A longitudinal study of psychological adjustment to familial genetic risk assessment for ovarian cancer.
OBJECTIVE
To evaluate the psychological adjustment of women during initial genetic ovarian cancer risk assessment and at clinic follow-up, 6-12 months later.


METHODS
Sixty-five subjects were assessed with the Centre for Epidemiological Studies Depression Scale (CESD), Spielberger's State Anxiety Inventory, and an 18-item, investigator-designed questionnaire yielding self-report on screening responses, worry about increased risk, identification of cancer-related deaths in relatives, worry about future cancer risks of daughters, alteration of future plans as a result of ovarian cancer risk, etc.


RESULTS
Thirty-three percent of subjects had CESD scores above the established cutoff for depression at baseline and 38% had scores above cutoff at follow-up. Sixteen percent of subjects had state scores on the State-Trait Anxiety Inventory higher than 1 standard deviation above average (norm) at baseline, while only 6% had scores higher than 1 SD above average at follow-up.


CONCLUSIONS
To identify factors associated with self-reported depression at follow-up, a series of demographic and self-reported variables (e.g., presence of identified problems in family, impact of genetic risk information, concern for daughter in the future) were entered in a multiple regression analysis with the CESD follow-up score as the dependent variable. Only one predictor accounted for a significant amount of variance in depression scores. Concern for daughter's risk in the future was associated with higher depression scores at follow-up (R = 0.33, P<0.02, R(2) = 11%).
Ritvo
P
P
Department of Public Health Sciences, Family & Community Medicine and Psychiatry, University of Toronto, Ontario, Canada. paul.ritvo@utoronto.ca
Robinson
G
G
Irvine
J
J
Brown
L
L
Murphy
K J
KJ
Stewart
D S
DS
Styra
R
R
Wang
C
C
Mullen
M
M
Cole
D
D
Rosen
B
B
D000223:Adaptation, Psychological; D000328:Adult; D003863:Depression / Q000209:etiology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D010051:Ovarian Neoplasms / Q000235:genetics* / Q000523:psychology*; D018570:Risk Assessment