Clinical and genetic factors associated with anxiety and depression in breast cancer patients: a cross-sectional study

Abstract

Background Despite the progress in assessment and treatment of breast cancer, being diagnosed with it or receiving chemotherapy treatment is still conceived as a traumatic experience. Women develop negative thoughts about life and death with detrimental effects on their daily physical functioning/activities, emotional state and overall quality of life. The aim of our study was to evaluate the level of anxiety and depression among breast cancer patients receiving chemotherapy and explore the correlation between these psychological disorders, clinical, sociodemographic and genetic factors. Methods A cross-sectional study was conducted among breast cancer patients undergoing intravenous chemotherapy at the oncology outpatient unit of Hôtel-Dieu de France hospital (November 2017–June 2019; Ethical approval number: CEHDF1016). All patients gave their written informed consent and completed several validated scales, including the Hospital Anxiety and Depression scale (HADS) for the assessment of anxiety and depression. Sleep quality, insomnia, cognitive function, fatigue and pain were also evaluated. Genotyping for certain gene polymorphisms (CLOCK, PER2, CRY2, OPRM1, ABCB1, COMT, DRD2) was performed using the Lightcycler® (Roche). Results A total of 112 women was included. The prevalence of depression was 43.4%, and 56.2% of the patients reported anxiety (based on the HADS classification). Multivariable analysis showed that higher cognitive scores and taking fosaprepitant were significantly associated with lower depression and anxiety scores. Moreover, being married compared to single was also associated with lower depression scores, whereas higher PSQI scores (worse sleep quality) and having the PER2 AA variant genotype compared to GG were significantly associated with higher depression scores. Finally, reporting a more severe insomnia and having the COMT Met/Met genotype were significantly associated with a higher anxiety score. Conclusions Our study demonstrated a strong relationship between depression scores and cognitive impairment, sleep quality, marital status, fosaprepitant intake, and PER2 polymorphism, while anxiety scores were correlated to cognitive impairment, insomnia severity, fosaprepitant intake, and COMT polymorphism. The association with PER polymorphism was not previously reported. Identification of genetic and clinical risk factors for anxiety and depression would help clinicians implement an individualized management therapy aiming at preventing and alleviating the burden of these symptoms in breast cancer patients, hence improving their overall quality of life.

Assessment of knowledge, attitude, and practice regarding the disposal of expired and unused medications among the Lebanese population

“…A possible explanation could be that people with higher levels of education and more stable financial conditions tend to seek information more intuitively than others and have a better grasp of their surroundings. Conversely, similar to other researchers’ results, less educated participants are more likely to experience difficulties seeking new information and might not be aware of the consequences of improperly disposing of medicines [ 43 ].…”

Anxiety and Depression in Patients with Breast Cancer: A Cross-sectional Study

“…A sectional study conducted on female breast cancer patients that undergoing intravenous chemotherapy at the oncology outpatient unit of Hotel-Dieu de France hospital when total of 112 women was included in the study. The prevalence of depression was 43.4% and 56.2% of the patients reported anxiety (based on the HADS classification) [25].…”

Immunomodulatory Role of CB2 Receptors in Emotional and Cognitive Disorders

“…They present high comorbidity with other psychiatric disorders, among which depressive disorders stand out (73,127,128). Different factors have increased the likelihood of developing anxiety, such as genetic, environmental, psychological, and developmental causes (129)(130)(131)(132)(133)(134)(135). The treatment of anxiety disorders includes psychotherapy and pharmacotherapy such as anxiolytic and antidepressant drugs.…”