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Depression and Stress Reactivity in Metastatic Breast Cancer

Janine Giese-Davis, PhD, Frank H. Wilhelm, PhD, Ansgar Conrad, Dipl-Psych, Heather C. Abercrombie, PhD, Sandra Sephton, PhD, Maya Yutsis, BA, Eric Neri, BS, C. Barr Taylor, MD, Helena C. Kraemer, PhD and David Spiegel, MD

From the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California (J.G.-D., M.Y., E.N., C.B.T., H.C.K., D.S.); the Department of Clinical Psychology and Psychotherapy, Institute for Psychology, University of Basel, Basel, Switzerland (F.H.W.); the Department of Veterans Affairs Health Care System, Palo Alto, California (A.C.); the Department of Psychiatry, University of Wisconsin Medical School, Madison, Wisconsin (H.C.A.); and the Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky (S.S.).


Figure 16
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  		Figure 1. Panel of means of Positive and Negative Affect (PANAS), high-frequency (lnHF) and very-low-frequency (lnVLF) heart rate variability, aortic characteristic impedance (ACI), and preejection period (PEP) for depressed and nondepressed patients with metastatic breast cancer during baseline and Trier Social Stress Test (TSST). Depressed women were significantly lower on positive affect, lnHF, lnLF (not shown), and lnVLF at baseline. During the TSST, depressed women were significantly lower on positive affect, lnHF, and lnVLF (main effects); higher on negative affect (main effect); and lower on ACI (group x time interaction).

 

Figure 26
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  		Figure 2. Panel of median cortisol during 2-day diurnal baseline at waking, wake + 30 minutes, 12:00 PM, 5:00 PM, and 9:00 PM and mean cortisol response during baseline and Trier Social Stress Test (TSST) for women with metastatic breast cancer (MBC) (middle figure). Depressed women were significantly lower on wake + 30-minute cortisol levels. We have also included the mean cortisol response during baseline and TSST for depressed and nondepressed women who either have MBC or who were at risk for cardiovascular disease (50) to illustrate the relative hyporesponsiveness of the patients with MBC.

 




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