Influence of age, performance status, cancer activity, and IL-6 on anxiety and depression in patients with metastatic breast cancer

Abstract

Depression and anxiety are the core disorders causing emotional distress in patients (pts) with metastatic breast cancer. The aim of our study was to screen metastatic breast cancer outpatients for anxiety and depression, and to investigate the influence of age, Karnofsky Performance Status (KPS), cancer activity, and inflammation as represented by IL-6 levels on these two mood disorders. Pts treated with chemotherapy for metastatic breast cancer (n = 70) were assessed using the Hospital Anxiety and Depression Scale (HADS) for symptoms (scores 0-21) and caseness (score ≥11) of clinical depression and anxiety. Blood samples for IL-6 concentrations were collected at 10:00 a.m. A total of 22 (31.4 %) pts were diagnosed with caseness of clinical depression and 23 (32.9 %) pts with clinical anxiety, while 12 pts were diagnosed positive for both mood disorders. Depression and anxiety were positively but moderately correlated (Spearman's r (2) = 0.24, p < 0.001). IL-6 was significantly correlated with symptoms of depression (r (2) = 0.42, p < 0.001) and to a lesser extent to symptoms of anxiety (r (2) = 0.16, p = 0.001). In addition, IL-6 was positively associated with tumor progression (p < 0.001). Multiple linear regression analysis showed that tumor progression (standardized b = 0.226, p = 0.047), symptoms of anxiety (b = 0.292, p = 0.016), and IL-6 (b = 0.314, p = 0.007) were independently associated with clinical depression, whereas anxiety was linked to tumor progression (b = 0.238, p = 0.030), symptoms of depression (b = 0.407, p < 0.001) and age (b = -0.381, p < 0.001), but not to IL-6 (b = 0.168, p = 0.134). Even though a positive correlation between depression and anxiety exists, clinical parameters like age, cancer activity, KPS, and IL-6 do influence depression and anxiety differently. Unlike clinical depression, anxiety is not associated with increased IL-6 levels, however, shows a reciprocal correlation with age.

Psychological distress and cancer pain: Results from a controlled cross-sectional survey in China

“…The impact of other previously identified socio-demographic predictors404142, such as age, gender and marital status, were not confirmed in our study. These inconsistencies may arise from differences in patient populations, statistical methodology, and measured symptom domains.…”

Co-occurrence of anxiety and depressive symptoms following breast cancer surgery and its impact on quality of life

“…Consistent with previous studies (Burgess et al, 2005; Hartl et al, 2010; Hong and Tian, 2014; Jehn et al, 2012; Linden et al, 2012; Parker et al, 2007; Thomas et al, 2010), patients with Higher Anxiety and Subsydromal Depression were younger than women with neither symptom. As noted in two previous reviews (Compas et al, 1999; Mosher and Danoff-Burg, 2005), a number of factors may explain these age-related differences.…”

Metastatic Breast Cancer Collateral Damage Project (MBCCD): Scale development and preliminary results of the Survey of Health, Impact, Needs, and Experiences (SHINE)

“…Additionally, higher depressive symptoms related to less benefit finding, and higher anxiety related to more financial concerns. Depression and anxiety are prominent concerns for MBC patients [13–16]. …”

“…A number of MBC patients report high levels of depressive symptoms [13, 14] and anxiety [15, 16]. One study demonstrated that 33% of MBC patients evidenced clinical levels of depression via diagnostic interviews [17].…”