Prevalence of Depression in Breast Cancer Survivors: a Systematic Review of Observational Studies

Background: Depression is common in breast cancer patients. The aim of this paper was to make a systematicreview of its prevalence and associated factors oin breast cancer survivors. Materials and
Methods: An extensivesystematic electronic review (PUBMED, CINAHL, PsyINFO and Ovid) and handsearch were carried out toretrieve published articles up to November 2012, using Depression OR Dysthymia AND (Cancer OR Tumor ORNeoplasms as the keywords. Information about the design of the studies, measuring scale, characteristics of theparticipants, prevalence of depression and its associated factors from the included studies were extracted andsummarized.
Results: We identified 32 eligible studies that recruited 10,826 breast cancer survivors. Most werecross-sectional or prospective designed. The most frequent instrument used to screen depression was the Centerfor Epidemiological Studies for Depression (CES-D, n=11 studies) followed by the Beck Depression Inventory(BDI, n=6 studies) and the Hospital Anxiety and Depression Scale (HADS, n=6 studies). CES-D returned aboutsimilar prevalence of depression (median=22%, range=13-56%) with BDI (median=22%, range=17-48%) buthigher than HADS (median=10%, range=1-22%). Depression was associated with several socio-demographicvariables, cancer-related factors, treatment-related factors, subject psychological factors, lifestyle factors, socialsupport and quality of life.
Conclusions: Breast cancer survivors are at risk for depression so that detection ofassociated factors is important in clinical practice.