title: Onset and relapse of psychiatric disorders following early breast cancer: a case-control study.
abstract: OBJECTIVE
  Our objective is to evaluate the mental status of primary early breast cancer survivors according to DSM-IV criteria, distinguishing new psychiatric diagnosis, which started after the cancer diagnosis from relapse.
  
  
  METHODS
  A comparative study of 144 breast cancer survivors and 125 women without previous history of cancer was carried out. Neuropsychiatric symptomatology was assessed retrospectively using standardized psychiatric examinations (Mini International Neuropsychiatric Interview, Watson's Post-Traumatic Stress Disorder Inventory) over three successive periods, 'before cancer' (from childhood to 3 years before the interview), 'around the cancer event' (the last 3 years including the time of diagnosis and treatment), and 'currently' (the last 2 weeks).
  
  
  RESULTS
  Increased rates of anxiety and mood disorders were observed following a diagnosis of breast cancer compared with controls (generalized anxiety disorder (GAD) and major depressive disorder (MDD); 10.4 vs 1.6% and 19.4 vs 8.8%, respectively). The cancer disease promoted the development of dysthymia (n=4 new cases/6 two-year prevalent cases) and PTSD (7/7) and the re-emergence of MDD (n=21 relapses/28 three-year prevalent cases) and GAD (10/15). No improvement in serious mood disorders such as MDD (16.0 vs 7.2%) and dysthymia (4.2 vs 0%) was reported at the time of interview, more than 1.75 years (median time) after the cancer surgery, the prevalence being 2-4 times greater in breast cancer survivors than in controls.
  
  
  CONCLUSIONS
  Despite significant advances in treatment, a diagnosis of breast cancer is highly associated with various forms of psychopathology, regardless of psychiatric history, with symptoms persisting after treatment. These results may assist clinicians in planning mental healthcare for women with breast cancer.
authors.affiliation: Inserm, U888, Montpellier, F-34000, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Gandubert
authors.forename: Isabelle
authors.initials: I
authors.lastname: Carrière
authors.forename: Chantal
authors.initials: C
authors.lastname: Escot
authors.forename: Maryvonne
authors.initials: M
authors.lastname: Soulier
authors.forename: Aziz
authors.initials: A
authors.lastname: Hermès
authors.forename: Patrick
authors.initials: P
authors.lastname: Boulet
authors.forename: Karen
authors.initials: K
authors.lastname: Ritchie
authors.forename: Isabelle
authors.initials: I
authors.lastname: Chaudieu
mesh_terms: D001008:Anxiety Disorders / Q000209:etiology; D001943:Breast Neoplasms / Q000523:psychology*; D016022:Case-Control Studies; D003865:Major Depressive Disorder / Q000209:etiology; D019263:Dysthymic Disorder / Q000209:etiology; D005260:Female; D006801:Humans; D001523:Mental Disorders / Q000209:etiology*; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012008:Recurrence; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology; D017741:Survivors / Q000523:psychology