Psychiatric Disorder in Women with Early Stage and Advanced Breast Cancer: a Comparative Analysis
Identifieur interne : 008A64 ( Main/Exploration ); précédent : 008A63; suivant : 008A65Psychiatric Disorder in Women with Early Stage and Advanced Breast Cancer: a Comparative Analysis
Auteurs : David W. Kissane ; Brenda Grabsch ; Anthony Love ; David M. Clarke ; Sidney Bloch ; Graeme C. SmithSource :
- Australian and New Zealand Journal of Psychiatry [ 0004-8674 ] ; 2004.
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Diagnostic and stastistical manual of mental disorders (USA), Enquêtes et questionnaires, Femelle, Humains, Indice de gravité médicale, Qualité de vie, Stade de la tumeur, Thérapie cognitive (), Trouble dysthymique (), Trouble dysthymique (diagnostic), Trouble dysthymique (épidémiologie), Trouble dépressif majeur (), Trouble dépressif majeur (diagnostic), Trouble dépressif majeur (épidémiologie), Troubles de l'adaptation (), Troubles de l'adaptation (diagnostic), Troubles de l'adaptation (épidémiologie), Tumeurs du sein (), Tumeurs du sein (anatomopathologie), Tumeurs du sein (épidémiologie).
- MESH :
- anatomopathologie : Tumeurs du sein.
- diagnostic : Trouble dysthymique, Trouble dépressif majeur, Troubles de l'adaptation.
- épidémiologie : Trouble dysthymique, Trouble dépressif majeur, Troubles de l'adaptation, Tumeurs du sein.
- Adulte d'âge moyen, Diagnostic and stastistical manual of mental disorders (USA), Enquêtes et questionnaires, Femelle, Humains, Indice de gravité médicale, Qualité de vie, Stade de la tumeur, Thérapie cognitive, Trouble dysthymique, Trouble dépressif majeur, Troubles de l'adaptation, Tumeurs du sein.
English descriptors
- KwdEn :
- Adjustment Disorders (diagnosis), Adjustment Disorders (epidemiology), Adjustment Disorders (therapy), Breast Neoplasms (epidemiology), Breast Neoplasms (pathology), Breast Neoplasms (surgery), Cognitive Therapy (methods), Depressive Disorder, Major (diagnosis), Depressive Disorder, Major (epidemiology), Depressive Disorder, Major (therapy), Diagnostic and Statistical Manual of Mental Disorders, Dysthymic Disorder (diagnosis), Dysthymic Disorder (epidemiology), Dysthymic Disorder (therapy), Female, Humans, Middle Aged, Neoplasm Staging, Quality of Life, Severity of Illness Index, Surveys and Questionnaires.
- MESH :
- diagnosis : Adjustment Disorders, Depressive Disorder, Major, Dysthymic Disorder.
- epidemiology : Adjustment Disorders, Breast Neoplasms, Depressive Disorder, Major, Dysthymic Disorder.
- methods : Cognitive Therapy.
- pathology : Breast Neoplasms.
- surgery : Breast Neoplasms.
- therapy : Adjustment Disorders, Depressive Disorder, Major, Dysthymic Disorder.
- Diagnostic and Statistical Manual of Mental Disorders, Female, Humans, Middle Aged, Neoplasm Staging, Quality of Life, Severity of Illness Index, Surveys and Questionnaires.
Abstract
Objective: To assess psychosocial morbidity in women with breast cancer and to compare the differential rates between women with early stage and advanced disease. Method: In this report, 303 women with early stage breast cancer, psychiatrically assessed at baseline (as part of a study of cognitive-existential group therapy during adjuvant chemotherapy), are compared with 200 women with advanced breast cancer (similarly assessed in a trial of supportive-expressive group therapy). A structured psychiatric interview plus self-report measures were used to assess psychiatric morbidity, quality of life and cognitive attitude to cancer. Results: The early stage patients, whose mean age was 46 years, were on average 3 months post-surgery and had an overall prevalence of DSM-IV psychiatric diagnosis of 45%. The metastatic patients, whose mean age was 51 years, were on average 63 months post-primary diagnosis and had an overall prevalence of DSM-IV diagnosis of 42%; the difference between the two rates was not statistically significant. Of women with early stage breast cancer, 36.7% had mood disorders, 9.6% suffering from major depression and 27.1% from minor depression. In the metastatic sample 31% had mood disorders, 6.5% having major depression and 24.5% with minor depression. Anxiety disorders were present in 8.6% of the early stage group and 6% of women with advanced disease. Fatigue, a past history of depression, and cognitive attitudes of helplessness, hopelessness or resignation were significantly associated with depression in both groups. The women from the metastatic sample were significantly less distressed by hair loss but more dissatisfied with body image, and had higher rates of lymphoedema and hot flushes than the early stage women. Conclusions: The rates of psychosocial distress are high, and similar, across patients with both early and advanced stage breast cancer, although the illness related causes of distress are different. These data present a challenge to clinical services to provide a comprehensive range of support services to ameliorate this distress.
Url:
DOI: 10.1080/j.1440-1614.2004.01358.x
Affiliations:
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<term>Adjustment Disorders (therapy)</term>
<term>Breast Neoplasms (epidemiology)</term>
<term>Breast Neoplasms (pathology)</term>
<term>Breast Neoplasms (surgery)</term>
<term>Cognitive Therapy (methods)</term>
<term>Depressive Disorder, Major (diagnosis)</term>
<term>Depressive Disorder, Major (epidemiology)</term>
<term>Depressive Disorder, Major (therapy)</term>
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<term>Female</term>
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<term>Troubles de l'adaptation (épidémiologie)</term>
<term>Tumeurs du sein ()</term>
<term>Tumeurs du sein (anatomopathologie)</term>
<term>Tumeurs du sein (épidémiologie)</term>
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<term>Trouble dépressif majeur</term>
<term>Troubles de l'adaptation</term>
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<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Adjustment Disorders</term>
<term>Breast Neoplasms</term>
<term>Depressive Disorder, Major</term>
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<front><div type="abstract" xml:lang="en">Objective: To assess psychosocial morbidity in women with breast cancer and to compare the differential rates between women with early stage and advanced disease. Method: In this report, 303 women with early stage breast cancer, psychiatrically assessed at baseline (as part of a study of cognitive-existential group therapy during adjuvant chemotherapy), are compared with 200 women with advanced breast cancer (similarly assessed in a trial of supportive-expressive group therapy). A structured psychiatric interview plus self-report measures were used to assess psychiatric morbidity, quality of life and cognitive attitude to cancer. Results: The early stage patients, whose mean age was 46 years, were on average 3 months post-surgery and had an overall prevalence of DSM-IV psychiatric diagnosis of 45%. The metastatic patients, whose mean age was 51 years, were on average 63 months post-primary diagnosis and had an overall prevalence of DSM-IV diagnosis of 42%; the difference between the two rates was not statistically significant. Of women with early stage breast cancer, 36.7% had mood disorders, 9.6% suffering from major depression and 27.1% from minor depression. In the metastatic sample 31% had mood disorders, 6.5% having major depression and 24.5% with minor depression. Anxiety disorders were present in 8.6% of the early stage group and 6% of women with advanced disease. Fatigue, a past history of depression, and cognitive attitudes of helplessness, hopelessness or resignation were significantly associated with depression in both groups. The women from the metastatic sample were significantly less distressed by hair loss but more dissatisfied with body image, and had higher rates of lymphoedema and hot flushes than the early stage women. Conclusions: The rates of psychosocial distress are high, and similar, across patients with both early and advanced stage breast cancer, although the illness related causes of distress are different. These data present a challenge to clinical services to provide a comprehensive range of support services to ameliorate this distress.</div>
</front>
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<name sortKey="Clarke, David M" sort="Clarke, David M" uniqKey="Clarke D" first="David M." last="Clarke">David M. Clarke</name>
<name sortKey="Grabsch, Brenda" sort="Grabsch, Brenda" uniqKey="Grabsch B" first="Brenda" last="Grabsch">Brenda Grabsch</name>
<name sortKey="Kissane, David W" sort="Kissane, David W" uniqKey="Kissane D" first="David W." last="Kissane">David W. Kissane</name>
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<name sortKey="Smith, Graeme C" sort="Smith, Graeme C" uniqKey="Smith G" first="Graeme C." last="Smith">Graeme C. Smith</name>
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