How long does depression at cancer diagnosis affect a patient’s health

PURPOSE OF THE STUDY: Many breast cancer patients report depressive symptoms at diagnosis. Although depressive symptoms improve, it is unknown whether women fully recover into the survivorship years, as previous studies have been crosssectional or only short-term. RESEARCH METHOD: Breast cancer patients were accrued following surgery and prior to adjuvant therapy (baseline) and then followed for 5 years. Measures of psychological and physical functioning (both patient and nurserated) were used. Baseline CES-D scores (11-item version) were used to classify patients as clinically depressed (scores > 10; n = 45; DEP) or non-depressed (scores < 10; n = 182; NON-DEP). FINDINGS: Using mixed model analyses, trajectories of physical and psychological functioning over 5 years for the groups were compared. For physical functioning (KPS and signs/symptoms of illness/treatment), the DEP group had poorer outcomes from baseline through 12 months (ps < .01). Over time, both groups gradually improved in physical functioning in a similar pattern (ps > .12). The psychological trajectories--depressive symptoms (CES-D), stress (IES), and quality of life (SF-36 mental and physical components)--were of similar form. Across outcomes, the DEP group had poorer functioning at baseline (ps < .001) and this difference was maintained through 24 months (ps < .05). The groups were equivalent thereafter (ps > .39). IMPLICATIONS: Significant depressive symptomatology at cancer diagnosis portends impaired functioning for years. For such individuals, physical symptoms remain significantly elevated through 12 months, and poorer quality of life and high levels of cancer-specific stress extend for another year. Only after 2 years do women depressed at diagnosis appear to attain a level of recovery similar to that of those not depressed at diagnosis. Thus, interventions are needed for patients vulnerable to slowed physical and psychological recovery from cancer.