Factors Affecting the Occurrence of Mental Health Problems in Female Cancer Survivors: A Nationwide Cohort Study

Abstract

The purpose of this study is to determine the effect of cancer survivorship stage and health-related behaviors on the risk of developing mental health problems (depressive and anxiety disorders) in women who have experienced cancers that affect women (breast cancer, cervical cancer, ovarian cancer, endometrial cancer). Using the healthcare utilization and medical checkup data from 2010 to 2020 provided by the National Health Insurance Service, the occurrence of mental health problems since 2020 was tracked for 36,801 women diagnosed with cancer. The occurrence of mental health problems was defined as the cases in which the disease code was assigned to anxiety disorders (F40~F44, F48) and depressive disorders (F32~34, F41.2, F92) as presented in ICD-10. To evaluate the effect of cancer survivorship stage and health-related behaviors on the development of mental health problems, the hazard ratio (HR) and 95% confidence intervals (CI) were calculated using the Cox proportional hazard model. During the follow-up period of 5.6 years, anxiety disorder occurred in 14,698 (39.9%), and by cancer type, breast cancer survivors accounted for the most at 1.02 per 1000 person-years. The risk of anxiety disorders increased in those who experienced cervical cancer (AHR, 1.08, 95% CI, 1.03–1.13) and those in the acute survivorship stage (AHR, 1.38, 95% CI, 1.22–1.55). In terms of health-related behaviors, the risk of developing anxiety disorder was shown to be reduced in drinkers (AHR, 0.91, 95% CI, 0.87–0.96), former smokers (AHR, 0.86, 95% CI, 0.77–0.97), and current smokers (AHR, 0.80, 95% CI, 0.71–0.90). During the follow-up period of 5.6 years, depressive disorder occurred in 6168(16.8%), and by cancer type, ovarian cancer survivors accounted for the most at 1.30 per 1000 person-years. The risk of developing depressive disorders was highest in those who experienced ovarian cancer (AHR, 1.40, 95% CI, 1.27–1.53) and those in the acute survivorship stage (AHR, 2.99, 95% CI, 2.60–3.42). For health-related behaviors, the risk of developing depressive disorders was increased in former smokers (AHR, 1.32, 95% CI, 1.14–1.54), current smokers (AHR, 1.21, 95% CI, 1.04–1.41), and those with insufficient physical activity (AHR, 1.09, 95% CI, 1.02–1.15). It has been confirmed that cancer type, cancer survivorship stage, and health-related behaviors, such as smoking, drinking, and physical activity, are significantly related to the risk of mental health problems. Thus, it is necessary to develop strategies to cope with mental health problems at the individual and national levels and to develop interventions to promote a more active lifestyle.

Experiencing anxiety in breast cancer survival: Does perceived emotional intelligence matter?

“…Descriptive statistics have displayed that the total sample showed moderate levels of anxiety and adequate scores in PEI dimensions. Our results have confirmed that BC survivors may manifest anxious symptoms even years after treatment 16–20 . However, despite experiencing this adversity, they perceive themselves as effective in attending to, understanding, and repairing their emotions 35 …”

“…Our results have confirmed that BC survivors may manifest anxious symptoms even years after treatment. [16][17][18][19][20] However, despite experiencing this adversity, they perceive themselves as effective in attending to, understanding, and repairing their emotions. 35 In contrast to studies that highlight that BC survivors are more vulnerable to anxiety than the general population, 5 comparisons of means have shown that there were no differences in anxiety levels.…”

“…In BC women the experience of anxiety can be related to the stage of cancer, the type of medical treatment and its adverse effects, the changes in femininity and sexuality, uncertainty, coping, or fear of recurrence, among others 11–15 . Thus, research indicates that BC patients present anxiety from the time of diagnosis until a few years later 16–20 . In other words, the emotional impact of the disease has already been described 21–25 …”

“…[11][12][13][14][15] Thus, research indicates that BC patients present anxiety from the time of diagnosis until a few years later. [16][17][18][19][20] In other words, the emotional impact of the disease has already been described. [21][22][23][24][25] In light of this mental disturbance, the research has emphasized the importance of emotional intelligence as a risk or protective factor on psychological variables such as depression, stress, well-being, or quality of life in the general population.…”

O Impacto Da Depressão Pós-Parto Na Saúde Da Mulher

“…Ademais, devido a várias mudanças que o corpo sofre durante o tratamento, também a possível indução da menopausa, alterações hormonais e deformidades nas mamas (KIM et al, 2022;BAQUIÃO;GRINCENKOV, 2019).…”