The status and correlates of depression and anxiety among breast-cancer survivors in Eastern China: a population-based, cross-sectional case–control study

BACKGROUND Breast cancer presents specific challenges both physiologically and psychologically to women, and consequently affect the patients' mental health. Psychosocial factors may play important roles in the symptoms and development of mental disorders among breast-cancer survivors. This study assesses the depression and anxiety status of breast-cancer survivors and further identifies the risk factors. METHODS A 1:1 matched, case-control study was conducted with a total sample of 222 individuals. Participants were selected from a national epidemiological survey. The Center for Epidemiological Studies-Depression Scale and State-Trait Anxiety Inventory were used to assess depression and anxiety. The Social Support Rating Scale and Perceived Social Support Scale were used as measures of social support and perceived social support, and the Rosenberg Self-Esteem Scale as a measure of self-esteem. Coping style was assessed using the Simplified Coping Style Questionnaire. The predictive effect of these psychosocial factors for depression and anxiety was investigated with hierarchical linear regressions. RESULTS Breast-cancer survivors experienced a high level of depressive and anxious symptoms. Multivariate analysis revealed that breast cancer functions as an independent but not a main risk factor of both depression and anxiety. Higher levels of depression and anxiety were positively associated with a higher level of passive coping style, and negatively with perceived social support, objective social support and an active coping style. CONCLUSIONS The mental health of breast-cancer survivors should be promoted through the transformation of coping styles and improvement of social support.