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01.06.2014 | Original Article

Depressive Symptom Trajectories During and After Adjuvant Treatment for Breast Cancer

verfasst von: Kristine A. Donovan, Ph.D., Brian D. Gonzalez, Ph.D., Brent J. Small, Ph.D., Michael A. Andrykowski, Ph.D., Paul B. Jacobsen, Ph.D.

Erschienen in: Annals of Behavioral Medicine | Ausgabe 3/2014

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Abstract

Background

The course of depressive symptoms during and after breast cancer treatment is not well understood.

Purpose

We identified patient subgroups based on distinct trajectories of depressive symptoms and determined whether subgroups could be distinguished by personal characteristics and coping strategies.

Methods

Breast cancer patients completed the Center for Epidemiologic Studies–Depression Scale on clinically meaningful occasions and during the posttreatment period. The Illness Management Questionnaire was completed prior to treatment.

Results

A three-class mixture model provided the best fit to the data. Subgroup membership was significantly (p < .05) associated with marital status, history of depression, and focusing on symptoms. In multivariate analysis, marital status and focusing on symptoms remained significant (p < .05) predictors of subgroup membership.

Conclusions

Distinct trajectories can be identified during and after adjuvant breast cancer therapy. Predictors of these trajectories have implications for addressing depressive symptoms in this clinical population and for future research.

Following a reviewer's suggestion, we reran the three class model constraining the intercept and slope covariance to zero for all three classes and allowing the intercept and slope variance in each class to be freely estimated. Unfortunately, the convergence problem was not remedied and the slope variance for the highest depressive symptom class was negative. Moreover, the fit of the model with the covariances constrained was not appreciably better than the three class model that we originally reported (−2ll = 2,611.93, df = 17, AIC = 5,257.85, BIC = 5,308.69). As such, we have retained the three class model.

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Titel: Depressive Symptom Trajectories During and After Adjuvant Treatment for Breast Cancer
verfasst von: Kristine A. Donovan, Ph.D.
Brian D. Gonzalez, Ph.D.
Brent J. Small, Ph.D.
Michael A. Andrykowski, Ph.D.
Paul B. Jacobsen, Ph.D.
Publikationsdatum: 01.06.2014
Verlag: Springer US
Erschienen in: Annals of Behavioral Medicine / Ausgabe 3/2014
Print ISSN: 0883-6612
Elektronische ISSN: 1532-4796
DOI: https://doi.org/10.1007/s12160-013-9550-2

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Depressive Symptom Trajectories During and After Adjuvant Treatment for Breast Cancer