‘How I was then and how I am now’: current and retrospective self-reports of anxiety and depression in Australian women with breast cancer

In an attempt to overcome the potential invalidity of response shift present in pre-test versus post-test designs, 197 breast cancer patients completed self-reports about their current anxiety and depression states about 2 years after diagnosis, and also for how they felt at the time of their diagnosis. Current and previous states of anxiety and depression, item analyses and factor analyses of these results, plus MANOVA across all items to test for changes over time (termed 'actual change' in the literature) were conducted. In addition, the combined anxiety and depression scores were analysed as a single unit to determine overlap of symptomatology and suggest possible treatments. As well as showing decreases in the proportion of participants who were experiencing clinically significant anxiety and depression from the time of diagnosis to the time of the survey, results indicated changes in the underlying anxiety symptomatology experienced by participants, moving from somatic complaints of fatigue to feelings of loss of control and inability to cope. The predominant symptomatology of depression remained consistently related to an inability to cope or make decisions, feelings of helplessness and loss. Suggestions for helping clinicians to deal with patients' symptomatology are discussed.