title: Psychological distress following first recurrence of disease in patients with breast cancer: prevalence and risk factors.
abstract: OBJECTIVE
  To investigate the prevalence of and risk factors for psychological distress following first recurrences of breast cancer.
  
  
  METHODS
  The sample was drawn consecutively from the inpatient and outpatient populations of the National Cancer Center Hospital in Japan during an 18-month period from July 1996 to December 1997. Of the 56 eligible patients, 55 women aged 30-73 year with recurrent breast cancer participated in the study. The prevalence of psychological distress, including major depressive disorder and adjustment disorders was evaluated according to the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Third edition-revised (DSM-III-R). Risk factors for psychological distress were analyzed with a logistic regression model.
  
  
  RESULTS
  Of the 55 subjects, 42% met the DSM-III-R criteria for major depressive disorder or adjustment disorders. Major depressive disorder was seen in 4 (7%), and adjustment disorders in 19 (35%). Logistic regression analysis showed that a disease-free interval of less than 24 months significantly predicted a diagnosis of major depressive disorder or adjustment disorders (odds ratio 5.28, 95% confidence interval; 1.28-21.8, p = 0.02).
  
  
  CONCLUSIONS
  These results suggest that it is important for all oncology staff to pay careful attention to the psychological health of patients who have been informed of their cancer recurrence, and that some psychosocial intervention is necessary for preventing distress in patients facing early recurrence.
authors.affiliation: Psycho-Oncology Division, National Cancer Center Research Institute East, Kashiwa, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Okamura
authors.forename: T
authors.initials: T
authors.lastname: Watanabe
authors.forename: M
authors.initials: M
authors.lastname: Narabayashi
authors.forename: N
authors.initials: N
authors.lastname: Katsumata
authors.forename: M
authors.initials: M
authors.lastname: Ando
authors.forename: I
authors.initials: I
authors.lastname: Adachi
authors.forename: T
authors.initials: T
authors.lastname: Akechi
authors.forename: Y
authors.initials: Y
authors.lastname: Uchitomi
mesh_terms: D000275:Adjustment Disorders / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D000339:Affect; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology*; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000209:etiology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000523:psychology*; D010146:Pain / Q000209:etiology / Q000523:psychology; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*