Researchers at Ohio State University's Comprehensive Cancer Center found that cancer-related traumatic stress was just one component that was linked to depression symptoms.
"Cancer occurs in the context of other problems and issues that are occurring in a woman's life," said Deanna Golden-Kreutz, co-author of the study and psychology research associate at Ohio State University. "Issues such as money problems may add to the stress of women who are dealing with breast cancer."
Money-related stress had a stronger link to depression symptoms among breast cancer patients than even stress related to the recent death or illness of a loved one, the study found.
Golden-Kreutz conducted the study with Barbara Andersen, professor of psychology at Ohio State. Their results appear in an upcoming issue of the journal Psycho-Oncology.
The study is part of the Stress and Immunity Cancer Projects at Ohio State, headed by Andersen, which examine psychological, biological, and quality of life aspects of cancer diagnosis and treatment.
This study included 210 women with stage II or III breast cancer in the Columbus area who had surgery within the past three months but who had not yet started additional treatment.
The participants completed questionnaires that examined, among other things, their levels of depression symptoms and three different types of stress: cancer-related traumatic stress, negative life events, and general stress. Cancer-related stress included having intrusive, continuing thoughts about their diagnosis. General stress included how much these women felt their life, outside of the cancer diagnosis, was overwhelming and out of control.
In addition, researchers asked participants about five specific negative life events in the past year: the death or serious illness of a loved one; major financial difficulties, divorce or other breakup from a partner, family member or close friend; major conflict with children or grandchildren; and muggings, robberies, accidents or other major events.
Results showed that about 18 percent of the participants had levels of depression high enough to indicate they needed psychological help.
About three-quarters of the women had experienced one of the five negative life events: about half reported the death or illness of a partner or other loved one and one-quarter had major financial difficulties.
However, only the major financial difficulties were linked to symptoms of depression among these breast cancer patients. The study can not prove that financial problems were a cause of depression among breast cancer patients, Golden-Kreutz emphasized. But the link suggests financial difficulties appear to be related to higher levels of depressive symptoms.
"Having cancer may add to the financial stress that some of these women were already experiencing before they were diagnosed," Golden-Kreutz said. "They may be worried about insurance issues and missing work."
As expected, the study also found that women who had higher levels of general stress and who reported more stress related to their cancer diagnosis, also were more likely to show symptoms of depression.
In addition, the results showed that women whose personalities tended to be more negative and pessimistic overall were also more likely to have depression symptoms.
"The results show the importance of considering all types of stress – not just that related to cancer – when assessing patients who might be at risk for depression," Golden-Kreutz said. "Clearly, the traumatic stress symptoms associated with cancer are important, but there are other types of stress going on, as well."
The study was supported in part by grants from the American Cancer Society, the Longaberger Company - American Cancer Society Grant for Breast Cancer Research, the U.S. Army, the National Institutes of Mental Health, and the National Cancer Institute.
Contact: Deanna Golden-Kreutz, 614-292-5170; Golden-kreutz.1@osu.edu
Written by Jeff Grabmeier, 614-292-8457; Grabmeier.1@osu.edu
Journal
Psycho-Oncology