Stress, anxiety, depression greater in treatment-naïve women with breast cancer

Treatment-naïve women with breast cancer are at a greater risk of perceived stress and of symptoms of anxiety and depression, finds a new study.

The study included 360 participants (mean age, 40.63±8.62) who were grouped into three, each comprising 120 patients: treatment-naïve breast cancer patients, benign disease controls, and health controls. The Perceived Stress Scale-4 items (PSS-4), Patient Health Questionnaire (PHQ-9), and Generalized Anxiety Disorder Scale (GAD-7) were used to assess psychological outcomes.

Perceived stress was significantly different among the breast cancer, benign control, and healthy control groups (5.95±2.51 vs 5.28±2.58 vs 4.33±2.31, respectively; p<0.001), as were anxiety (p=0.011) and depression (p<0.001). Spearman correlation analysis found that stress significantly interacted with both depression and anxiety (p<0.001 for both).

Multivariable regression analysis showed that women who were treatment-naïve were at a significantly greater risk of perceived stress than comparators with benign disease (B, –0.71, 95 percent confidence interval [CI], –1.34 to –0.07; p=0.029) and heathy controls (B, –1.58, 95 percent CI, –2.21 to –0.95; p<0.001).

Anxiety was also more likely to develop in patients than in benign-disease and healthy controls, though this effect was attenuated after adjusting for perceived stress. The risk of depression was only greater relative to healthy controls, but was independent of perceived stress.

Mediation analysis confirmed that stress had both a relative direct and indirect effect on depression, while only its relative indirect effect on anxiety was significant.