Determinants of suicidal ideation in patients with breast cancer

Authors

  • Jae-Min Kim,

    1. Department of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
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  • Ji-Eun Jang,

    1. Department of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
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  • Robert Stewart,

    1. Institute of Psychiatry, King's College London, London, UK
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  • Seon-Young Kim,

    1. Department of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
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  • Sung-Wan Kim,

    1. Department of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
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  • Hee-Ju Kang,

    1. Department of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
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  • Il-Seon Shin,

    1. Department of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
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  • Min-Ho Park,

    1. Breast and Endocrine Tumor Clinic, and Mental Health Clinic, Chonnam National University Hwasun Hospital, Hwasun, Korea
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  • Jung-Han Yoon,

    1. Breast and Endocrine Tumor Clinic, and Mental Health Clinic, Chonnam National University Hwasun Hospital, Hwasun, Korea
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  • Jin-Sang Yoon

    Corresponding author
    1. Department of Psychiatry, Chonnam National University Medical School, and Depression Clinical Research Center, Chonnam National University Hospital, Gwangju, Korea
    • Correspondence to: Department of Psychiatry, Chonnam National University Medical School, 160 Baekseoro, Dong-gu, Gwangju 501-757, Korea. E-mail: jsyoon@chonnam.ac.kr

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Abstract

Background

Breast cancer survivors are at higher risk of psychological problems including suicidal ideation. However, studies on suicidal ideation in breast cancer survivors have been rare and have not been investigated prospectively. This study aimed to investigate the prevalence and independent risk factors for suicidal ideation within 1 week and at 1 year after breast surgery for breast cancer.

Methods

A total of 284 patients with breast cancer were evaluated within 1 week after breast surgery, and 244 (84%) were followed up 1 year later. Suicidal ideation was ascertained using the item ‘suicidal thoughts’ from the Beck Depression Inventory. Various factors potentially related to suicidal ideation were evaluated including sociodemographic and clinical characteristics, and genetic polymorphisms on serotonin and brain-derived neurotrophic factor (BDNF) systems.

Results

Suicidal ideation was present in 10.9% of participants at 1 week and 11.4% at 1 year after breast surgery. Suicidal ideation was independently associated with depression and physical disability at 1 week and with living alone, anxiety, advanced cancer stage, and the BDNF met allele (but not with genetic polymorphisms on serotonergic system) at 1 year after breast surgery.

Conclusions

Suicidal ideation was common and had similar prevalences in both short-term and longer-term follow-ups after breast cancer. However, associated factors were substantially different between the two evaluation points, which suggest that time-specific programs may be needed for identifying and managing suicidal risk in patients with breast cancer. Copyright © 2013 John Wiley & Sons, Ltd.

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