title: Denial in lung cancer patients: a longitudinal study.
abstract: BACKGROUND
  Although denial in cancer patients is well known clinically, few studies investigating the prevalence of denial over time have been conducted. The objectives of this study are to investigate the level of denial in lung cancer patients over time and the impact of socio-demographic and illness-related variables on denial in these patients.
  
  
  METHODS
  The level of denial was measured in 195 consecutive newly diagnosed lung cancer patients, using the Denial of Cancer Interview. Four assessments were conducted in eight months. Socio-demographic data were collected during the interviews. Medical data were provided by the chest physicians.
  
  
  RESULTS
  Most patients (86.6%) displayed a low or moderate level of denial at baseline. A small number (3%) showed a high level of denial. The mean level of denial was lowest at baseline and increased over time. Male lung cancer patients exhibited more denial than did female ones, and younger patients showed less denial than did the elderly. Shortly after diagnosis, patients with a lower level of education denied stronger than higher educated patients, and during the course of illness, both groups showed the same level of denial.
  
  
  CONCLUSIONS
  A certain level of denial has to be considered a normal phenomenon in lung cancer patients, part of the illness process that they undergo. Whether the level of denial is related to adaptive or maladaptive coping remains to be investigated.
authors.affiliation: Department of Psychiatry, Bronovo Hospital, The Hague, The Netherlands. msitavos@wxs.nl
authors.forename: Martina S
authors.initials: MS
authors.lastname: Vos
authors.forename: Hein
authors.initials: H
authors.lastname: Putter
authors.forename: Hans C
authors.initials: HC
authors.lastname: van Houwelingen
authors.forename: Hanneke C J M
authors.initials: HC
authors.lastname: de Haes
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D003430:Cross-Sectional Studies; D003717:Denial, Psychological; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D011795:Surveys and Questionnaires