Psychiatry Investig.  2018 Feb;15(2):133-140. 10.30773/pi.2017.07.26.

Associations Among Plasma Stress Markers and Symptoms of Anxiety and Depression in Patients with Breast Cancer Following Surgery

Affiliations
  • 1Department of Psychiatry, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea. gabriel.jdu@gmail.com
  • 2Department of Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
  • 3Department of Information Management Systems, Dong-A University, Busan, Republic of Korea.

Abstract


OBJECTIVE
The objective of present study is to analyze the prevalence of depression and anxiety following breast cancer surgery and to assess the factors that affect postoperative psychological symptoms.
METHODS
The Hamilton Rating Scale for Depression (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), Body Image Scale (BIS), and Rosenberg Self Esteem Scale (RSES) were used to assess the psychological states of patients who had been diagnosed with and had undergone surgery for breast cancer. Blood concentrations of the stress markers adrenocorticotropic hormone, cortisol, arginine-vasopressin, and angiotensin-converting enzyme were measured. Pearson's correlation analysis and multilinear regression analysis were used to analyse the data.
RESULTS
At least mild depressive symptoms were noted in 50.5% of patients, while 42.4% of patients exhibited at least mild anxiety symptoms. HAM-D score was positively correlated with HAM-A (r=0.83, p < 0.001) and BIS (r=0.29, p < 0.001) scores and negatively correlated with RSES score (r=-0.41, p < 0.001). HAM-A score was positively correlated with BIS score (r=0.32, p < 0.001) and negatively correlated with RSES score (r=-0.27, p < 0.001). There were no statistically significant associations between stress markers and depression/anxiety.
CONCLUSION
Patients with breast cancer frequently exhibit postoperative depression and anxiety, which are related to low levels of self-esteem and distorted body image.

Keyword

Breast cancer; Body image; HPA axis; Depression; Anxiety

MeSH Terms

Adrenocorticotropic Hormone
Anxiety*
Body Image
Breast Neoplasms*
Breast*
Depression*
Humans
Hydrocortisone
Plasma*
Prevalence
Self Concept
Adrenocorticotropic Hormone
Hydrocortisone
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