Abstract
Background
Major cancer organizations recommend depression screening in patients and survivors. The Patient Health Questionnaire-9 (PHQ-9) is often suggested, with limited information about its use.
Methods
Enrollment data collected from younger breast cancer survivors participating in a behavioral intervention trial were used to examine the relationship between PHQ-9 scores (range = 0-27), patient characteristics and responses to standardized psychosocial assessment tools. Major depressive disorder criterion was met if responses to the first two PHQ-9 items (range = 0-6) were >3. The sample was categorized by total PHQ-9 scores: <5 (minimal depressive symptoms), 5-9 (mild to moderate depressive symptoms) and >10 (moderate to severe depression). PHQ-9 category associations with medical, demographic, psychosocial and behavioral characteristics were examined using ANOVA for continuous variables and chi-square tests for categorical variables.
Results
231 women met the study pre-screening eligibility criterion of mild depressive symptoms and enrolled in the study. On average, they were 45.2 years old and 2.6 years since diagnosis. At enrollment, 22.1% met the screening criterion for possible major depressive disorder; among those with PHQ-9 scores >10, 58.3% met this criterion. Anxiety, fatigue, insomnia, and intrusive thoughts about cancer were frequent and were associated with depressive symptom severity (all Ps <.001). In contrast, neither demographic nor cancer treatment characteristics were associated with depressive symptoms.
Conclusions
Depressive symptoms in this selected sample of younger breast cancer survivors were independent of demographic characteristics or cancer treatment history, suggesting that depression screening is necessary to detect uncontrolled depressive symptoms.
Racial disparities in healthy behaviors and cancer screening among breast cancer survivors and women without cancer: National Health Interview Survey 2005
