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Depression as a risk factor for breast cancer: investigating methodological limitations in the literature

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Abstract

Purpose

A relationship between depression and the development of breast cancer has not been convincingly shown in the research conducted over the past three decades.

Methods

In an effort to better understand the conflicting results, a review was conducted focusing on the methodological problems associated with this literature, including time frame between the assessment of depression and the diagnosis of breast cancer and the use of somatic items in measuring depression. Fifteen breast cancer prospective studies were reviewed.

Results

While twelve of the studies found positive associations between depression and breast cancer development, three studies found negative associations. With regard to the predictive associations between depression and breast cancer incidence, the findings revealed that (a) studies using a longer time frame found a stronger association than studies using a shorter time frame and (b) studies utilizing depression measures that did not contain somatic items found a smaller association than studies utilizing depression measures that did contain these items.

Conclusions

Future studies should ensure that sufficient periods of time between the measurement of depression and the assessment of cancer and avoid measuring depression using somatic items.

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Notes

  1. It should be noted that Gross et al.’s [49] publication is an update of Gallo et al. [47] including an additional wave of data collection, which extends the time frame from 13 to 24 years. In addition, both studies use only partially identical methodological control variables.

References

  1. American Cancer Society. Cancer Facts & Figures 2010. Available from URL: http://www.cancer.org/acs/groups/content/@epidemiologysurveilance/documents/document/acspc-026238.pdf. Accessed 5 Sep 2011

  2. Greer S (1983) Cancer and the mind. Br J Psychiatry 14:535–543

    Article  Google Scholar 

  3. Snow HL (1893) Cancer and the cancer process. Churchill, London

    Google Scholar 

  4. Ader R, Cohen N, Felten D (1995) Psychoneuroimmunology: interaction between the nervous system and the immune system. Lancet 345:99–103

    Article  PubMed  CAS  Google Scholar 

  5. Andersen BL, Farrar WB, Golden-Kreutz D et al (1998) Stress and immune responses after surgical treatment for regional breast cancer. J Natl Cancer Inst 90:30–36

    Article  PubMed  CAS  Google Scholar 

  6. Schleifer SJ, Keller SE, Bartlett JA, Eckholdt HM, Delaney BR (1996) Immunity in young adults with major depressive disorder. Am J Psychiatry 153:477–482

    PubMed  CAS  Google Scholar 

  7. Kiecolt-Glaser JK, Robles TF, Heffner KL, Loving TJ, Glaser R (2002) Psycho-oncology and cancer: psychoneuroimmunology and cancer. Ann Oncol 13:165–169

    Article  PubMed  Google Scholar 

  8. Glaser R, Thorn BE, Tarr KL, Kiecolt-Glaser JK, D’Ambrosio SM (1985) Effects of stress on methyltransfease synthesis: an important DNA repair enzyme. Br J Health Psychol 4:403–412

    Article  CAS  Google Scholar 

  9. Pulaski L, Kania K, Ratajewski M et al (2005) Differential regulation of the human MRP2 and MRP3 gene expression by glucocorticoids. J Steroid Biochem Mol Biol 2005(96):229–234

    Article  Google Scholar 

  10. Su F, Ouyang N, Zhu P et al (2005) Psychological stress induces chemoresistance in breast cancer by upregulating mdr1. Biochem Biophys Res Commun 329:888–897

    Article  PubMed  CAS  Google Scholar 

  11. Ticher A, Haus E, Ron IG et al (1996) The pattern of hormonal circadian time structure (acrophase) as an assessor of breast cancer risk. Int J Cancer 65:591–593

    Article  PubMed  CAS  Google Scholar 

  12. Butow PN, Hiller JE, Price MA, Thackway SV, Kricker A, Tennant CC (2000) Epidemiological evidence for a relationship between life events, coping style, and personality factors in the development of breast cancer. J Psychosom Res 49:169–181

    Article  PubMed  CAS  Google Scholar 

  13. Dalton SO, Boesen EH, Ross L, Schapiro IR, Johansen C (2002) Mind and cancer: do psychological factors cause cancer? Eur J Cancer 38:1313–1323

    Article  PubMed  CAS  Google Scholar 

  14. Garssen B (2004) Psychological factors and cancer development: evidence after 30 years of research. Clin Psychol Rev 24:315–338

    Article  PubMed  Google Scholar 

  15. McGee R, Williams S, Elwood M (1994) Depression and the development of cancer: a meta-analysis. Soc Sci Med 38:187–192

    Article  PubMed  CAS  Google Scholar 

  16. McKenna MC, Zevon MA, Corn B, Rounds J (1999) Psychosocial factors and the development of breast cancer: a meta-analysis. Health Psychol 18:520–531

    Article  PubMed  CAS  Google Scholar 

  17. Oerleman MEJ, van den Akker M, Schuurman AG, Kellen E, Buntinx F (2007) A meta-analysis on depression and subsequent cancer risk. Clin Pract Epidemiol Mental Health 3:29

    Article  Google Scholar 

  18. Spiegel D, Giese-Davis J (2003) Depression and cancer: mechanisms and disease progression. Biol Psychiatry 54:269–282

    Article  PubMed  Google Scholar 

  19. Friberg S, Mattson S (1997) On the growth rates of human malignant tumors: implications for medical decision making. J Surg Oncol 65:284–297

    Article  PubMed  CAS  Google Scholar 

  20. Spratt JS, Meyer JS, Spratt JA (1996) Rates of growth of human solid neoplasms: part II. J Surg Oncol 61:68–83

    Article  PubMed  CAS  Google Scholar 

  21. Eskelinen M, Ollonen P (2011) Beck Depression Inventory in patients with breast disease and breast cancer: a prospective case–control study. In Vivo 25:111–116

    PubMed  Google Scholar 

  22. Eskelinen M, Ollonen P (2011) Montgomery-Asberg Depression Rating Scale (MADRS) in healthy study subjects, in patients with breast disease and breast cancer: a prospective case–control study. Anticancer Res 31:1065–1069

    PubMed  Google Scholar 

  23. Eskelinen M, Ollonen P (2011) Montgomery-Asberg Depression Rating Scale (MADRS) in healthy study subjects, in patients with breast disease and breast cancer: a prospective case–control study. Anticancer Res 31:1065–1069

    PubMed  Google Scholar 

  24. Eskelinen M, Ollonen P (2011) Measurement of pessimism: Hopelessness Scale in healthy study subjects, in patients with breast disease and breast cancer: a prospective case–control study in Finland. Anticancer Res 31:4019–4023

    PubMed  Google Scholar 

  25. Ollonen P, Lehtonen J, Eskelinen M (2005) Anxiety, depression and the history of psychiatric symptoms in patients with breast disease: a prospective case–control study in Kuopio, Finland. Anticancer Res 25:2527–2534

    PubMed  Google Scholar 

  26. Dugan W, McDonald MV, Passik SD, Rosenfeld BD, Theobald D, Edgerton S (1998) Use of the Zung Self-Rating Depression Scale in cancer patients: feasibility as a screening tool. Psycho-Oncology 7:483–493

    Article  PubMed  CAS  Google Scholar 

  27. Wedding U, Koch A, Röhrig B et al (2007) Requestioning depression in patients with cancer: contribution of somatic and affective symptoms to Beck’s Depression Inventory. Ann Oncol 18:1875–1881

    Article  PubMed  CAS  Google Scholar 

  28. Endicott J (1984) Measurement of depression in patients with cancer. Cancer 53:2243–2248

    PubMed  CAS  Google Scholar 

  29. Cavaugh S (1984) Diagnosing depression in the hospitalised patient with chronic medical illness. J Clin Psychiatry 45:13–16

    Google Scholar 

  30. Ryder AG, Yang J, Zhu X, Yao S, Yi J, Heine SJ, Bagby RM (2008) The cultural shaping of depression: somatic symptoms in China, psychological symptoms in North America? J Abnorm Psychol 117:300–313

    Article  PubMed  Google Scholar 

  31. American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), 4th edn. American Psychiatric Association, Washington, DC

    Google Scholar 

  32. Akechi T, Nakano T, Akizuki N et al (2003) Somatic symptoms for diagnosing major depression in cancer patients. Psychosomatics 44:244–248

    Article  PubMed  Google Scholar 

  33. Bleiker EM, Hendriks JH, Otten JD, Verbeek AL, van der Ploeg HM (2008) Personality factors and breast cancer risk: a 13-year follow-up. J Natl Cancer Inst 100:213–218

    Article  PubMed  Google Scholar 

  34. Bushman BJ, Wang MC (2009) Vote-counting procedures in meta-analysis. In: Cooper H, Hedges LV, Valentine JC (eds) The handbook of research synthesis and meta-analysis, 2nd edn. Russell Sage Foundation, New York, pp 207–220

    Google Scholar 

  35. Aro AR, de Koning HJ, Schreck M, Hendriksson M, Anttila A, Pukkala E (2005) Psychological risk factors of incidence of breast cancer: a prospective cohort study in Finland. Psychol Med 35:1515–1521

    Article  PubMed  CAS  Google Scholar 

  36. Bleiker EMA, van der Ploeg JHCL, Hendriks HJA (1996) Personality factors and breast cancer development: a prospective longitudinal study. J Natl Cancer Inst 88:1478–1482

    Article  PubMed  CAS  Google Scholar 

  37. Penninx BW, Guralnik JM, Pahor M et al (1998) Chronically depressed mood and cancer risk in older persons. J Natl Cancer Inst 90:1888–1893

    Article  PubMed  CAS  Google Scholar 

  38. Goldacre MJ, Wotton CJ, Yeates D, Seagroatt V, Flint J (2007) Cancer in people with depression and anxiety: record-linkage study. Soc Psychiatry Epidemiol 42:683–689

    Article  Google Scholar 

  39. Nykliček I, Louwman WJ, Van Nierop PW, Wijnands CJ, Coebergh JW, Pop VJ (2003) Depression and the lower risk for breast cancer development in middle-aged women: a prospective study. Psychol Med 33:1111–1117

    Article  PubMed  Google Scholar 

  40. Gallo JJ, Armenian HK, Ford DE, Eaton WW, Khachaturian AS (2000) Major depression and cancer: the 13-year follow-up of the Baltimore epidemiologic catchment area sample (United States). Cancer Causes Control 11:751–758

    Article  PubMed  CAS  Google Scholar 

  41. Gross AL, Gallo JJ, Eaton WW (2010) Depression and cancer risk: 24 years of follow-up of the Baltimore epidemiologic catchment area sample. Cancer Causes Control 21:191–199

    Article  PubMed  Google Scholar 

  42. Jacobs JR, Bovasso GB (2000) Early and chronic stress and their relation to breast cancer. Psychol Med 30:669–678

    Article  PubMed  CAS  Google Scholar 

  43. Lichtman JH (1996) Are depressive symptoms, social networks and social support, or self-evaluated health measures predictive of cancer incidence and stage of diagnosis? Evidence from a prospective community based sample of elderly New Haven residents (Doctoral dissertation). Yale University, New Haven

    Google Scholar 

  44. Hahn RC, Petitti DB (1988) Minnesota Multiphasic Personality Inventory-rated depression and the incidence of breast cancer. Cancer 61:845–848

    Article  PubMed  CAS  Google Scholar 

  45. Hjerl K, Andersen EW, Keiding N et al (1999) Breast cancer risk among women with psychiatric admission with affective or neurotic disorders: a nationwide cohort study in Denmark. Br J Cancer 81:907–911

    Article  PubMed  CAS  Google Scholar 

  46. Dalton SO, Mellemkjaer L, Olsen JH, Mortensen PB, Johansen C (2002) Depression and cancer risk: a register-based study of patients hospitalized with affective disorders, Denmark, 1969–1993. Am J Epidemiol 155:1088–1095

    Article  PubMed  Google Scholar 

  47. Kaplan GA, Reynolds P (1988) Depression and cancer mortality and morbidity: prospective evidence from the Alameda County study. J Behav Med 11:1–13

    Article  PubMed  CAS  Google Scholar 

  48. Knekt P, Raitasalo R, Heliövaara M et al (1996) Elevated lung cancer risk among persons with depressed mood. Am J Epidemiol 144:1096–1103

    Article  PubMed  CAS  Google Scholar 

  49. Chen Y-H, Lin H-C (2011) Increased risk of cancer subsequent to severe depression-A nationwide population-based study. J Affect Disord 131:200–206

    Article  PubMed  Google Scholar 

  50. Liang J-A, Sun L-M, Muo C-H et al (2011) The analysis of depression and subsequent cancer risk in Taiwan. Cancer Epidemiol Biomark Prev 20:473–475

    Article  Google Scholar 

  51. Schuurman AG, van den Akker M, Ensinck KTJL et al (2001) Does depression increase susceptibility for somatic disease? NWO-report. Research Institute Ex Tra, Maastricht

    Google Scholar 

  52. Kuehner C, Holzhauer S, Huffziger S (2007) Decreased cortisol response to awakening is associated with cognitive vulnerability to depression in a nonclinical sample of young adults. Psychoneuroendocrinology 32:199–209

    Article  PubMed  CAS  Google Scholar 

  53. Nolen-Hoeksema S, Morrow J (1991) A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta earthquake. J Pers Soc Psychol 61:115–121

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The review was not supported by any kind of grant.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Educational and Counseling Psychology, University of Louisville, 2301 S. Third Street, Louisville, KY, 40292, USA

    Patrick Pössel, Erica Adams & Jeffrey C. Valentine

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  1. Patrick Pössel
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  2. Erica Adams
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  3. Jeffrey C. Valentine
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Correspondence to Patrick Pössel.

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Pössel, P., Adams, E. & Valentine, J.C. Depression as a risk factor for breast cancer: investigating methodological limitations in the literature. Cancer Causes Control 23, 1223–1229 (2012). https://doi.org/10.1007/s10552-012-0014-y

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  • DOI: https://doi.org/10.1007/s10552-012-0014-y

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