Depressive and Post-Traumatic Stress Symptoms and Their Associations with Health-Related Quality of Life in Women with Breast Cancer: A Cross-Sectional Secondary Analysis.
4 affiliations
- 1Department of Midwifery, School of Healthcare Sciences, University of Western Macedonia, Keptse, 50200 Ptolemaida, Greece.
- 2Department of Nursing, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece.
- 3Department of Midwifery, University of West Attica, 12243 Athens, Greece.
- 4School of Health Science, International Hellenic University, 57400 Thessaloniki, Greece.
Abstract
Background
Breast cancer (BC) significantly affects patients' quality of life (QoL), not only through the physical burden of disease and its treatment but also through psychological mechanisms. The aim of this study was to investigate the associations between HRQoL, depressive symptoms, and post-traumatic stress symptoms in Greek women with BC, and to examine sociodemographic and clinical factors associated with depressive and post-traumatic stress symptom severity.Methods
This cross-sectional secondary analysis included 107 women with BC from a previously described cohort. Participants completed a structured demographic and clinical questionnaire, the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), the Patient Health Questionnaire-9 (PHQ-9), and the EORTC Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30).Results
In total, 64.5% of participants had moderate to severe depressive symptoms, with a mean PHQ-9 score of 11.9. In exploratory adjusted analyses, mastectomy and an interval of 1-3 years since BC diagnosis were associated with higher PHQ-9 scores, whereas previous endocrine therapy alone was associated with lower PHQ-9 scores. Regarding post-traumatic stress symptoms, 51.4% of participants met all four PCL-5 DSM-5 symptom-cluster requirements for probable PTSD. Rural residence, mastectomy, and an interval of 1-3 years since BC diagnosis were independently associated with higher PCL-5 scores. Greater depressive symptom severity and probable PTSD status were both significantly associated with poorer HRQoL across multiple functional and symptom domains. Participants meeting the PCL-5 symptom-cluster criteria for probable PTSD also reported greater depressive symptom severity.Conclusions
Greek women with BC experienced a substantial burden of depressive and post-traumatic stress symptoms, which were closely interrelated and associated with poorer HRQoL. Exploratory multivariable analyses suggested associations between selected sociodemographic and clinical characteristics and psychological symptom severity; however, larger prospective studies are needed to confirm these findings. The findings support the relevance of psychological assessment as part of comprehensive BC care.
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BibTeX
@article{karagiannaki2026depressive,
title = {{Depressive and Post-Traumatic Stress Symptoms and Their Associations with Health-Related Quality of Life in Women with Breast Cancer: A Cross-Sectional Secondary Analysis.}},
author = {Anastasia Karagiannaki and Vasiliki Michou and Evangelia Antoniou and Menelaos Zafrakas and Panagiotis Eskitzis},
journal = {Medical sciences (Basel, Switzerland)},
year = {2026},
month = sep,
doi = {10.3390/medsci14060625},
url = {https://europepmc.org/article/MED/42930544},
note = {CC BY},
}
RIS
TY - JOUR
TI - Depressive and Post-Traumatic Stress Symptoms and Their Associations with Health-Related Quality of Life in Women with Breast Cancer: A Cross-Sectional Secondary Analysis.
AU - Anastasia Karagiannaki
AU - Vasiliki Michou
AU - Evangelia Antoniou
AU - Menelaos Zafrakas
AU - Panagiotis Eskitzis
PY - 2026
DA - 2026/09/30
JO - Medical sciences (Basel, Switzerland)
DO - 10.3390/medsci14060625
UR - https://europepmc.org/article/MED/42930544
AB - Background Breast cancer (BC) significantly affects patients' quality of life (QoL), not only through the physical burden of disease and its treatment but also through psychological mechanisms. The aim of this study was to investigate the associations between HRQoL, depressive symptoms, and post-traumatic stress symptoms in Greek women with BC, and to examine sociodemographic and clinical factors associated with depressive and post-traumatic stress symptom severity.Methods This cross-sectional secondary analysis included 107 women with BC from a previously described cohort. Participants completed a structured demographic and clinical questionnaire, the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), the Patient Health Questionnaire-9 (PHQ-9), and the EORTC Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30).Results In total, 64.5% of participants had moderate to severe depressive symptoms, with a mean PHQ-9 score of 11.9. In exploratory adjusted analyses, mastectomy and an interval of 1-3 years since BC diagnosis were associated with higher PHQ-9 scores, whereas previous endocrine therapy alone was associated with lower PHQ-9 scores. Regarding post-traumatic stress symptoms, 51.4% of participants met all four PCL-5 DSM-5 symptom-cluster requirements for probable PTSD. Rural residence, mastectomy, and an interval of 1-3 years since BC diagnosis were independently associated with higher PCL-5 scores. Greater depressive symptom severity and probable PTSD status were both significantly associated with poorer HRQoL across multiple functional and symptom domains. Participants meeting the PCL-5 symptom-cluster criteria for probable PTSD also reported greater depressive symptom severity.Conclusions Greek women with BC experienced a substantial burden of depressive and post-traumatic stress symptoms, which were closely interrelated and associated with poorer HRQoL. Exploratory multivariable analyses suggested associations between selected sociodemographic and clinical characteristics and psychological symptom severity; however, larger prospective studies are needed to confirm these findings. The findings support the relevance of psychological assessment as part of comprehensive BC care.
SN - 2076-3271
ER -