Depression And Anxiety In 461 Patients With Breast Cancer And Their Impact On Quality Of Life And Prognosis

Objective: To investigate the status and influencing factors of depression and anxiety and quality of life in 461 patients with breast cancer in Xinjiang,and to explore the effects of depression and anxiety on quality of life and prognosis of breast cancer patients.Methods: All breast cancer patients selected as subjects were hospitalized in the Xinjiang Medical University Department of breast cancer Surgery from January 2018 to June 2019.A cross-sectional survey was conducted using the Quality of Life Measurement Scale(EORTC QLQ-C30),Zung’s Self-Rating Depression Scale(SDS)and Zung’s Self-Rating Anxiety Scale(SAS).To evaluate the status of depression,anxiety disorder and quality of life in breast cancer patients,the influencing factors of comorbidities of depression or anxiety disorder in breast cancer patients were analyzed by binary logistic regression model,and the influencing factors of quality of life on breast cancer patients were evaluated by multiple linear regression model.All patients included in the study were followed up,and kaplan-Meier survival analysis was performed to draw the survival curve of breast cancer patients with comorbidized depression or anxiety disorder,and the difference in median survival time and survival rate of breast cancer patients with or without depression and anxiety disorder was analyzed by log-rank test.Cox proportional risk model was used to control potential confounding factors to analyze the effect of depression and anxiety on the prognosis of breast cancer patients.Results: From January2018 to June 2019,a total of 513 patients were hospitalized,and 461 patients(89.86%)met the inclusion and exclusion criteria,including 197 patients(42.70%)with depressive mood disorder.There were 146 cases(31.70%),44 cases(9.50%)and 7 cases(1.50%)of mild,moderate and severe depressive mood disorders,respectively.There were 240patients(52.10%)with anxiety disorder,included which 146 patients(31.70%)with mild,64 patients(13.90%)with moderate and 30 patients(6.50%)with severe anxiety disorder,respectively.Multifactorial results showed that age,personal monthly income,course of disease,chemotherapy and exercise were the influencing factors of depressive mood disorder in breast cancer patients.Household registration,education level,course of disease,exercise and other chronic diseases(coronary heart disease,or diabetes,or hypertension)were influential factors for anxiety disorders in breast cancer patients.Multiple linear regression model analysis showed that depression,anxiety,age,exercise,disease duration,tumor metastasis and chemotherapy were independent influencing factors of quality of life of breast cancer patients(P <0.05).The more serious the degree of depression and anxiety,the worse the total health status and functional dimension of patients,the more serious the symptom,the worse the quality of life of patients.Spearman correlation analysis showed that Depression and anxiety mood disorders have certain correlation with the quality of life in breast cancer patients,among which,in the functional dimension,emotional function has the closest correlation with depression and anxiety mood disorders.On the symptom dimension,fatigue and insomnia were most closely associated with depression and anxiety mood disorders(all P<0.05).Univariate analysis showed that there was no significant difference in median survival time between patients with and without depression(P=0.866),but there was significant difference in median survival time between patients with and without anxiety disorder(P=0.012).Multivariate Cox proportional risk regression model showed that depression and anxiety were not associated with prognosis of breast cancer patients(P=0.564).Conclusion: 461 breast cancer patients with a greater incidence of depression,anxiety disorder,this has to do with age,household,income,exercise,duration and tumor stage and other related factors,therefore attaches great importance to the mental health of patients with breast cancer,especially in the early diagnosis of breast cancer for young patients,patients with low income and rural household registration in patients with positive psychological intervention.2.Depression,anxiety and other negative emotions are closely related to the quality of life of breast cancer patients,and actively improving patients’ depression,anxiety and other emotional disorders is conducive to improving the quality of life of patients.3.This study did not find the influence of depression and anxiety on short-term prognosis of patients.For the further verification need large-sample and long-term follow-up studies.