tive measures of depression might have predicted the development of cancer, but neither of the two scales used in the present study showed such an association. Although no study is definitive, the weight of evidence casts considerable doubt on a connection between depressive symptoms and cancer morbidity and mortality.
Although the CES-D assesses many aspects of depression that are important for its diagnosis, it was not intended as a substitute for clinical diagnosis. The results of the present study apply only to symptoms of depression and do not address the risks for cancer morbidity and mortality associated with clinical depression. However, Bieliauskas and Garron ( 1982) noted that diagnoses of clinical depression were unrelated to the prospective development of cancer.
It is unlikely that the present lack of association between symptoms of depression and cancer is due to small sample sizes or invalid predictors. Both the CES- D and GWB-D were significant risks for psychiatric diagnoses in the 16-year follow-up of this sample ( Zonderman, Herbst, Schmidt, Costa, & McCrae, 1991). In proportional hazards analyses, these measures of depression were significantly associated with subsequent diagnoses of depression and other psychiatric disorders after controlling for demographic variables and previous history of psychological problems. Depressive symptoms predicted late as well as early occurrence of psychiatric diagnoses and showed a pattern of increasing risk with increasing scores, even below clinical cut-offs. However, when a measure of the personality disposition of neuroticism was included in the analysis, the contribution of depression to the prediction of psychiatric diagnoses was substantially reduced, supporting the view that neuroticism predisposes individuals to a wide range of psychiatric problems.
The National Health and Nutrition Examination Survey Epidemiologic Followup Study was jointly initiated by the National Institute on Aging and the National Center for Health Statistics, and has been developed and funded by the National Institute on Aging; National Center for Health Statistics; National Cancer Institute; National Heart, Lung, and Blood Institute; National Institute of Arthritis, Diabetes, and Digestive and Kidney Diseases; National Institute of Mental Health; National Institute of Alcohol Abuse and Alcoholism; National Institute of Allergy and Infectious Diseases; and the National Institute of Neurological and Communicative Disorders and Stroke.
Andrianopoulos G. D. ( 1990). "Cancer and psychosocial traits, continued". Journal of the American Medical Association, 263, 513.