Carreira H, et al. - In breast cancer survivors (≥1 year), authors systematically reviewed the evidence on adverse mental health outcomes compared with women with no history of cancer. They noted a compelling evidence of an increased risk of anxiety, depression, and suicide, and neurocognitive and sexual dysfunctions in breast cancer survivors, vs women with no prior cancer. In order to support evidence-based prevention and management strategies, this information can be used.

Methods

• Experts identified the studies by searching MEDLINE, PsycINFO, the Cumulative Index to Nursing and Allied Health Literature, and the Social Sciences Citation Index, and through backward citation tracking.
• The studies were selected, data were extracted, and the risk of bias were assessed by two researchers.

Results

• Authors included 60 studies.
• Findings suggested that out of 38 studies of depression, 33 observed more depression in breast cancer survivors; they noted a statistically significance of this in 19 studies overall, including six of seven where depression was ascertained clinically, three of four studies of antidepressants, and 13 of 31 that quantified depressive symptoms.
• Results demonstrated that out of 21 studies of anxiety, 17 observed more anxiety in breast cancer survivors, statistically significant in 11 studies overall, including two of four with clinical/prescription-based outcomes, and in eight of 17 of anxiety symptoms.
• Statistically significantly increased symptoms/frequency of neurocognitive dysfunction (18 of 24 studies), sexual dysfunctions (5 of 6 studies), sleep disturbance (5 of 5 studies), stress-related disorders/PTSD (2 of 3 studies), suicide (2 of 2 studies), somatisation (2 of 2 studies), and bipolar and obsessive-compulsive disorders (1 of 1 study each) were also seen in breast cancer survivors.
• They noted heterogeneity of studies in terms of participants’ characteristics, time since diagnosis, ascertainment of outcomes, and measures reported.
• As per data, high risk of selection bias and confounding by socio-economic status were seen in approximately one-half of the studies.