Objective:

To evaluate patterns of association between anxiety and depression and the different elements of the construct of quality of life, in patients with locally advanced breast cancer or disseminated stages.

Methods:

With a single measure over time, HADS and FACIT-B scales were applied in 107women histologically confirmed to have breast cancer, in stages IIB, IIIA, IIIB, IIIC and IV. Factor analysis and multidimensional scaling methods were used to analyze patterns of association.

Results:

In 84.1% of the patients clinical anxiety was found (95%CI, 75.8-90.5%) and clinical depression in 25.2% (95%CI, 17.3-34.6%). Factor analysis groups items of the two scales in 4 domains which accounted for 59% of the total variance, where 2 items (H11 and B8) showed high values of uniqueness and low factor loadings. Multidimensional scaling suggests five groups, showing proximity between depressive symptoms and physical symptoms, as well as between anxious symptoms and related to functionality and social and family environment.

Conclusions:

The HADS in patients with neoplastic disease detects a high frequency of depressive and especially anxious symptoms, which makes it advisable to reevaluate their psychometric properties in patients with cancer. The association between depressive symptoms of HADS and physical symptoms of quality of life construct is in favor of the difficulty of diagnosing depressive disorder in patients with cancer, so it may be necessary to develop instruments that allow locating symptoms or clinical characteristics that facilitate this diagnosis.

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