Pessimism as a predictor of emotional morbidity one year following breast cancer surgery

Abstract

The prevalence of and predictive factors for emotional morbidity (measured by the Hospital Anxiety and Depression Scale (HAD)) one year following surgery, with special focus on dispositional optimism/pessimism (measured by the Life Orientation Test (LOT-R), was examined in 165 women, newly diagnosed with breast cancer. Patients characteristics, appraisal of cancer diagnosis, beliefs about treatment efficacy, treatment decision-making participation, coping and emotional morbidity was assessed by self-rating questionnaires. Prevalence of anxiety and depression cases at time of diagnosis was 34 and 12%, respectively, and 26 and 9% after one year. Prevalence of emotional morbidity was significantly enlarged among pessimists at all assessments. Pessimism was the strongest predictor for anxiety (OR: 0.86 C.I. 95% 0.77 - 0.95) and depression (OR: 0.83, C.I. 95% 0.73 - 0.95) one year following breast cancer surgery. Optimists and pessimists differed not only in regard to coping styles, but also in regards to predictors of emotional morbidity. Optimists experiencing anxiety at time of breast cancer diagnosis had about six times higher risk of experiencing anxiety after one year, compared to optimists without preoperative anxiety. For pessimists, the more pessimistic one was about one's overall future the higher risk for developing anxiety following one year of breast cancer surgery. Pessimists, who endorse helpless/hopeless coping style when receiving a diagnosis of breast cancer, had three times greater risk for experiencing depression one year after breast cancer surgery, than pessimists who did not. Health care professionals should therefore provide intervention for pessimists, as well as for patients with high anxiety scores at time of diagnosis.

Relationships of anxiety and depressive symptoms with pain perception in post-mastectomy women. An intragroup analysis

“…An answer is therefore actively sought to the question of how emotions, beliefs, social support, socioeconomic status and behavior make it possible to identify factors involved in initiating, changing severity, and maintaining the presence of chronic pain symptoms. The presence of anxiety and depressive symptoms in breast cancer survivors has been noted in other authors' studies [1][2][3]8,11,[22][23][24] .…”

Does rapid genetic counseling and testing in newly diagnosed breast cancer patients cause additional psychosocial distress? results from a randomized clinical trial

“…Such heightened levels of distress and compromised HRQL have also been described in breast cancer patients without a high-risk profile. [16][17][18] Unfortunately, we did not have data available for breast cancer patients without a high-risk profile for comparison of distress levels. Contrary to our original expectations, at follow-up, women in the RGCT group did not report significantly lower levels of cancer worries or cancer-related distress or more problems with body image or sexuality than the UC group.…”

Depression, Anxiety and Sexual Satisfaction in Breast Cancer Patients and their Partners-Izmir Oncology Group Study

“…The rates are high in women with breast cancer, most of whom suffer from both types of symptoms (Nazlican et al, 2012;Pumo et al, 2012). Moreover, negative mood states such as depression and anxiety significantly increase the risk of mortality in women with breast cancer (Schou et al, 2004).…”