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The nature and scope of depression and its relationship to physical symptom distress and functional status were examined in 79 women 3 to 7 months after breast cancer diagnosis. Psychiatric diagnostic criteria for depressive disorders and a depression rating scale were used to measure depression. Nine percent of the sample had depressive disorder, and 24% had elevated depressive symptoms. Women with elevated depressive symptoms had more physical symptom distress (p <.0001) and more impaired functioning (p<.0001) than subjects with depressive disorders and without depression. Multiple regression was used to examine the contribution of key variables to functional status. Two variables accounted for 35% of the variance in functional status: symptom distress (28%) and depressive symptoms (7%).