alicia K. Matthews, Shelly A. Cummings, Olufunmilayo I. Olopade

Published in: Journal of Genetic Counseling | Issue 4/2006

Abstract

The aims of this study were to (1) assess the level of depression among women seeking cancer genetic counseling and risk assessment and to (2) identify and describe the demographic, health history, and health behavior correlates of clinically significant depression. Participants were 280 women presenting for an intake appointment at a university cancer risk clinic. During intake, participants completed questionnaires assessing demographics, health history, health practices, and depression. Twenty-eight percent of the sample met criteria for at least mild depression. Descriptive statistics indicated that depressed women were more likely to be African American, to have more children, less likely to receive a mammogram, and consumed fewer alcoholic drinks per week than nondepressed women. Given the known associations between depression, health behaviors such as cancer screening, and potential responses to the genetic testing process, assessment of mood disturbance remains an important consideration for genetic counselors.

To further investigate the possible difference in depression between women with and without a cancer history, total BDI scores were examined. Women with a cancer history reported higher numbers of BDI symptoms (M=7.82), on average, than did women with no history of cancer (M=5.94), t(278)=2.53, p<.05. Given the likely impact of a cancer diagnosis on behavior, we also explored potential health behavior differences between women with and without a history of cancer. Women with a history of cancer were more likely to report prior tobacco use (40.8%) than were women with no cancer history (28.6%), χ²(1)=4.26, p<.05. Similarly, women with a history of cancer were more likely to have received a mammogram (96.9%) than were women who had never had cancer (81.4%), χ²(1)=13.09, p<.001. Mammogram frequency did not differ by cancer status. Finally, women with no history of cancer were more likely to report receipt of a Pap smear (38.1%) than were women with a cancer history (24.2%), χ²(1)=5.56, p<.05. There were no other differences in health behavior between the groups.

Ahmed, N. U., Fort, J. G., Elzey, J. D., & Belay, Y. (2005). Empowering factors for regular mammography screening in under-served populations: Pilot survey results in Tennessee. Ethn Dis, 15, 387–94.PubMed

Armstrong, K., Calzone, K., Stopfer, J., Fitzgerald, G., Coyne, J., & Weber, B. (2000). Factors associated with decisions about clinical BRCA1/2 testing. Cancer Epidemiol Biomark Prev, 9, 1251–1254.

Audrain, J., Schwartz, M. D., Lerman, C., Hughes, C., Peshkin, B. N., & Biesecker, B. (1997). Psychological distress in women seeking genetic counseling for breast-ovarian cancer risk: The contributions of personality and appraisal. Ann Behav Med, 19, 370–377.PubMedCrossRef

Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clin Psychol Rev, 8, 77–100.CrossRef

Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression. Arch Gen Psychiatry, 4, 561–571.PubMed

Beebe, D. W., Finer, E., & Holmbeck, G. N. (1996). Low-end specificity of four depression measures: Findings and suggestions for the research use of depression tests. J Pers Assess, 67, 272–284.PubMedCrossRef

Biesecker, B. B., Ishibe, N., Hadley, D. W., Giambarresi, T. R., Kase, R. G., Lerman, C., & Struewing, J. P. (2000). Psychosocial factors predicting BRCA1/BRCA2 testing decisions in members of hereditary breast and ovarian cancer families. Am J Med Genet, 93(4), 257–263.PubMedCrossRef

Cappelli, M., Surh, L., Humphreys, L., Verma, S., Logan, D., Hunter, A., & Allanson, J. (1999). Psychological and social determinants of women’s decisions to undergo genetic counseling and testing for breast cancer. Clin Genet, 55(6), 419–430.PubMedCrossRef

Consedine, N. S., Magai, C., Horton, D., Neugut, A. I., & Gillespie, M. (2005). Health belief model factors in mammography screening: Testing for interactions among subpopulations of Caribbean women. Ethn Dis, 15, 444–452.PubMed

Culver, J. L., Arena, P. L., Antoni, M. H., & Carver, C. S. (2002). Coping and distress among women under treatment for early stage breast cancer: Comparing African Americans, Hispanics and non-Hispanic Whites. Psychooncology, 11, 495–504.PubMedCrossRef

Deshields, T., Tibbs, T., Fan, M., & Taylor, M. (in press). Differences in patterns of depression after treatment for breast cancer. Psychooncology.

DiMatteo, M. R., Lepper, H. S., & Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med, 160, 2101–2107.PubMedCrossRef

Duric, V., Butow, P., Sharpe, L., Lobb, E., Meiser, B., Barratt, A., & Tucker, K. (2003). Reducing psychological distress in a genetic counseling consultation for breast cancer. J Genet Counsel, 12(3), 243–264.CrossRef

Ell, K., Sanchez, K., Vourlekis, B., Lee, P. J., Dwight-Johnson, M., Lagomasino, I., Muderspach, L., & Russell, C. (2005). Depression, correlates of depression, and receipt of depression care among low-income women with breast or gynecologic cancer. J Clin Oncol, 23(13), 3052–3060.PubMedCrossRef

Emmons, K. M., Kalkbrenner, K. J., Klar, N., Light, T., Schneider, K. A., & Garber, J. E. (2000). Behavioral risk factors among women presenting for genetic testing. Cancer Epidemiol Biomark Prev, 9, 89–94.

Green, C. A., & Pope, C. R. (2000). Depressive symptoms, health promotion, and health risk behaviors. Am J Health Promot, 15, 29–34.PubMed

Groth-Marnat, G. (1997). Handbook of psychological assessment (3rd ed., pp. 124–126). New York: Wiley.

Hasin, D. S., Goodwin, R. D., Stinson, F. S., & Grant, B. F. (2005). Epidemiology of major depressive disorder: Results from the National Epidemiologic Survey on Alcoholism and Related Conditions. Arch Gen Psychiatry, 62, 1097–1106.PubMedCrossRef

Honda, K., Goodwin, R. D., & Neugut, A. I. (2005). The associations between psychological distress and cancer prevention practices. Cancer Detect Prev, 29, 25–36.PubMedCrossRef

Hughes, C., Lerman, C., & Lustbader, E. (1996). Ethnic differences in risk perception among women at increased risk for breast cancer. Breast Cancer Res Treat, 40, 15–35.CrossRef

Hammar, A., Lund, A., & Hugdahl, K. (2003). Selective impairment in effortful information processing in major depression. J Int Neuropsychol Soc, 9, 954–959.PubMedCrossRef

Heckman, T. G., Kochman, A., Sikkema, K. J., & Kalichman, S. C. (1999). Depressive symptomatology, daily stressors, and ways of coping among middle-age and older adults living with HIV disease. J Ment Health Aging, 5, 311–322.

Husaini, B. A., Sherkat, D. E., Bragg, R., Levine, R., Emerson, J. S., Mentes, C. M., & Cain, V. A. (2001). Predictors of breast cancer screening in a panel study of African American women. Women Health, 34(3), 35–51.PubMedCrossRef

Hutson, S. P. (2003). Attitudes and psychological impact of genetic testing, genetic counseling, and breast cancer risk assessment among women at increased risk. Oncol Nurs Forum, 30, 241–246.PubMedCrossRef

Kash, K. M., Holland, J. C., Halper, M. S., & Miller, D. G. (1992). Psychological distress and surveillance behaviors of women with a family history of breast cancer. J Natl Cancer Inst, 84, 24–30.PubMedCrossRef

Katz, M. R., Kopek, N., Waldron, J., Devins, G. M., & Tomlinson, G. (2004). Screening for depression in head and neck cancer. Psychooncology, 13, 269–280.PubMedCrossRef

Kelsen, D. P., Portenoy, R. K., Thaler, H. T., Niedzwiecki, D., Passik, S. D., Tao, Y., Banks, W., Brennan, M. F., & Foley, K. M. (1995). Pain and depression in patients with newly diagnosed pancreas cancer. J Clin Oncol, 13(3), 748–755.PubMed

Kim, O. (2002). The relationship of depression to health risk behaviors and health perceptions in Korean college students. Adolescence, 37, 575–584.PubMed

Lerman, C., Daly, M., Masny, A., & Balshem, A. (1994a). Attitudes about genetic testing for breast-ovarian cancer susceptibility. J Clin Oncol, 12, 843–850.PubMed

Lerman, C., Daly, M., Sands, C., Balshem, A., Lustbader, E., Heggan, T., Goldstein, L., James, J., & Engstrom, P. (1993). Mammography adherence and psychological distress among women at risk for breast cancer. J Natl Cancer Inst, 85(13), 1074–1080.PubMedCrossRef

Lerman, C., Hughes, C., Benkendorf, J. L., Biesecker, B., Kerner, J., Willison, J., Eads, N., Hadley, D., & Lynch, J. (1999). Racial differences in testing motivation and psychological distress following pretest education for BRCA1 gene testing. Cancer Epidemiol Biomark Prev, 8(4 Pt 2), 361–367.

Lerman, C., Kash, K., & Stefanek, M. (1994b). Younger women at increased risk for breast cancer: Perceived risk, psychological well-being, and surveillance behavior. J Natl Cancer Inst Monogr, 6, 171–176.

Lerman, C., Schwartz, M. D., Lin, T. H., Hughes, C., Narod, S., & Lynch, H. T. (1997). The influence of psychological distress on use of genetic testing for cancer risk. J Consult Clin Psychol, 65, 414–420.PubMedCrossRef

Matthews, A. K., Cummings, S., Thompson, S., Wohl, V., List, M., & Olopade, O. I. (2000). Genetic testing of African Americans for susceptibility to inherited cancers: Use of focus groups to determine factors contributing to participation. J Psychosoc Oncol, 18, 1–19.CrossRef

Matthews, A. K., Brandenburg, D. L., Cummings, S., & Olopade, O. (2002). Incorporating a psychological counselor in a cancer risk assessment program: Necessity, acceptability, and potential roles. J Genet Counsel, 11, 51–64.CrossRef

Miki, Y., Swensen, J., Shattuck-Eidens, D., Futreal, P. A., Harshman, K., & Tavtigian, S., Liu, Q., Cochran, C., Bennett, L. M., Ding, W., et al. (1994). A strong candidate for the breast and ovarian cancer susceptibility gene BRCA1. Science, 266(5182), 66–71.PubMedCrossRef

Murphy, F. C., Rubinsztein, J. S., Michael, A., Rogers, R. D., Robbins, T. W., Paykel, E. S., & Sahakian, B. J. (2001). Decision-making cognition in mania and depression. Psychol Med, 31(4), 679–693.PubMedCrossRef

Passik, S. D., Dugan, W., McDonald, M. V., Rosenfeld, B., Theobald, D. E., & Edgerton, S. (1998). Oncologists’ recognition of depression in their patients with cancer. J Clin Oncol, 16, 1594–1600.PubMed

Pirraglia, P. A., Sanyal, P., Singer, D. E., & Ferris, T. G. (2004). Depressive symptom burden as a barrier to screening for breast and cervical cancers. J Womens Health (Larchmt), 13, 731–738.CrossRef

Risch, H. A., McLaughlin, J. R., Cole, D. E., Rosen, B., Bradley, L., Kwan, E., Jack, E., Vesprini, D. J., Kuperstein, G., Abrahamson, J. L., Fan, I., Wong, B., & Narod, S. A. (2001). Prevalence and penetrance of germline BRCA1 and BRCA2 mutations in a population series of 649 women with ovarian cancer. Am J Hum Genet, 68(3), 700–710.

Rosal, M. C., Ockene, J. K., Ma, Y., Hebert, J. R., Merriam, P. A., Matthews, C. E., & Ockene, I. S. (2001). Behavioral risk factors among members of a health maintenance organization. Prev Med, 33, 586–594.PubMedCrossRef

Spencer, S. M., Lehman, J. M., Wynings, C., Arena, P., Carver, C. S., Antoni, M. H., Derhagopian, R. P., Ironson, G., & Love, N. (1999). Concerns about breast cancer and relations to psychosocial well-being in a multiethnic sample of early-stage patients. Health Psychol, 18(2), 159–168.PubMedCrossRef

Stafford, R. S., Ausiello, J. C., Misra, B., & Saglam, D. (2000). National patterns of depression treatment in primary care. Primary Care Companion. J Clin Psychiatry, 2, 211–216.

Stefanek, M. E., Helzlsouer, K. J., Wilcox, P. M., & Houn, F. (1995). Predictors of and satisfaction with bilateral prophylactic mastectomy. Prev Med, 24, 412–419.PubMedCrossRef

Stein, J. A., & Nyamathi, A. (1999). Gender differences in relationships among stress, coping, and health risk behaviors in impoverished, minority populations. Pers Indiv Dif, 26, 141–157.CrossRef

Tangney, C. C., Young, J. A., Murtaugh, M. A., Cobleigh, M. A., & Oleaske, D. M. (2002). Self-reported dietary habits, overall dietary quality and symptomology of breast cancer survivors: A cross examination. Breast Cancer Res Treat, 71, 113–123.PubMedCrossRef

Wellisch, D. K., & Lindberg, N. M. (2001). A psychological profile of depressed and nondepressed women at high risk for breast cancer. Psychosomatics, 42, 330–336.PubMedCrossRef

Wood, M. E., Mullineaux, L., Rahm, A. K., Fairclough, D., & Wenzel, L. (2000). Impact of BRCA1 testing on women with cancer: A pilot study. Genet Test, 4, 265–272.PubMedCrossRef

Wooster, R., Bignell, G., Lancaster, J., Swift, S., Seal, S., Mangion, J., Collins, N., Gregory, S., Gumbs, C., & Micklem, G. (1995). Identification of the breast cancer susceptibility gene BRCA2. Nature, 378(6559), 789–792.PubMedCrossRef

Zabora, J., Brintzenhofeszoc, K., Curbow, B., Hooker, C., & Piantadosi, S. (2001). The prevalence of psychological distress by cancer site. Psychooncology, 10, 19–28.PubMedCrossRef

Zung, W. W., Broadhead, W. E., & Roth, M. E. (1993). Prevalence of depressive symptoms in primary care. J Fam Pract, 37, 337–344.PubMed

Title: Correlates of Depressive Symptoms Among Women Seeking Cancer Genetic Counseling and Risk Assessment at a High-Risk Cancer Clinic
Authors: Molly Middlecamp Kodl
Judith W. Lee
Alicia K. Matthews
Shelly A. Cummings
Olufunmilayo I. Olopade
Publication date: 01-08-2006
Publisher: Springer US
Published in: Journal of Genetic Counseling / Issue 4/2006
Print ISSN: 1059-7700
Electronic ISSN: 1573-3599
DOI: https://doi.org/10.1007/s10897-006-9025-8

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Correlates of Depressive Symptoms Among Women Seeking Cancer Genetic Counseling and Risk Assessment at a High-Risk Cancer Clinic

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