title: Psychological morbidity and quality of life in women with advanced breast cancer: a cross-sectional survey.
abstract: OBJECTIVE
  Our purpose was to determine the frequency of psychiatric morbidity and to assess the quality of life of women with advanced breast cancer.
  
  
  METHODS
  The 227 women in the sample were recruited in Melbourne, Australia, and were interviewed (prior to intervention) for a randomized controlled trial of supportive-expressive group therapy. The main outcome measures were DSM-IV psychiatric diagnoses plus quality of life data based on the EORTC QLQ-C30 (core) and QLQ-BR23 (breast module) instruments.
  
  
  RESULTS
  Forty-two percent of the women (97/227) had a psychiatric disorder; 35.7% (81) of these had depression or anxiety or both. Specific diagnoses were minor depression in 58 women (25.6%), major depression in 16 (7%), anxiety disorder in 14 (6.2%), and phobic disorder in 9 (4%). Seventeen (7.5%) women had more than one disorder. In terms of quality of life, one-third felt less attractive, one-quarter were dissatisfied with their body image, and, in most, sexual interest had waned. Menopausal symptoms such as hot flashes affected less than one-third, whereas symptoms of lymphedema were experienced by 26 (11.5%).
  
  
  CONCLUSIONS
  Women with advanced breast cancer have high rates of psychiatric and psychological disturbance. Quality of life is substantially affected. Clinicians need to be vigilant in monitoring psychological adjustment as part of a comprehensive biopsychosocial approach.
authors.affiliation: University of Melbourne Centre for Palliative Care, Departments of Medicine and Psychiatry, St. Vincent's Hospital and Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia.
authors.forename: Brenda
authors.initials: B
authors.lastname: Grabsch
authors.forename: David M
authors.initials: DM
authors.lastname: Clarke
authors.forename: Anthony
authors.initials: A
authors.lastname: Love
authors.forename: Dean P
authors.initials: DP
authors.lastname: McKenzie
authors.forename: Raymond D
authors.initials: RD
authors.lastname: Snyder
authors.forename: Sidney
authors.initials: S
authors.lastname: Bloch
authors.forename: Graeme
authors.initials: G
authors.lastname: Smith
authors.forename: David W
authors.initials: DW
authors.lastname: Kissane
mesh_terms: D001008:Anxiety Disorders / Q000453:epidemiology; D001943:Breast Neoplasms / Q000523:psychology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D011788:Quality of Life; D012307:Risk Factors; D014739:Victoria / Q000453:epidemiology