The current case-control study examines the associations between different psychiatric domains and sleep disorders in breast cancer patients and correlates them with some of the patients and disease characteristics.
Breast cancer and its invasive treatment option are perceived as a loss of health or body integrity, or even a challenge for the loss of life itself. Such loss may be a triggering force for the development of depression. Also, pain associated with the disease itself and with its treatment is considered as a factor to increase the liability to develop depression and anxiety.
Assessment of prevalence of depression among patients with breast cancer revealed that those patients have significantly higher scores of depressions than those of the control group. A data that is common in different similar studies [19,20,21].
Facing a malignancy is a big shock and distress for the patient and is considered by the many as a life crisis which causes psychological instability ranging from anxiety to depression.
Several previous studies show that family support is an important determinant to protect from depression in cancer patients. The current results show that patients with poor family support are manifested with higher levels of depression and anxiety than those with high family support (mean scores of 21.0 ± 4.185 versus 18.2 ± 1.781) [22]. Also, patients with recurrent disease after treatment had a higher prevalence of depression than those without recurrence. This can be explained by the burden of treatment (radio and chemotherapy). Such findings are like those previous data obtained by Jovana and Milutin [23].
Several previous studies show that family support is an important determinant to protect from depression in cancer patients. The current results show that patients with poor family support are manifested with higher levels of depression and anxiety than those with high family support (mean scores of 21.0 ± 4.185 versus 18.2 ± 1.781) [22]. Also, patients with recurrent disease after treatment had a higher prevalence of depression than those without recurrence. This can be explained by the burden of treatment (radio and chemotherapy). Such findings are like those previous data obtained by Jovana and Milutin [23].
Cancer-related stress is considered as a precipitating factor for the development of different psychiatric symptoms. Evaluating different psychiatric symptoms using symptom checklist (somatization, obsession, sensitivity, anxiety, phobic anxiety, hostility, paranoia ideation and psychoticism) shows that patients with breast cancer scored statistically higher mean scores in somatization, obsession, sensitivity, anxiety, and phobic anxiety than those of the control group. Other different studies showed comparable results [24, 25].
The severe physical and psychological stress, exerted by the cancer itself and its treatment modalities (chemo and radiotherapy), makes depression, somatization, obsession, sensitivity, anxiety, and phobic anxiety symptoms more prevalent in women with breast cancer.
The general-distress factors have been demonstrated in seven mood and anxiety disorders (major depression, dysthymia, agoraphobia, social phobia, simple phobia, GAD, and panic disorder) [26].
Sleep is essential to the maintenance of physiological and psychological health in humans. Evaluating the presence of sleep disorders in the studied sample using Sleep Disorder Scale shows that patients with breast cancer scored a significantly higher mean score of insomnia, hypersomnia, interrupted sleep, nightmares, and total sleep disorder than in control group. These data consistent with the data showing that about 30% to 70% of the adult population suffering from cancer reported one or more sleep problems [2].
Patients with breast cancer are one of the most common examples of sleep disturbance suffering [27,28,29]. A study done by Harris reported that breast cancer patients had sleep problems before diagnosis and sleep disorders aggravated after the diagnosis and ongoing therapy [29].
Such sleep disorders are not only affected by the cancer diagnosis itself but also correlated with the disease staging and with the type of treatment used (radiotherapy and chemotherapy). Also, the current results show that sleep disorders in cancer patients have a higher prevalence in patients with metastasizing and recurrent cancer than those without recurrence of the tumors (Table 9).
By correlating the different stressors (whether social or physical) which are being faced by breast cancer patients with different study domains as depression and anxiety and sleep disorders, we conclude that there is a positive correlation between all, these stressors, and the different study domains. The association between physical and social symptoms burden and the incidence of depression and anxiety in breast cancer patients were done by [30].