Pessimism predicts anxiety and depression in breast cancer survivors: A 5‐year follow‐up study. Issue 6 (29th April 2019) - Faye‐Schjøll, Hege Hovd
Abstract: Objective: We investigated the prevalence of anxiety and depression at diagnosis and at 1, 3, and 5 years after breast cancer diagnosis. We hypothesized that a low level of optimism (pessimism) at diagnosis could predict change in anxiety and depression 5 years later. Methods: Three hundred sixty‐seven women with operable breast cancer were included, and data were collected at all five‐time points for 293 of these. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). Dispositional optimism/pessimism was measured using the Life Orientation Test–Revised (LOT–R). Frequency analysis was used to determine the prevalence of anxiety and depression. Logistic regression was used to examine dispositional optimism/pessimism as a predictor of change in anxiety and depression 5 years after diagnosis. Results: The prevalence rates of anxiety and depression 5 years after diagnosis were 26.3% and 9.6%, respectively. Predictors of change in anxiety 5 years after diagnosis were pessimism (odds ratio [OR] = 0.82; 95% confidence interval [CI]: 0.76‐0.89, P < .001); younger age (OR = 0.96; 95% CI: 0.93‐0.99, P = .005); and anxiety at diagnosis (OR = 2.41; 95% CI: 1.33‐4.37, P = .004). Predictors of change in depression 5 years after diagnosis were pessimism (OR = 0.84; 95% CI: 0.77‐0.94, P < .001) and comorbidity (OR = 1.51, 95% CI: 1.10‐2.06, P = 0.01). Conclusion: Anxiety and depression did not decrease after the first postoperative year. Pessimism was a predictor of change in both anxiety and depression 5 years after breast cancer diagnosis.