title: Do adverse life events and mood disorders influence delayed presentation of breast cancer?
abstract: OBJECTIVE
  The purpose of this study is to examine the influence of adverse life experiences and mood disorders on delayed presentation of breast cancer.
  
  
  METHODS
  One hundred fifty-eight patients were interviewed 5 months after diagnosis to assess the prevalence of adverse life events and difficulties using the Bedford College Life Events and Difficulties Schedule, and psychiatric morbidity using the Structured Clinical Interview (SCID) and DSM-III-R diagnostic criteria.
  
  
  RESULTS
  There was no association between experiencing a severe life event (p = 0.5) or difficulty, whether severe or nonsevere (p = 0.8), in the year preceding symptom discovery and patient delay. Counterintuitively, women who presented promptly to their GP (<12 weeks) with breast symptoms were more likely than those who delayed >/=12 weeks to report having a nonsevere event in the year before symptom discovery (p < 0.001). This appeared however, to be an artifact, because the women presenting promptly were recalling events that were closer in time to the research interview. Patient delay was not related to prevalence of depression (p = 0.2) or anxiety (p = 0.8) in the year preceding symptom discovery.
  
  
  CONCLUSIONS
  This study suggests that neither adverse life experiences nor mood disorder in the year before symptom discovery increase the risk of patients with symptoms of breast cancer delaying their presentation to a general practitioner.
authors.affiliation: ICRF Psychosocial Oncology Group, Guy's, King's, and St. Thomas's Hospitals' School of Medicine, King's College, London, UK. caroline.burgess@kcl.ac.uk
authors.forename: C C
authors.initials: CC
authors.lastname: Burgess
authors.forename: A J
authors.initials: AJ
authors.lastname: Ramirez
authors.forename: P
authors.initials: P
authors.lastname: Smith
authors.forename: M A
authors.initials: MA
authors.lastname: Richards
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis*; D003863:Depression / Q000175:diagnosis* / Q000523:psychology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008016:Life Change Events; D019964:Mood Disorders / Q000175:diagnosis* / Q000523:psychology; D010342:Patient Acceptance of Health Care; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D013997:Time Factors