{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T09:20:53Z","timestamp":1778923253415,"version":"3.51.4"},"reference-count":31,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T00:00:00Z","timestamp":1647820800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"European Regional Development Funds","award":["POCI-01-0145-FEDER016867"],"award-info":[{"award-number":["POCI-01-0145-FEDER016867"]}]},{"name":"European Regional Development Funds","award":["POCI-01-0145-FEDER-032358"],"award-info":[{"award-number":["POCI-01-0145-FEDER-032358"]}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","doi-asserted-by":"publisher","award":["PTDC\/DTP-EPI\/7183\/2014"],"award-info":[{"award-number":["PTDC\/DTP-EPI\/7183\/2014"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","doi-asserted-by":"publisher","award":["UIDB\/04750\/2020"],"award-info":[{"award-number":["UIDB\/04750\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","doi-asserted-by":"publisher","award":["LA\/P\/0064\/2020"],"award-info":[{"award-number":["LA\/P\/0064\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","doi-asserted-by":"publisher","award":["PTDC\/SAU-EPI\/6275\/2020"],"award-info":[{"award-number":["PTDC\/SAU-EPI\/6275\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","doi-asserted-by":"publisher","award":["PTDC\/SAU-EPI\/32358\/2017"],"award-info":[{"award-number":["PTDC\/SAU-EPI\/32358\/2017"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Current Oncology"],"abstract":"<jats:p>Anxiety and depression are frequent among patients with breast cancer (BCa). Evidence of the persistence and recovery from these conditions and their determinants is scarce. We describe the occurrence of clinically significant anxiety and depression symptoms and their associated factors among BCa patients. A total of 506 women admitted in 2012 at the Portuguese Institute of Oncology of Porto were evaluated before treatment and after one, three, and five years (7.9% attrition rate). The five-year prevalence of anxiety and\/or depression (Hospital Anxiety and Depression Scale, subscores \u2265 11) was 55.4%. The peak prevalence for anxiety was before treatment (38.0%), and after one year for depression (13.1%). One in five patients with anxiety\/depression at baseline had persistent anxiety\/depression over time, while only 11% and 22% recovered permanently from anxiety and depression, respectively, during the first year. Higher education, higher income, practicing physical activity, and adequate fruit and vegetable intake were protective factors against anxiety and\/or depression. Loss of job and income, anxiolytics and antidepressants, cancer-related neuropathic pain, and mastectomy were associated with higher odds of anxiety and\/or depression. These results highlight the importance of monitoring anxiety\/depression during the first five years after cancer diagnosis and identify factors associated with these conditions.<\/jats:p>","DOI":"10.3390\/curroncol29030173","type":"journal-article","created":{"date-parts":[[2022,3,21]],"date-time":"2022-03-21T13:24:59Z","timestamp":1647869099000},"page":"2141-2153","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Prevalence and Persistence of Anxiety and Depression over Five Years since Breast Cancer Diagnosis\u2014The NEON-BC Prospective Study"],"prefix":"10.3390","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0186-7223","authenticated-orcid":false,"given":"Catarina","family":"Lopes","sequence":"first","affiliation":[{"name":"EPIUnit\u2014Instituto de Sa\u00fade P\u00fablica, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal"},{"name":"Laborat\u00f3rio para a Investiga\u00e7\u00e3o Integrativa e Translacional em Sa\u00fade Populacional (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal"}]},{"given":"Luisa","family":"Lopes-Concei\u00e7\u00e3o","sequence":"additional","affiliation":[{"name":"EPIUnit\u2014Instituto de Sa\u00fade P\u00fablica, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9246-589X","authenticated-orcid":false,"given":"Filipa","family":"Fontes","sequence":"additional","affiliation":[{"name":"EPIUnit\u2014Instituto de Sa\u00fade P\u00fablica, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal"},{"name":"Laborat\u00f3rio para a Investiga\u00e7\u00e3o Integrativa e Translacional em Sa\u00fade Populacional (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal"},{"name":"Instituto Portugu\u00eas de Oncologia do Porto, 4200-072 Porto, Portugal"}]},{"given":"Augusto","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Instituto Portugu\u00eas de Oncologia do Porto, 4200-072 Porto, Portugal"}]},{"given":"Susana","family":"Pereira","sequence":"additional","affiliation":[{"name":"EPIUnit\u2014Instituto de Sa\u00fade P\u00fablica, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal"},{"name":"Laborat\u00f3rio para a Investiga\u00e7\u00e3o Integrativa e Translacional em Sa\u00fade Populacional (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal"},{"name":"Instituto Portugu\u00eas de Oncologia do Porto, 4200-072 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1870-1430","authenticated-orcid":false,"given":"Nuno","family":"Lunet","sequence":"additional","affiliation":[{"name":"EPIUnit\u2014Instituto de Sa\u00fade P\u00fablica, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal"},{"name":"Laborat\u00f3rio para a Investiga\u00e7\u00e3o Integrativa e Translacional em Sa\u00fade Populacional (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal"},{"name":"Departamento de Ci\u00eancias da Sa\u00fade P\u00fablica e Forenses e Educa\u00e7\u00e3o M\u00e9dica, Faculdade de Medicina da Universidade do Porto, 4200-319 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1652-8999","authenticated-orcid":false,"given":"Nat\u00e1lia","family":"Ara\u00fajo","sequence":"additional","affiliation":[{"name":"EPIUnit\u2014Instituto de Sa\u00fade P\u00fablica, Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal"},{"name":"Laborat\u00f3rio para a Investiga\u00e7\u00e3o Integrativa e Translacional em Sa\u00fade Populacional (ITR), Rua das Taipas 135, 4050-600 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2022,3,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1016\/j.clbc.2019.01.006","article-title":"The Global and Regional Survival Rate of Women With Breast Cancer: A Systematic Review and Meta-analysis","volume":"19","author":"Maajani","year":"2019","journal-title":"Clin. Breast Cancer"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1093\/jnci\/djy177","article-title":"Associations Between Breast Cancer Survivorship and Adverse Mental Health Outcomes: A Systematic Review","volume":"110","author":"Carreira","year":"2018","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1097\/NCC.0000000000000451","article-title":"Longitudinal Trends in Anxiety, Depression, and Quality of Life During Different Intermittent Periods of Adjuvant Breast Cancer Chemotherapy","volume":"41","author":"Zhang","year":"2018","journal-title":"Cancer Nurs."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"3186","DOI":"10.1038\/s41380-020-00865-6","article-title":"Prognostic value of depression and anxiety on breast cancer recurrence and mortality: A systematic review and meta-analysis of 282,203 patients","volume":"25","author":"Wang","year":"2020","journal-title":"Mol. Psychiatry"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/j.jpainsymman.2017.04.011","article-title":"Neuropathic Pain After Breast Cancer Treatment: Characterization and Risk Factors","volume":"54","author":"Pereira","year":"2017","journal-title":"J. Pain Symptom Manag."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.breast.2021.05.006","article-title":"Trajectories of cognitive performance over five years in a prospective cohort of patients with breast cancer (NEON-BC)","volume":"58","author":"Severo","year":"2021","journal-title":"Breast"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1002\/pon.4601","article-title":"Predictors of emotional distress a year or more after diagnosis of cancer: A systematic review of the literature","volume":"27","author":"Cook","year":"2018","journal-title":"Psycho-Oncology"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Breidenbach, C., Heidkamp, P., Hiltrop, K., Pfaff, H., Enders, A., Ernstmann, N., and Kowalski, C. (2022). Prevalence and determinants of anxiety and depression in long-term breast cancer survivors. BMC Psychiatry, 22.","DOI":"10.1186\/s12888-022-03735-3"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1981","DOI":"10.1002\/nop2.876","article-title":"Correlations of social isolation and anxiety and depression symptoms among patients with breast cancer of Heilongjiang province in China: The mediating role of social support","volume":"8","author":"Liu","year":"2021","journal-title":"Nurs. Open"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1007\/s00520-021-06477-2","article-title":"The prevalence of anxiety and depression and its association with coping strategies, supportive care needs, and social support among women with breast cancer","volume":"30","author":"Mohammadi","year":"2022","journal-title":"Supportive Care Cancer"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e006301","DOI":"10.1136\/bmjopen-2014-006301","article-title":"Neurological complications of breast cancer: Study protocol of a prospective cohort study","volume":"4","author":"Pereira","year":"2014","journal-title":"BMJ Open"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1080\/13803395.2011.589374","article-title":"Montreal Cognitive Assessment (MoCA): Normative study for the Portuguese population","volume":"33","author":"Freitas","year":"2011","journal-title":"J. Clin. Exp. Neuropsychol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1471","DOI":"10.1245\/s10434-010-0985-4","article-title":"The American Joint Committee on Cancer: The 7th edition of the AJCC cancer staging manual and the future of TNM","volume":"17","author":"Edge","year":"2010","journal-title":"Ann. Surg. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1111\/j.1600-0447.1983.tb09716.x","article-title":"The Hospital Anxiety and Depression Scale","volume":"67","author":"Zigmond","year":"1983","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1080\/13548500500524088","article-title":"Validation study of a Portuguese version of the Hospital Anxiety and Depression Scale","volume":"12","author":"Silva","year":"2007","journal-title":"Psychol. Health Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.jad.2010.01.067","article-title":"Diagnostic validity of the Hospital Anxiety and Depression Scale (HADS) in cancer and palliative settings: A meta-analysis","volume":"126","author":"Mitchell","year":"2010","journal-title":"J. Affect. Disord."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.genhosppsych.2017.09.009","article-title":"Changes in depression status during the year after breast cancer surgery and impact on quality of life and functioning","volume":"50","author":"Kim","year":"2018","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1002\/pon.5084","article-title":"Pessimism predicts anxiety and depression in breast cancer survivors: A 5-year follow-up study","volume":"28","year":"2019","journal-title":"Psychooncology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.breast.2009.11.007","article-title":"The course of anxiety and depression over 5 years of follow-up and risk factors in women with early breast cancer: Results from the UK Standardisation of Radiotherapy Trials (START)","volume":"19","author":"Hopwood","year":"2010","journal-title":"Breast"},{"key":"ref_21","first-page":"1661","article-title":"Assessment of Depression and Anxiety in Breast Cancer Patients: Prevalence and Associated Factors","volume":"19","author":"Tsaras","year":"2018","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Civilotti, C., Botto, R., Maran, D.A., Leonardis, B.D., Bianciotto, B., and Stanizzo, M.R. (2021). Anxiety and Depression in Women Newly Diagnosed with Breast Cancer and Waiting for Surgery: Prevalence and Associations with Socio-Demographic Variables. Medicina, 57.","DOI":"10.3390\/medicina57050454"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1016\/j.jpainsymman.2016.10.366","article-title":"Longitudinal Examination of Symptom Profiles Among Breast Cancer Survivors","volume":"53","author":"Avis","year":"2017","journal-title":"J. Pain Symptom Manag."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.1002\/pon.3780","article-title":"Partner support and anxiety in young women with breast cancer","volume":"24","author":"Borstelmann","year":"2015","journal-title":"Psychooncology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"4700","DOI":"10.1002\/cncr.31735","article-title":"Return to work after breast cancer diagnosis: An observational prospective study in Brazil","volume":"124","author":"Landeiro","year":"2018","journal-title":"Cancer"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.breast.2019.07.007","article-title":"Changes in employment status up to 5 years after breast cancer diagnosis: A prospective cohort study","volume":"48","author":"Monteiro","year":"2019","journal-title":"Breast"},{"key":"ref_27","first-page":"979","article-title":"Interventions to improve healthy lifestyles and their effects on psychological variables among breast cancer survivors: A systematic review","volume":"35","year":"2018","journal-title":"Nutr. Hosp."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"725","DOI":"10.31557\/APJCP.2021.22.3.725","article-title":"The Effect of Exercise on Life Quality and Depression Levels of Breast Cancer Patients","volume":"22","author":"Aydin","year":"2021","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e526","DOI":"10.1016\/j.clbc.2021.01.003","article-title":"Higher Risk of Depression After Total Mastectomy Versus Breast Reconstruction Among Adult Women With Breast Cancer: A Systematic Review and Metaregression","volume":"21","author":"Padmalatha","year":"2021","journal-title":"Clin. Breast Cancer"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"145","DOI":"10.5152\/tjbh.2016.2913","article-title":"Body Image of Women with Breast Cancer After Mastectomy: A Qualitative Research","volume":"12","year":"2016","journal-title":"J. Breast Health"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1016\/j.jpainsymman.2013.12.239","article-title":"Chronic Pain in Breast Cancer Survivors: Comparison of Psychosocial, Surgical, and Medical Characteristics Between Survivors With and Without Pain","volume":"48","author":"Smeby","year":"2014","journal-title":"J. Pain Symptom Manag."}],"container-title":["Current Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1718-7729\/29\/3\/173\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:40:17Z","timestamp":1760136017000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1718-7729\/29\/3\/173"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,21]]},"references-count":31,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,3]]}},"alternative-id":["curroncol29030173"],"URL":"https:\/\/doi.org\/10.3390\/curroncol29030173","relation":{},"ISSN":["1718-7729"],"issn-type":[{"value":"1718-7729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,21]]}}}