Psychological morbidity and quality of life in Australian women with early-stage breast cancer: a cross-sectional survey.
OBJECTIVE
To determine the prevalence of psychological morbidity and describe quality of life in women with early-stage breast cancer.


METHODS
Cross-sectional descriptive study (3 months after conservative breast surgery or mastectomy) of patients from nine general hospitals in Melbourne, Victoria, October 1994 to March 1997.


METHODS
303 women with early-stage breast cancer entering a randomised trial of adjuvant psychological group therapy; mean age, 46 years (SD, 8).


METHODS
Diagnostic and Statistical Manual of Mental Health (DSM)-IV psychiatric diagnoses generated by the Monash Interview for Liaison Psychiatry; quality-of-life data based on the the European Organization for Research and Treatment of Cancer quality-of-life questionnaire (QLQ)-C30 (core) and QLQ-BR23 (breast module) instruments.


RESULTS
45% of the women (135/303) had a psychiatric disorder; 42% (127) of the sample had depression or anxiety, or both; there was minor depression in 82 (27.1%), an anxiety disorder in 26 (8.6%), major depression in 29 (9.6%) and a phobic disorder in 21 (6.9%). 20% of women (61) had more than one disorder. On quality-of-life measures nearly one-third of the women felt less attractive and most had lost interest in sexual activity. There was substantial distress about hair loss. Symptoms of lymphoedema were described by 13 women (4.3%). Breast conservation surgery was associated with a better body image (P<0.01).


CONCLUSIONS
Women recently diagnosed with early-stage breast cancer have high rates of psychiatric and psychological disturbance. Quality of life is substantially affected. Clinicians should actively explore their patients' psychological adjustment to enable early recognition and treatment of these disorders.
Kissane
D W
DW
University of Melbourne Centre for Palliative Care, Department of Medicine, St Vincent's Hospital, and Peter MacCallum Cancer Institute, VIC. dwk@rubens.its.unimelb.edu.au
Clarke
D M
DM
Ikin
J
J
Bloch
S
S
Smith
G C
GC
Vitetta
L
L
McKenzie
D P
DP
D000223:Adaptation, Psychological; D000328:Adult; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D001943:Breast Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000523:psychology; D015412:Mastectomy, Segmental / Q000523:psychology; D008875:Middle Aged; D009367:Neoplasm Staging; D010348:Patient Care Team; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group; D011788:Quality of Life; D012803:Sick Role