Depression and Anxiety in Women with Early Breast Cancer


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Five Year Observation Cohort Study by Burgess et al

a)      This study by Burgess et al was aimed at examining the prevalence of and risk factors for depression and anxiety in women with early breast cancer. The research question is not given but they might have been close to these; (1) what is the prevalence of depression and anxiety in women with early breast cancer (2) which are the risk factors for depression and anxiety in women with early breast cancer?  The hypothesis would be: Depression and anxiety is highly prevalent in women with early breast cancer.

b)      This is study can be categorized as a qualitative research. This is because the research did not just provide statistics about prevalence of depression and anxiety among women with breast cancer but also provided a description of why these were prevalent (risk factors). Use of interviews and observation as means of data collection also qualifies it as a qualitative research.

c)      The main independent variable was early breast cancer

d)      The main dependent variables were prevalence of depression and anxiety.

e)      Age was a dependent variable and the study targeted women below 60 years. One of the risk factor was severely stressful non-cancer related life experiences. These were assesses using the Bedford College life events and difficulties schedule. Another risk factor, intimate confiding relationship, was defined as relationship with a cohabiting factor. The third risk factor, previous psychological treatment, was defined as any psychological treatment from a general practitioner or as a hospital inpatient or outpatient.

f)        The main dependent variable, point of prevalence of depression and anxiety, was calculated as the percentage of women with depression and anxiety or both in the month before a given point.  The annual period preference was the percentage of women who had at least one episode of anxiety or depression or both over the one year period.

g)      In regard to women with early cancer the study picked women who were about 8 weeks after diagnosis. Risk factors were assessed using Cox’s proportional hazard model.

h)      In regard to prevalence, women were groped in to two; those who had experienced a period of anxiety, depression or both within a period of one year and those who had not.

i)        A number of relationships were established after the study. One of them was that, prevalence of depression and anxiety was high among women who had just been diagnosed with breast cancer (less that one year after diagnosis) and levels of prevalence decline as time passes by.  At the time of diagnosis previous psychological treatment were found to be some of the risk factors that influenced levels of depression and anxiety. In the medium term risks associated to depression and anxiety were previous psychological treatment, severe non-cancer difficulties and lack of an intimate confiding relationship. In longer term the risk factors were established as lack of intimate confiding relationship, younger age, severe non-cancer difficulties and earlier episodes of depression, anxiety or both.

j)        Considering people with a past history with the disease may be a sick relative would have brought different outcome.

k) The study concluded that there are increased levels of anxiety and depression within the first year of diagnosis of cancer which require attention and psychological help.

 Validation of the Shortened COPE for Use with Breast Cancer Patients Undergoing Radiation Therapy by Fillion et al

a)      The research question in this study was to analyze the consistency and reliability of the 28-item shortened COPE tool for coping skills among women with cancer. This study investigates the coping skills of women with cancer and compares finding with the COPE measurement criteria. The hypothesis would be; the shortened COPE instrument is reliable and consistent in measuring coping behavior of suffering patients

b)      This is a quantitative research. It provides measurements and statistics rather than providing a description or explanation.

c)      The independent variables in this study are the eight scales of coping used by COPE. The author has identified a list of 8 coping skills;  disengagement, self-distraction, active coping, using emotional support from partners, emotional support from friends, turning to religion, humor and substance abuse. Other independent variable included age, income and level of education.

d)      The dependent variables are coping ability and mood states such as anxiety, depression and anger. These variables are caused by the coping skills. Reliability and consistency of COPE are also dependent variables

e)      The study has defined all the scale of coping by COPE; disengagement, self-distraction, active coping, using emotional support from partners, emotional support from friends, turning to religion, humor and substance abuse. Disengagement was defined as the act of denying presence of illness, self distraction is the process of turning to other activities in order to forget your illness, active coping refers to action geared towards developing a plan of action, emotional support is the act of socializing with others in order to feel better, other may turn to religion, others make jokes in order to forget their illness while others turn to drugs. The researcher selected women with at least 8 years in school, income of $ 50,000 and aged 31 – 79 years.

f)        The various moods which are dependent on the cooping skills were also defined. These included; anxiety, depression, fatigue, anger confusion and vigor. Reliability is the ability of the instrument to give accurate results while consistency is the ability of the instrument to replicate results.

g)      The study examined performance of the coping scales by comparing and correlating its finding with those of other instruments such as POMS and CHIP.

h)      Conceptual definition used in defining the mood disturbances were also used in the operational definition of this dependent variable.

i)        Findings of the study established and dismissed various relationships. One of them was that there was relationship between active coping and anxiety and depression among the subject. The author attempts to give an explanation that individual become less concerned with stressor factors they have less control over with time. Another finding was that avoidance coping was highly related to mood disturbance. Disengagement was found to be highly correlated with anger, anxiety and depression.

j)        The author should have included variable such as Psychological treatment. People who have undergone psychological treatment may have given a different outcome.

k)      The main aim of the study was to analyze the reliability and consistency of the COPE shorted version in measuring coping skill. The finding gave the indication that this instrument was highly reliable and consistent.


Burgess C. et al (2005). Depression and Anxiety in Women with Breast Cancer: Five Year Observational Cohort Study. BJM

Fillison L. et al (2002). Validation of the Shortened COPE for Use with Breast Cancer Patients Undergoing Radiation Therapy. Social Spring, 21 (1), 17-34


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