title: Psychological characteristics and subjective symptoms as determinants of psychological distress in patients prior to breast cancer diagnosis.
abstract: OBJECTIVE
  The objective of this study was to determine how psychological characteristics, subjective symptoms, a family history of breast cancer, and age impact psychological distress in outpatients at the first hospital visit prior to breast cancer diagnosis.
  
  
  METHODS
  Participants were prediagnosed women with complaints of breast symptoms who either came to our hospital directly, or with a referral from another clinic. Patients were asked to complete questionnaires to determine the following: trait anxiety (State-Trait Anxiety Inventory), negative emotional suppression (Courtauld Emotional Control Scale), life stress events (Life Experiences Survey), and psychological distress (Profile of Mood States). We examined subjective symptoms (lumps, pain, abnormal nipple discharge, or deformed nipple) and family history of breast cancer based on answers to the interview sheet filled out by patients on their first visit. We analyzed a total of 154 patients who completed the questionnaires out of 237 eligible patients.
  
  
  RESULTS
  A significant model was obtained by multiple regression analysis (adjusted R (2) = 0.574, p < 0.01) in which the standard partial regression coefficients for trait anxiety, suppression of anxiety, negative life change events, positive life change events, and subjective symptoms were statistically significant (beta = 0.623, 0.133, 0.155, 0.108, and 0.124, respectively; p < 0.05).
  
  
  CONCLUSIONS
  Psychological distress prior to diagnosis was higher in patients who had high trait anxiety, suppression of anxiety, many life stress events, and subjective symptoms. In particular, trait anxiety had a large impact on psychological distress, underscoring the need for and importance of adequate psychological care.
authors.affiliation: Department of Medical Psychology, Graduate School of Medical Sciences, Kitasato University, 1-15-1 Kitasato, Sagamihara, Kanagawa 228-8555, Japan. dm06001m@st.kitasato-u.ac.jp
authors.forename: Noriko
authors.initials: N
authors.lastname: Ando
authors.forename: Yumi
authors.initials: Y
authors.lastname: Iwamitsu
authors.forename: Masaru
authors.initials: M
authors.lastname: Kuranami
authors.forename: Shigemi
authors.initials: S
authors.lastname: Okazaki
authors.forename: Mei
authors.initials: M
authors.lastname: Wada
authors.forename: Kenji
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Keiko
authors.initials: K
authors.lastname: Todoroki
authors.forename: Masahiko
authors.initials: M
authors.lastname: Watanabe
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Miyaoka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology*; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D020022:Genetic Predisposition to Disease / Q000523:psychology*; D006801:Humans; D007564:Japan; D008016:Life Change Events; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology; D013315:Stress, Psychological / Q000209:etiology*; D011795:Surveys and Questionnaires; D055815:Young Adult