ABSTRACT
OBJECTIVE: A significant number of breast cancer patients, during their life with the diagnosis, experience emotional distress in the form of depression and anxiety. Psychological resilience is the ability of a person to protect his/her mental health when faced with adverse circumstances such as the cancer diagnosis. This study aims to assess the resilience in breast cancer patients and to explore whether depression affects the resilience. MATERIAL AND METHODS: Two hundred eighteen (218) women, treated for early breast cancer responded to Connor - Davidson Resilience Scale and Hospital Depression and Anxiety Scale, in order to assess the level of psychological resilience and the level of depression. RESULTS: There is a significant negative correlation between depression and resilience in our sample (r = - 0.562, p < 0.001). Individuals with higher levels of depression have lower levels of psychological resilience. There is no statistically significant correlation between the ages of the participants; time passed since diagnosis, cancer stage and resilience levels. CONCLUSION: This study shows that patients who are less depressed have higher levels of resilience and that psychological resilience may independently contribute to lower levels of depression among breast cancer patients. The level of psychological resilience may be a protective factor for depression and psychological distress.
ABSTRACT
BACKGROUND: Many studies have shown that a relationship exists between quality of life (QoL) and resilience in breast cancer patients, but few studies present information on the nature of this relationship of resilience on QoL. Our aim was to examine the relationship between resilience and quality of life in breast cancer patients. METHODS: QoL was measured in 218 consequent breast cancer patients, with EORTC - QLQ Core 30 questionnaire, and EORTC QLQ-BR23. The resilience was measured with Connor Davidson Resilience Scale. RESULTS: The global quality of life was positively correlated with the levels of resilience (R = 0.39 p < 0.001). All functional scales (physical, role, emotional, cognitive and social functioning was in a positive correlation with resilience. The symptoms severity (fatigue, nausea and vomitus, pain, dyspnea, insomnia, appetite loss, constipation, diarrhea, financial difficulties) was in negative correlation with resilience. Less resilient breast cancer patients reported worse body image and future perspective and suffered from more severe adverse effects of systemic therapy, and arm/breast symptoms. CONCLUSION: Our findings show that psychological resilience affects different aspects of health-related quality of life. More resilient patients have significantly better quality of life in almost all aspects of QoL.
ABSTRACT
BACKGROUND: A growing body of evidence shows that brain-derived neurotrophic factor (BDNF) plays a role in depressive disorder. Serum BDNF levels are lower in depressed patients and they increase after a long course of antidepressant treatment. Our study aims to test the effect of antidepressant treatment on serum BDNF levels in patients with a depressive episode, after they have achieved remission in two studies in Macedonia and Bulgaria. SUBJECTS AND METHODS: In the Macedonian study 23 patients were included (11 female, 12 male) diagnosed with a first depressive episode according to ICD-10, as well as 23 control subjects age- and sex-matched without a history of psychiatric disorder. In the Bulgarian study 10 female patients with depression and 10 control subjects were included. We have applied the Hamilton Depression Rating Scale (HDRS) to assess depression severity. Blood samples were collected before antidepressive treatment and after remission was achieved (decrease to 7 points or less on HDRS). RESULTS: In the Macedonian study, mean serum BDNF level at baseline was 13.15±6.75 ng/ml and the mean HDRS score was 28.52±4.02. Untreated depressed patients showed significantly lower serum BDNF levels compared to the control group (25.95±9.17 ng/ml). After remission was achieved, the mean serum BDNF level was 24.73±11.80 ng/ml whereas the mean HDRS score was 7.04±3.15. After 8 weeks of treatment there was no statistically significant difference in the serum BDNF levels between the two groups. In the Bulgarian study, baseline mean serum BDNF levels were 26.84±8.66 ng/ml, after 3 weeks treatment and remission was achieved mean serum BDNF levels were 30.33±9.25 ng/ml and in the control group mean serum BDNF levels were 25.04±2.88 ng/ml. Integrated results showed baseline mean serum BDNF levels of 17.30±9.66 ng/ml, after achieved remission 26.43±11.25 ng/ml and in the control group mean serum BDNF levels of 25.68±7.76 ng/ml. CONCLUSION: The Bulgarian results showed no statistical difference between the depressed group and controls. The Integrated results and the Macedonian study supported previous findings of low BDNF levels in untreated depressive patients compared to healthy controls, and that those levels increase after antidepressant treatment. These results may suggest that low serum levels of BDNF are a state abnormality that is evident during depression and normalizes during remission.
