Relationship between perceived social support, mental adjustment to cancer, and depression among patients with breast cancer

Objective: Psychological morbidity is common among patients with breast cancer. The present study aimed to find the relationship between modifiable determinants, that is, perceived social support (PSS) and mental adjustment to cancer (reflecting coping) with depression in patients with breast cancer.

Methods: A total of 76 adult patients with breast cancer undergoing treatment at a tertiary care hospital were recruited in this cross-sectional study. Patients were diagnosed for depression as per ICD-10 criteria. Hamilton Depression Rating Scale was used for assessing the severity of depression. PSS and coping style were assessed using the Multidimensional Scale for Perceived Social Support and Mini-Mental Adjustment to Cancer scale. We analyzed the data using Fisher exact test, Mann-Whitney U test, Spearman's correlation, logistic regression, and mediation analysis.

Results: 26.3% patients had depression. The logistic regression showed that PSS is a significant predictor of the occurrence of depression in patients with breast cancer (OR = 0.793, 95% CI: 0.634-0.992). The mediation analysis showed that hopelessness-helplessness (a maladaptive subscale) mediates the effects of PSS on depression.

Conclusion: The effect of PSS on the occurrence of depression is mediated through maladaptive coping (hopelessness-helplessness). Accessing these factors can provide an important avenue for psychological intervention in breast cancer patients.