Depressive Symptoms
A total of 22% of the women scored above a cut point for depression, indicating elevated depressive symptoms, and 38% did so for anxiety, Dr. Lindberg reported. This cut point "is not a diagnosis of clinical depression, but rather a footprint in that direction," Dr. Wellisch emphasized. "A test score is not a diagnosis. That requires a clinical interview, which was not done in these cases."
Compared with the rest of the sample, the depressed women were significantly younger, 40 years vs 43 years on average, and more likely to be unmarried and without children. They had more relatives with breast cancer—2.3 vs 1.98. And they were less likely to have personally seen the results of their relatives’ breast cancer surgery, which indicates less intimacy and more secrecy within the family, Dr. Wellisch said.
In addition, the depressed women generally overestimated their cancer risk, sometimes drastically. Half viewed themselves as likely to develop the disease, although calculations showed that only about 18% would. Virtually none underestimated their calculated risk.
The women scoring above the depression cut point, however, did have higher computed risk than the women scoring below it, were themselves younger at the time of the first relative’s diagnosis, and were significantly more anxious. "The younger at initial exposure, the sadder," Dr. Wellisch said. "The more relatives, the sadder. The more worried, the sadder. And family secrecy breeds sadness."
Compliance
Mammograms and especially breast self-exams caused these women considerable anxiety, Dr. Lindberg said. Few, on the other hand, felt anxious about having a Pap smear, and 88% were up to date for that test.
Seventy-nine percent were also in compliance with recommendations to get mammograms. Just over a third, however, said they performed BSE monthly, and 28% said they never did. Many claimed that they do not know what they were feeling when they tried to examine their breasts.
