IDENTIFICATION OF DISTINCT DEPRESSIVE SYMPTOM TRAJECTORIES IN WOMEN FOLLOWING SURGERY FOR BREAST CANCER
Identifieur interne : 003774 ( Pmc/Curation ); précédent : 003773; suivant : 003775IDENTIFICATION OF DISTINCT DEPRESSIVE SYMPTOM TRAJECTORIES IN WOMEN FOLLOWING SURGERY FOR BREAST CANCER
Auteurs : Laura B. Dunn [États-Unis] ; Bruce A. Cooper [États-Unis] ; John Neuhaus [États-Unis] ; Claudia West [États-Unis] ; Steven Paul [États-Unis] ; Bradley Aouizerat [États-Unis] ; Gary Abrams [États-Unis] ; Janet Edrington [États-Unis] ; Debby Hamolsky [États-Unis] ; Christine Miaskowski [États-Unis]Source :
- Health psychology : official journal of the Division of Health Psychology, American Psychological Association [ 0278-6133 ] ; 2011.
Abstract
Most longitudinal studies of depressive symptoms reported mean symptom scores that tend to obscure interindividual heterogeneity in the symptom experience. The identification of subgroups of patients with distinct trajectories of depressive symptoms may help identify high risk individuals who require an intervention. This study aimed to identify subgroups of breast cancer patients (n=398) with distinct trajectories of depressive symptoms in the first six months after surgery, as well as predictors of these trajectories.
Growth mixture modeling was used to identify the latent classes based on Center for Epidemiological Studies-Depression scale scores completed prior to and monthly for six months after surgery.
Four latent classes of patients with distinct depressive symptom trajectories were identified: Resilient (38.9%), Subsyndromal (45.2%), Delayed (11.3%), and Peak (4.5%). Patients in the Subsyndromal class were significantly younger than patients in the Resilient class. Compared to the Resilient class, Subsyndromal, Delayed, and Peak classes had higher mean trait and state anxiety scores prior to surgery. Except for axillary lymph node dissection (ALND), disease- and treatment-related characteristics did not differ across the classes. A greater proportion of women in the Subsyndromal class had an ALND compared to those in the Resilient class.
Breast cancer patients experience different trajectories of depressive symptoms after surgery. Of note, over 60% of these women were classified into one of three distinct subgroups with clinically significant levels of depressive symptoms. Identification of phenotypic and genotypic predictors of symptom trajectories after cancer treatment warrants additional investigation.
Url:
DOI: 10.1037/a0024366
PubMed: 21728421
PubMed Central: 3217116
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title>
<p id="P1">Most longitudinal studies of depressive symptoms reported mean symptom scores that tend to obscure interindividual heterogeneity in the symptom experience. The identification of subgroups of patients with distinct trajectories of depressive symptoms may help identify high risk individuals who require an intervention. This study aimed to identify subgroups of breast cancer patients (n=398) with distinct trajectories of depressive symptoms in the first six months after surgery, as well as predictors of these trajectories.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Growth mixture modeling was used to identify the latent classes based on Center for Epidemiological Studies-Depression scale scores completed prior to and monthly for six months after surgery.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Four latent classes of patients with distinct depressive symptom trajectories were identified: Resilient (38.9%), Subsyndromal (45.2%), Delayed (11.3%), and Peak (4.5%). Patients in the Subsyndromal class were significantly younger than patients in the Resilient class. Compared to the Resilient class, Subsyndromal, Delayed, and Peak classes had higher mean trait and state anxiety scores prior to surgery. Except for axillary lymph node dissection (ALND), disease- and treatment-related characteristics did not differ across the classes. A greater proportion of women in the Subsyndromal class had an ALND compared to those in the Resilient class.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Breast cancer patients experience different trajectories of depressive symptoms after surgery. Of note, over 60% of these women were classified into one of three distinct subgroups with clinically significant levels of depressive symptoms. Identification of phenotypic and genotypic predictors of symptom trajectories after cancer treatment warrants additional investigation.</p>
</sec>
</div>
</front>
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<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
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<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8211523</journal-id>
<journal-id journal-id-type="pubmed-jr-id">3573</journal-id>
<journal-id journal-id-type="nlm-ta">Health Psychol</journal-id>
<journal-id journal-id-type="iso-abbrev">Health Psychol</journal-id>
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<article-id pub-id-type="manuscript">NIHMS325241</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>IDENTIFICATION OF DISTINCT DEPRESSIVE SYMPTOM TRAJECTORIES IN WOMEN FOLLOWING SURGERY FOR BREAST CANCER</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Dunn</surname>
<given-names>Laura B.</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Cooper</surname>
<given-names>Bruce A.</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Neuhaus</surname>
<given-names>John</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>West</surname>
<given-names>Claudia</given-names>
</name>
<degrees>RN, MS</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Paul</surname>
<given-names>Steven</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Aouizerat</surname>
<given-names>Bradley</given-names>
</name>
<degrees>MAS, PhD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Abrams</surname>
<given-names>Gary</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Edrington</surname>
<given-names>Janet</given-names>
</name>
<degrees>RN, PhD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hamolsky</surname>
<given-names>Debby</given-names>
</name>
<degrees>RN, MS</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Miaskowski</surname>
<given-names>Christine</given-names>
</name>
<degrees>RN, PhD, FAAN</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
School of Medicine, University of California, San Francisco, CA</aff>
<aff id="A2"><label>2</label>
School of Nursing, University of California, San Francisco, CA</aff>
<aff id="A3"><label>3</label>
Institute for Human Genetics, University of California, San Francisco, CA</aff>
<author-notes><corresp id="cor1">Address correspondence to: Christine Miaskowski, RN, PhD, FAAN, Professor and Associate Dean, University of California, 2 Koret Way – Box 0610, San Francisco, CA 94143-0610, 415-476-9407, 415-476-8899, <email>chris.miaskowski@nursing.ucsf.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>21</day>
<month>9</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="epub"><day>04</day>
<month>7</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="ppub"><month>11</month>
<year>2011</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>11</month>
<year>2012</year>
</pub-date>
<volume>30</volume>
<issue>6</issue>
<fpage>683</fpage>
<lpage>692</lpage>
<abstract><sec id="S1"><title>Objective</title>
<p id="P1">Most longitudinal studies of depressive symptoms reported mean symptom scores that tend to obscure interindividual heterogeneity in the symptom experience. The identification of subgroups of patients with distinct trajectories of depressive symptoms may help identify high risk individuals who require an intervention. This study aimed to identify subgroups of breast cancer patients (n=398) with distinct trajectories of depressive symptoms in the first six months after surgery, as well as predictors of these trajectories.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">Growth mixture modeling was used to identify the latent classes based on Center for Epidemiological Studies-Depression scale scores completed prior to and monthly for six months after surgery.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">Four latent classes of patients with distinct depressive symptom trajectories were identified: Resilient (38.9%), Subsyndromal (45.2%), Delayed (11.3%), and Peak (4.5%). Patients in the Subsyndromal class were significantly younger than patients in the Resilient class. Compared to the Resilient class, Subsyndromal, Delayed, and Peak classes had higher mean trait and state anxiety scores prior to surgery. Except for axillary lymph node dissection (ALND), disease- and treatment-related characteristics did not differ across the classes. A greater proportion of women in the Subsyndromal class had an ALND compared to those in the Resilient class.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Breast cancer patients experience different trajectories of depressive symptoms after surgery. Of note, over 60% of these women were classified into one of three distinct subgroups with clinically significant levels of depressive symptoms. Identification of phenotypic and genotypic predictors of symptom trajectories after cancer treatment warrants additional investigation.</p>
</sec>
</abstract>
<kwd-group><kwd>breast cancer</kwd>
<kwd>depression</kwd>
<kwd>anxiety</kwd>
<kwd>growth mixture modeling</kwd>
<kwd>latent profiles</kwd>
<kwd>psychological distress</kwd>
</kwd-group>
<funding-group><award-group><funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>R01 CA118658-01A1 || CA</award-id>
</award-group>
<award-group><funding-source country="United States">National Cancer Institute : NCI</funding-source>
<award-id>R01 CA107091-01 || CA</award-id>
</award-group>
</funding-group>
</article-meta>
</front>
</pmc>
</record>
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