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Relationship of oestrogen receptor status to depressive symptoms and quality of life in breast cancer patients

Published online by Cambridge University Press:  26 February 2013

Jong-Hoon Kim ,
Byoung-Jo Lee ,
Jae-Nam Bae  and
Bong-Jin Hahm
Jong-Hoon Kim
Affiliation:
Department of Psychiatry, Gil Medical Center, Gachon University, Incheon, Republic of Korea
Byoung-Jo Lee
Affiliation:
Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea Department of psychiatry, Boram Hospital, Incheon, Republic of Korea
Jae-Nam Bae
Affiliation:
Department of Psychiatry, Inha University College of Medicine, Incheon, Republic of Korea
Bong-Jin Hahm*
Affiliation:
Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea Department of Psychiatry and Behavioral Sciences, Seoul National University, College of Medicine, Seoul, Republic of Korea Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
*
Dr. Bong-Jin Hahm, Department of Psychiatry and Behavioral Sciences, Seoul National University, College of Medicine, 28 Yongon-Dong, Chongno-Gu, Seoul, 110-744, Republic of Korea. Tel: 82-2-2072-2557; Fax: 82-2-744-7241; E-mail: [email protected]
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Abstract

Objective

We investigated the relationship of oestrogen receptor (ER) status to the severity of depressive symptoms and quality of life (QOL) impairment in breast cancer patients.

Methods

Seventy-seven breast cancer patients with comorbid depression were evaluated with the Hamilton Depression Rating Scale (HAMD), the Clinical Global Impression-Severity of Illness (CGI-S) for depression, and the Functional Assessment of Cancer Therapy-Breast (FACT-B). ER status was determined using immunohistochemical analysis.

Results

The ER-positive group (n = 31) showed significantly higher scores compared with the ER-negative group (n = 46) on HAMD total (p = 0.04) and somatic anxiety factor (p = 0.004) scores as well as CGI-S score (p = 0.03). As for QOL measured with the FACT-B, a significantly higher score was found on the Functional Well-Being (FWB) subscale in the ER-positive group (p = 0.001). The relationships were further analysed using generalised linear models (GLM), after controlling for the influence of the current anti-oestrogen treatment. The analysis revealed that ER status was still significantly related to the FWB subscale score of the FACT-B (p = 0.04). However, the HAMD and CGI-S scores were no longer significantly related to ER status after the influence of anti-oestrogen treatment was controlled for.

Conclusion

These results suggest that ER status, which is a well-known biological prognostic factor in breast cancer, may be related to the severity of certain aspects of depressive symptoms or QOL impairment, implying a role of the ER in affective and behavioural regulation. However, anti-oestrogen treatments significantly influence these relationships.

Keywords

anti-oestrogen treatment, breast cancer, depressive symptoms, oestrogen receptor status, QOL
Type
Original Articles
Information
Acta Neuropsychiatrica , Volume 25 , Issue 5 , October 2013 , pp. 283 - 288
Copyright
Copyright © Scandinavian College of Neuropsychopharmacology 2013 

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References

1.Weinberger, T, Forrester, A, Markov, D, Chism, K, Kunkel, EJ. Women at a dangerous intersection: diagnosis and treatment of depression and related disorders in patients with breast cancer. Psychiatr Clin North Am 2010;33:409–422.CrossRefGoogle Scholar
2.Spiegel, D, Giese-Davis, J. Depression and cancer: mechanisms and disease progression. Biol Psychiatry 2003;54:269–282.CrossRefGoogle ScholarPubMed
3.Bower, JE. Behavioral symptoms in patients with breast cancer and survivors. J Clin Oncol 2008;26:768–777.CrossRefGoogle ScholarPubMed
4.Snoj, Z, Akelj, MP, Lièina, M, Pregelj, P. Psychosocial correlates of progesterone receptors in breast cancer. Depress Anxiety 2009;26:544–549.Google ScholarPubMed
5. Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), Davies, C, Godwin, Jet al. Relevance of breast cancer hormone receptors and other factors to the efficacy of adjuvant tamoxifen: patient-level meta-analysis of randomised trials. Lancet 2011;378:771–784.Google Scholar
6.Razavi, D, Farvacques, C, Delvaux, Net al. Psychosocial correlates of oestrogen and progesterone receptors in breast cancer. Lancet 1990;335:931–933.CrossRefGoogle ScholarPubMed
7.Rosenqvist, S, Berglund, G, Bolund, Cet al. Lack of correlation between anxiety parameters and oestrogen receptor status in early breast cancer. Eur J Cancer 1993;29A:1325–1326.CrossRefGoogle ScholarPubMed
8.Chen, X, Zheng, Y, Zheng, Wet al. Prevalence of depression and its related factors among Chinese women with breast cancer. Acta Oncol 2009;48:1128–1136.CrossRefGoogle ScholarPubMed
9.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision. Washington, DC: American Psychiatric Association, 2000.Google Scholar
10.Oken, MM, Creech, RH, Tormey, DCet al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 1982;5:649–655.CrossRefGoogle ScholarPubMed
11.Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960;23:56–62.CrossRefGoogle ScholarPubMed
12.Guy, W. ECDEU Assessment Manual for Psychopharmacology, Revised. Rockville: National Institute of Mental Health, 1976.Google Scholar
13.Brady, MJ, Cella, DF, Mo Fet al. Reliability and validity of the functional assessment of cancer therapy-breast quality-of-life instrument. J Clin Oncol 1997;15:974–986.CrossRefGoogle ScholarPubMed
14.Pancheri, P, Picardi, A, Pasquini, M, Gaetano, P, Biondi, M. Psychopathological dimensions of depression: a factor study of the 17-item Hamilton Depression Rating Scale in unipolar depressed outpatients. J Affect Disord 2002;68:41–47.CrossRefGoogle ScholarPubMed
15.Hammond, ME, Hayes, DF, Dowsett, Met al. American Society of Clinical Oncology/College of American Pathologists guideline recommendations for immunohistochemical testing of estrogen and progesterone receptors in breast cancer. J Clin Oncol 2010;28:2784–2795.CrossRefGoogle Scholar
16.Henry, NL, Stearns, V, Flockhart, DA, Hayes, DF, Riba, M. Drug interactions and pharmacogenomics in the treatment of breast cancer and depression. Am J Psychiatry 2008;165:1251–1255.CrossRefGoogle ScholarPubMed
17.Holsboer, F, Künzel, HE. Clinical Neuroendocrinology. In: Charney DS and Nestler EJ, editors. Neurobiology of Mental Illness, 2nd edn. New York: Oxford University Press, 2004. p. 155–170.Google Scholar
18.Rubinow, DR, Schmidt, PJ, Roca, CA. Estrogen-serotonin interactions: implications for affective regulation. Biol Psychiatry 1998;44:839–850.CrossRefGoogle ScholarPubMed
19.Kulkarni, J, Garland, KA, Scaffidi, Aet al. A pilot study of hormone modulation as a new treatment for mania in women with bipolar affective disorder. Psychoneuroendocrinology 2006;31:543–547.CrossRefGoogle ScholarPubMed
20.Zarate, CA JrSingh, JB, Carlson, PJet al. Efficacy of a protein kinase C inhibitor (tamoxifen) in the treatment of acute mania: a pilot study. Bipolar Disord 2007;9:561–570.CrossRefGoogle ScholarPubMed
21.Bromberger, JT, Schott, LL, Kravitz, HMet al. Longitudinal change in reproductive hormones and depressive symptoms across the menopausal transition: results from the Study of Women's Health Across the Nation (SWAN). Arch Gen Psychiatry 2010;67:598–607.CrossRefGoogle Scholar
22.Weiser, MJ, Foradori, CD, Handa, RJ. Estrogen receptor beta in the brain: from form to function. Brain Res Rev 2008;57:309–320.CrossRefGoogle ScholarPubMed