A new analysis has found that women with medium or low levels of income are particularly susceptible to anxiety and depression after being diagnosed with the precancerous breast condition, ductal carcinoma in situ (DCIS). Published early online in Cancer, a peer-reviewed journal of the American Cancer Society, the study suggests that women with financial hardship may benefit from psychosocial interventions that are designed to accommodate their unique needs.
While research suggests that education and financial status, also known as socioeconomic status, can affect mental and physical health, few studies have examined its impact on psychological adjustment following a major stressor such as being diagnosed with a potentially serious medical condition. To investigate, Janet de Moor, MPH, PhD, of The Ohio State University College of Public Health and colleagues looked at whether socioeconomic status affects the development of feelings of anxiety and depression in women after they are diagnosed with DCIS. The investigators also explored whether social support might impact the effects of socioeconomic status on distress in these women.
During the study, 487 women with newly diagnosed DCIS completed questions about sociodemographic, psychosocial, and clinical characteristics at the time of enrollment and again nine months after their diagnosis. The researchers found that financial status was inversely associated with distress at the nine month follow up point: women with financial hardship reported higher levels of anxiety and depression than women with no financial hardship. Financial status also predicted change in anxiety and depression: women with medium to high levels of financial hardship reported an increase in their feelings of anxiety and depression during the study period, while women with no financial hardship reported a decrease in their feelings of anxiety and depression over time. In addition, the probability of exhibiting signs of clinical depression increased with increasing financial hardship.
The researchers noted that a woman's education level did not appear to have an impact on whether or not she developed anxiety or depression. Also, the presence of social support did not explain the association between financial status and change in distress, and social support did not buffer the effect of low socioeconomic status on anxiety and depression.
"Women with medium or low socioeconomic status are forced to manage competing stressors: the stress of financial hardship and the stress of a major health event," said Dr. de Moor. "Because these concomitant stressors leave women vulnerable to escalating distress after their DCIS diagnosis, women with medium or low financial status may benefit from psychosocial interventions."
"The role of socioeconomic status in adjustment following ductal carcinoma in situ." Janet S. de Moor, Ann H. Partridge, Eric P. Winer, Jennifer Ligibel, and Karen M. Emmons. Cancer; Published Online: February 8, 2010, DOI:10.1002/cncr.24832