ABSTRACT
OBJECTIVE: Breast cancer has psychological consequences that impact quality of life. We examined factors associated with negative psychological consequences of a breast cancer diagnosis, in a diverse sample of 910 recently diagnosed patients (378 African American, 372 white, and 160 Latina). METHODS: Patients completed an in-person interview as part of the Breast Cancer Care in Chicago study within an average of 4 months from diagnosis. The Cockburn negative psychological consequences of breast cancer screening scale was revised to focus on a breast cancer diagnosis. Path analysis assessed predictors of psychological consequences and potential mediators between race/ethnicity and psychological consequences. RESULTS: Compared to white counterparts, bivariate analysis showed African American (ß = 1.4, P < .05) and Latina (ß = 3.6, P < .001) women reported greater psychological consequences. Strongest predictors (P < .05 for all) included unmet social support (ß = .38), and provider trust (ß = .12), followed by stage at diagnosis (ß = .10) and perceived neighborhood social disorder (ß = .09).The strongest mediator between race/ethnicity and psychological consequences was unmet social support. CONCLUSIONS: African American and Latina women reported greater psychological consequences related to their breast cancer diagnosis; this disparity was mediated by differences in unmet social support. Social support represents a promising point of intervention.
Subject(s)
Black or African American/psychology , Breast Neoplasms/diagnosis , Breast Neoplasms/psychology , Hispanic or Latino/psychology , Quality of Life , White People/psychology , Adult , Aged , Breast Neoplasms/ethnology , Chicago/epidemiology , Early Detection of Cancer , Female , Humans , Middle Aged , Perception , Residence Characteristics , Social SupportABSTRACT
Depression in its own right is a disabling condition impairing all aspects of human function. In persons with a chronic medical disease, depression often makes the management of chronic illness more difficult. Recently, vitamin D has been reported in the scientific and lay press as an important factor that may have significant health benefits in the prevention and the treatment of many chronic illnesses. Most individuals in this country have insufficient levels of vitamin D. This is also true for persons with depression as well as other mental disorders. Whether this is due to insufficient dietary intake, lifestyle (e.g., little outdoor exposure to sunshine), or other factors is addressed in this paper. In addition, groups at risk and suggested treatment for inadequate vitamin D levels are addressed. Effective detection and treatment of inadequate vitamin D levels in persons with depression and other mental disorders may be an easy and cost-effective therapy which could improve patients' long-term health outcomes as well as their quality of life.
