Association between postoperative anxiety and depression symptoms and willingness for breast reconstruction in breast cancer patients

Table 1 General characteristics of study participants, n (%)

Characteristics	Statistics
Age (years)	52.83 ± 5.92
BMI (kg/m2)	23.98 ± 6.02
Gender - female	112 (100.0)
Marital status - married	96 (85.71)
Education - Bachelor’s or above	28 (25.00)
Employed	52 (46.43)
Urban residents	64 (57.14)
Smoking history	12 (10.71)
Drinking history	18 (16.07)
Comorbid chronic diseases	36 (32.14)
Family history of breast cancer	8 (7.14)

BMI: Body mass index.

Table 2 Prevalence of anxiety and depression symptoms, n (%)

Psychological symptoms	Score	Prevalence
Anxiety symptoms (SAS)	46.25 ± 10.82	48 (42.86)
Mild anxiety		36 (32.14)
Moderate anxiety		10 (8.93)
Severe anxiety		2 (1.79)
Depression symptoms (SDS)	48.73 ± 11.35	44 (39.29)
Mild depression		32 (28.57)
Moderate depression		10 (8.93)
Severe depression		2 (1.79)
Anxiety-depression comorbidity		32 (28.57)

SAS: Self-Rating Anxiety Scale; SDS: Self-Rating Depression Scale.

Table 3 Comparison of patient characteristics between anxiety and non-anxiety groups, n (%)

Indicators	Anxiety group (n = 48)	Non-anxiety group (n = 64)	P value
SDS score	56.42 ± 9.87	42.94 ± 8.26	< 0.001
Depression prevalence	36 (75.00)	8 (12.50)	< 0.001
Cognition score	15.83 ± 4.26	20.88 ± 3.95	< 0.001
Attitude score	39.67 ± 7.84	48.75 ± 7.62	< 0.001
Reconstruction intention	8 (16.67)	28 (43.75)	0.027
Mean age (years)	54.67 ± 5.38	51.50 ± 5.94	0.036

SDS: Self-Rating Depression Scale.

Table 4 Comparison of breast reconstruction cognition and attitudes among patients with different psychological states

Indicators	Normal (n = 40)	Anxiety-only (n = 16)	Depression-only (n = 12)	Comorbidity (n = 32)	P value
Cognition score	22.35 ± 3.42	18.25 ± 3.86	17.83 ± 4.12	14.19 ± 3.75	< 0.001
Attitude score	50.85 ± 6.92	42.75 ± 7.34	41.67 ± 7.89	36.25 ± 6.58	< 0.001
Reconstruction intention (%)	55.00	25.00	16.67	6.25	0.005
SAS score	42.15 ± 6.23	54.38 ± 4.12	43.67 ± 5.89	59.88 ± 8.45	< 0.001
SDS score	44.23 ± 5.67	46.85 ± 6.12	56.92 ± 7.34	61.45 ± 9.12	< 0.001

SAS: Self-Rating Anxiety Scale; SDS: Self-Rating Depression Scale.

Table 5 Correlation analysis between anxiety-depression scores and breast reconstruction cognition and attitudes

Variables	Cognition score	Attitude score
SAS score	r = -0.412, P = 0.002b	r = -0.386, P = 0.003b
SDS score	r = -0.435, P = 0.001b	r = -0.402, P = 0.002b
Age	r = -0.325, P = 0.014a	r = -0.298, P = 0.025a
Education level	r = 0.418, P = 0.001b	r = 0.385, P = 0.003b
Employment status	r = 0.312, P = 0.018a	r = 0.341, P = 0.012a

^aP < 0.05.

^bP < 0.01.

SAS: Self-Rating Anxiety Scale; SDS: Self-Rating Depression Scale.

Table 6 Logistic regression analysis of influencing factors of breast reconstruction intention¹

Variables	β	OR	95%CI	P value
Age	-0.114	0.893	0.834-0.972	0.007
SAS score	-0.132	0.876	0.812-0.945	< 0.001
Cognition score	0.176	1.193	1.040-1.461	0.015
Attitude score	0.293	1.340	1.098-1.792	0.006
Education level	0.198	1.219	1.056-1.407	0.007

¹Model statistics: χ² = 38.72, P < 0.001; Hosmer-Lemeshow test: χ² = 5.84, P = 0.665; Nagelkerke R² = 0.658.

SAS: Self-Rating Anxiety Scale; OR: Odds ratio; CI: Confidence interval.