Prevalence and predictors of anxiety and depression among breast cancer patients in low-and middle-income countries: a cross-sectional study

Breast cancer diagnosis and treatment can be profoundly traumatic for women, often affecting psychological well-being, with many experiencing anxiety and depression especially in resource limited settings. This study examines the prevalence and predictors of anxiety and depression in breast cancer patients in Abbottabad, Pakistan. A cross-sectional study was conducted on 96 female breast cancer survivors receiving treatment (October 2023 to May 2024) at the Islamabad Diagnostic Center Breast Cancer Clinic and Ayub Teaching Hospital MTI. Anxiety and depression were assessed using the Generalized Anxiety Disorder-7 Questionnaire (GAD-7) and Patient Health Questionnaire (PHQ-9). The study population was characterized by a high proportion of patients with no formal education (52.1%) and unemployment (91.7%). The prevalence of anxiety and depression was substantially high at 41.7% and 79.2%, respectively. Regression analysis identified age and stage of cancer as significant predictors of anxiety and depression. Multivariate logistic regression identified younger age (20-40 years) and Stage 2 Cancer (compared to Stage 4) as significant predictors of anxiety, while age (41-60 years) was the main significant predictor of depression. The high burden of depression (79.2%) and anxiety (41.7%) among breast cancer patients in this low-income setting is alarming. Age and cancer stage are critical predictive factors, underscoring the need for targeted mental health interventions and support strategies for younger patients and those in earlier stages of treatment.