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Biomedical and Psychosocial Determinants of Psychiatric Morbidity Among Postoperative Ambulatory Breast Cancer Patients

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Abstract

There has been much interest in the psychosocial issues faced by breast cancer patients because of the high prevalence of the disease and the severe psychological impact of the cancer itself, as well as its treatment. The objective of our study was to investigate the determinants of psychiatric morbidity among postoperative ambulatory breast cancer patients. The variables examined included the patients' biomedical characteristics, demographic characteristics, current concerns, coping responses and social support factors. Patients Completed the Hospital Anxiety and Depression Scale (HADS) and the Mental Adjustment to Cancer scale (MAC scale), and information pertaining to demographic variables, current concerns and social support factors was obtained by a specially designed questionnaire. Available data were obtained from 148 randomly selected postoperative ambulatory breast cancer patients. The prevalence of psychiatric morbidity (including clinical anxiety and depression) evaluated by using the HADS cut-off point was 23%. The results of univariate analyses indicated that pain, dyspnea, having children with health problems, various other concerns (about children, other family members, the patients' own health and future treatment) and poor coping responses (low fighting spirit, high anxious preoccupation, high fatalism and high helplessness/hopelessness) were significant determinants of the patients' psychiatric morbidity. Additionally, in the logistic regression analysis, having children with health problems and having a low fighting spirit and a high helplessness/hopelessness were final significant determinants. Postoperative ambulatory breast cancer patients with these problems should be given careful attention, and psychosocial intervention may be beneficial for them.

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References

  1. Research Group for Population-based Cancer Registration in Japan: Cancer incidence in Japan. In: Tominaga S, Oshima A (eds) Cancer Mortality and Morbidity Statistics. Japan and the world-1999. Japan Scientific Societies Press, Tokyo, 1999, pp 83-143

  2. Tsuguma H: Epidemiology. In: Ariyoshi H, Saijo N, Sasaki Y, Fukuoka M, Watanabe T (eds) Clinical Oncology. Gan to Kagakuryoho sya, Tokyo, 1996, pp 209-226

    Google Scholar 

  3. Velikova G, Stark D, Selby P: Quality of life instruments in oncology. Eur J Cancer 35: 1571-1580, 1999

    Google Scholar 

  4. Maguire GP, Lee EG, Bevington DJ, Kuchemann CS, Crabtree RJ, Cornell CE: Psychiatric problems in the first year after mastectomy. BMJ 1: 963-965, 1978

    Google Scholar 

  5. Silberfarb PM, Maurer H, Crouthamel CS: Psychosocial aspects of neoplastic disease: I. Functional status of breast cancer patients during different treatment regimens. Am J Psychiatry 137: 450-455, 1980

    Google Scholar 

  6. Fallowfield LJ, Hall A, Maguire GP, Baum M: Psychological outcome of different treatment policies in women with early breast cancer outside a clinical trial. BMJ 301: 575-580, 1990

    Google Scholar 

  7. Hopwood P, Howell A, Maguire P: Psychiatric morbidity in patients with advanced cancer of the breast: prevalence measured by two self-rating questionnaires. Br J Cancer 64: 349-352, 1991

    Google Scholar 

  8. Pinder KL, Ramirez AJ, Black ME, Richards MA, Gregory WM, Rubens RD: Psychiatric disorder in patients with advanced breast cancer: prevalence and associated factors. Eur J Cancer 29A: 524-527, 1993

    Google Scholar 

  9. Pinder KL, Ramirez AJ, Richards MA, Gregory WM: Cognitive response and psychiatric disorder in women with operable breast cancer. Psycho-oncology 3: 129-137, 1994

    Google Scholar 

  10. Fukue M, Uchitomi Y, Ishida Y, Kugaya A, Minagawa H, Yamawaki S: The relationship between mood states and background factors in ambulatory breast cancer patients. Jpn J Clin Psychiat 24: 1359-1365, 1995 (in Japanese)

    Google Scholar 

  11. Northouse LL: Breast cancer in younger women: effects on interpersonal and family relations. Monogr J Natl Cancer Inst 16: 183-190, 1994

    Google Scholar 

  12. Passik SD, Newman ML, Brennan M, Tunkel R: Predictors of psychological distress, sexual dysfunction and physical functioning among women with upper extremity lymphedema related to breast cancer. Psycho-oncology: 4, 255-263, 1995

    Google Scholar 

  13. Hughson AVM, Cooper AF, McArdle C, Smith DC: Psychological impact of adjuvant chemotherapy in the first two years after mastectomy. BMJ 293: 1268-1271, 1986

    Google Scholar 

  14. Cathcart CK, Jones SE, Pumroy CS, Peters GN, Knox SM, Cheek JH: Clinical recognition and management of depression in node negative breast cancer patients treated with tamoxifen. Breast Cancer Res Treat 27: 277-281, 1993

    Google Scholar 

  15. Koopman C, Hermanson K, Diamond S, Angell K, Spiegel D: Social support, life stress, pa in and emotional adjustment to advanced breast cancer. Psycho-oncology 7: 101-111, 1995

    Google Scholar 

  16. Neuling SJ, Winefield HR: Social support and recovery after surgery for breast cancer: frequency and correlates of supportive behaviors by family, friends and surgeon. Soc Sci Med 27: 385-392, 1988

    Google Scholar 

  17. Watson M, Greer S, Rowden L, Gorman C, Robertson B, Bliss JM, Tunmore R: Relationships between emotional control, adjustment to cancer and depression and anxiety in breast cancer patients. Psychol Med 21: 51-57, 1991

    Google Scholar 

  18. Zigmond AS, Snaith RP: The Hospital Anxiety and Depression Scale. Acta Psychiat Scand 67: 361-370, 1983

    Google Scholar 

  19. Kugaya A, Akechi T, Okuyama T, Okamura H, Uchitomi Y: Screening for psychological distress in Japanese cancer patients. Jpn J Clin Oncol 28: 333-338, 1998

    Google Scholar 

  20. Derogatis LR, Morrow GR, Fetting J, Penman D, Piasetsky S, Schmale AM, Henrichs M, Carnicke CLM, Jr.: The prevalence of psychiatric disorders among cancer patients. JAMA 249: 751-757, 1983

    Google Scholar 

  21. Watson M, Greer S, Young J, Inayat Q, Burgess C, Robertson B: Development of a questionnaire measure of adjustment to cancer: the MAC scale. Psychol Med 18: 203-209, 1988

    Google Scholar 

  22. Akechi T, Kugaya A, Okamura H, Mikami I, Nishiwaki Y, Fukue M, Yamawaki S, Uchitomi Y: Validity and reliability of the Japanese version of the Mental Adjustment to Cancer (MAC) scale. Jpn J Psychiat Treat 12: 1065-1071, 1997 (in Japanese)

    Google Scholar 

  23. Passik SD, Dugan W, McDonald MV, Rosenfeld B, Theobald DE, Edgerton S: Oncologists' recognition of depression in their patients with cancer. J Clin Oncol 16: 1594-1600, 1998

    Google Scholar 

  24. McDonald MV, Passik SD, Dugan W, Rosenfeld B, Theobald DE, Edgerton S: Nurses' recognition of depression in their patients with cancer. Oncol Nurs Forum 26: 593-599

  25. Hosaka T, Awazu H, Aoki T, Okuyama T, Yamawaki S: Screening for adjustment disorders and major depression in otolaryngology patients using the Hospital Anxiety and Depression Scale. Int J Psych Clin Pract 3: 43-48, 1998

    Google Scholar 

  26. Hopwood P, Howell A, Maguire P: Screening for psychiatric morbidity in patients with advanced breast cancer: validation of two self-report questionnaires. Br J Cancer 64: 353-356, 1991

    Google Scholar 

  27. Razavi D, Delvaux N, Bredart A, Paesmans M, Debusscher L, Bron D, Stryckmans P: Screening for psychiatric disorders in a lymphoma out-patient population. Eur J Cancer 28A: 1869-1872, 1992

    Google Scholar 

  28. Ibbotson T, Maguire P, Selby P, Priestman T, Wallace L: Screening for anxiety and depression in cancer patients: the effects of disease and treatment. Eur J Cancer 30A: 37-40, 1994

    Google Scholar 

  29. Roth AJ, Kornblith AB, Batel-Copel L, Peabody E, Scher HI, Holland JC: Rapid screening for psychological distress in men with prostate carcinoma. Cancer 82: 1904-1908, 1998

    Google Scholar 

  30. Chochinov HM, Wilson KG, Enns M, Lander S: “Are you depressed?” Screening for depression in the terminally ill. Am J Psychiat 154: 674-676, 1997

    Google Scholar 

  31. Lewis FM, Hammond MA, Woods NF: The family's functioning with newly diagnosed breast cancer in the mother: the development of an explanatory model. J Behav Med 16: 351-70, 1993

    Google Scholar 

  32. Hilton BA, Elfert H: Children's experiences with mothers' early breast cancer. Cancer Pract 4: 96-104, 1996

    Google Scholar 

  33. Akechi T, Kugaya A, Okamura H, Nishiwaki Y, Yamawaki S, Uchitomi Y: Predictive factors for psychological distress in ambulatory lung cancer patients. Supp Care Cancer 6: 281-286, 1998

    Google Scholar 

  34. Kugaya A, Akechi T, Okamura H, Mikami I, Uchitomi Y: Correlates of depressed mood in ambulatory head and neck cancer patients. Psycho-oncology 8: 494-499, 1999

    Google Scholar 

  35. Greer S, Morris T, Pettingale KW, Haybittle JL: Psychological response to breast cancer and 15 year outcome. Lancet 335: 49-50, 1990

    Google Scholar 

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Authors and Affiliations

  1. Psycho-Oncology Division, National Cancer Center Research Institute East, Kashiwa, Chiba, Japan

    Tatsuo Akechi, Toru Okuyama & Yosuke Uchitomi

  2. Psychiatry Division, National Cancer Center Hospital East, Kashiwa, Chiba, Japan

    Tatsuo Akechi & Yosuke Uchitomi

  3. Division of Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan

    Shigeru Imoto

  4. Department of Psychiatry and Neurosciences, Hiroshima University School of Medicine, Minami-ku, Hiroshima, Japan

    Shigeto Yamawaki

Authors
  1. Tatsuo Akechi
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  2. Toru Okuyama
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  3. Shigeru Imoto
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  4. Shigeto Yamawaki
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  5. Yosuke Uchitomi
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Akechi, T., Okuyama, T., Imoto, S. et al. Biomedical and Psychosocial Determinants of Psychiatric Morbidity Among Postoperative Ambulatory Breast Cancer Patients. Breast Cancer Res Treat 65, 195–202 (2001). https://doi.org/10.1023/A:1010661530585

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