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

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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.

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Abbreviations

DSM-IV:

Diagnostic and statistical manual of mental disorders

HADS:

Hospital Anxiety and Depression Scale

IL-6:

Interleukin 6

KPS:

Karnofsky performance status

MMSE:

Mini-mental state examination

PD:

Progressive disease

PR:

Partial remission

Pts:

Patients

SD:

Stable disease

WHO:

World Health Organization

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Authors and Affiliations

  1. Medizinische Klinik m. S. Hämatologie, Onkologie und Tumorimmunologie, Charité Campus Virchow, Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    C. F. Jehn

  2. Hämatologisch-onkologische Praxis Altona, Mörkenstraße 47, 22767, Hamburg, Germany

    B. Flath

  3. Institut für Biometrie und Klinische Epidemiologie, Charité Campus Mitte, Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany

    A. Strux

  4. Klinik für Psychiatrie und Psychotherapie, Charité Campus Mitte, Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany

    M. Krebs

  5. Medizinische Klinik m. S. Hämatologie, Onkologie und Tumorimmunologie, Charité Campus Benjamin Franklin, Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Germany

    A. Pezzutto & D. Lüftner

  6. Medizinische Klinik m. S. Hämatologie, Onkologie und Tumorimmunologie, Charité Campus Mitte, Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany

    K. Possinger

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  1. C. F. Jehn
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Correspondence to C. F. Jehn.

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Jehn, C.F., Flath, B., Strux, A. et al. Influence of age, performance status, cancer activity, and IL-6 on anxiety and depression in patients with metastatic breast cancer. Breast Cancer Res Treat 136, 789–794 (2012). https://doi.org/10.1007/s10549-012-2311-2

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  • DOI: https://doi.org/10.1007/s10549-012-2311-2

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