Psychosocial predictors of distress and depression among South African breast cancer patients

Objective: The present study focused on psychological distress and symptoms of depression among a sample of patients attending an outpatient breast cancer clinic in South Africa. The authors also sought to identify the predictors of distress and depression by using demographic, medical, and psychosocial variables, including perceived and received social support. Methods: A convenience sample of breast cancer patients was recruited from the Breast Clinic at a hospital in the Western Cape, South Africa. Participants (N = 201) were asked to complete a questionnaire battery consisting of, inter alia, the Center for Epidemiological Studies-Depression Scale, the Hopkins Symptom Checklist, and the Berlin Social Support Scales. Results: More than one-third of participants scored in the elevated ranges on the Center for Epidemiological Studies-Depression Scale and Hopkins Symptom Checklist, indicating that distress and symptoms of depression were a concern for a sizable minority of participants. Regression analysis showed that body change stress and perceived social support were significant predictors of both psychological distress and symptoms of depression. Conclusions: Distress and depressive symptoms are prevalent among South African breast cancer patients, especially those with higher body change stress and lower perceived support. For breast cancer patients who are distressed or have symptoms of depression, social support, information, psychosocial counseling, and in some cases, referral for medication management and cognitive psychotherapy is indicated. This article calls attention to the need for psychosocial services directed at supporting patients receiving care at breast clinics in South Africa.