The course of psychiatric co-morbidity in patients with breast cancer--results from the prospective multi-centre BRENDA II study

Psychooncology. 2016 May;25(5):590-6. doi: 10.1002/pon.3978. Epub 2015 Sep 11.

Abstract

Purpose: This study examined the frequency of psychiatric co-morbidity in patients with breast cancer, its changes over time and predictors for these changes.

Methods: In a prospective study with measurements before surgery (t1, baseline), 1 month (t2) and 8 months thereafter (t3) using the Patient Health Questionnaire, we examined the course of psychiatric co-morbidity in breast cancer patients. The co-morbidity courses were grouped into healthy (no co-morbidity during the study), acute (co-morbidity at t1 and/or t2, but not at t3), emerging (no co-morbidity at t1, but at t3) and chronic (co-morbidity at t1 and t3).

Results: Of the 598 participants, 19% had acute, 10% emerging and 9% chronic psychiatric co-morbidity. Acute co-morbidity was more common in patients with poor quality of life (odds ratio (OR) 9.6, 95% confidence interval (CI) 4.4-20.8) and somatic co-morbidity (OR 3.8, CI 1.1-12.4). Patients who perceived support from their doctors had acute co-morbidity less frequently (OR 0.7, CI 0.5-1.0). Emerging co-morbidity occurred more often in younger patients (OR 2.4, CI 1.2-4.7) and in patients with another cancer in their own (OR 2.0, CI 1.1-3.9) or family (OR 2.1, CI 1.1-4.3) histories, less often in patients with support from doctors (OR 0.6, CI 0.4-1.0). Chronic co-morbidity was related to poor quality of life (OR 12.1, CI 3.6-39.9).

Conclusion: We found acute and emerging psychiatric co-morbidities less often in patients who reported having a supportive doctor-patient relationship. Patients that require psycho-oncological support often have poor quality of life and have experienced cancer before. Copyright © 2015 John Wiley & Sons, Ltd.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / epidemiology*
  • Breast Neoplasms / psychology
  • Comorbidity
  • Female
  • Germany / epidemiology
  • Humans
  • Mental Disorders / epidemiology*
  • Mental Disorders / etiology*
  • Mental Disorders / therapy
  • Middle Aged
  • Odds Ratio
  • Patient Outcome Assessment
  • Physician-Patient Relations
  • Prospective Studies
  • Quality of Life / psychology*
  • Stress, Psychological / epidemiology*
  • Stress, Psychological / etiology*
  • Stress, Psychological / psychology