title: Is genetic counseling a stressful event?
abstract: OBJECTIVE
  The aim of this paper was to investigate whether cancer genetic counseling could be considered as a stressful event and associated with more anxiety and/or depression compared to other cancer-related events for instance attending mammography screening or receiving a cancer diagnosis.
  
  
  METHODS
  A total of 4911 individuals from three Scandinavian countries were included in the study. Data was collected from individuals who had attended either cancer genetic counseling (self-referred and physician-referred) or routine mammography screening, were recalled for a second mammograpy due to a suspicious mammogram, had received a cancer diagnosis or had received medical follow-up after a breast cancer-surgery. Data from the genetic counseling group was also compared to normative data. Participants filled in the Hospital Anxiety and Depression Scale twice: prior to a potentially stressful event and 14 days after the event.
  
  
  RESULTS
  Pre-counseling cancer genetic counselees reported significant lower level of anxiety compared to the cancer-related group, but higher levels of anxiety compared to the general population. Furthermore, the level of depression observed within the genetic counseling group was lower compared to other participants. Post-event there was no significant difference in anxiety levels between the cancer genetic counselees and all other groups; however, the level of depression reported in the self-referred group was significantly lower than observed in all other groups. Notably, the level of anxiety and depression had decreased significantly from pre-to post-events within the genetic counseling group. In the cancer-related group only the level of anxiety had decreased significantly post-event.
  
  
  CONCLUSIONS
  Individuals who attend cancer genetic counseling do not suffer more anxiety or depression compared to all other cancer-related groups. However, some counselees might need additional sessions and extended support. Thus, identifying extremely worried individuals who need more support, and allocating further resources to their care, seems to be more sufficient.
authors.affiliation: Department of Public Health and Caring Sciences, Uppsala University, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Nordin
authors.forename: Afsaneh
authors.initials: A
authors.lastname: Roshanai
authors.forename: Cathrine
authors.initials: C
authors.lastname: Bjorvatn
authors.forename: Katharina
authors.initials: K
authors.lastname: Wollf
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Mikkelsen
authors.forename: Ingvar
authors.initials: I
authors.lastname: Bjelland
authors.forename: Gerd
authors.initials: G
authors.lastname: Kvale
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000000981:diagnostic imaging / Q000235:genetics / Q000601:surgery; D003863:Depression / Q000209:etiology / Q000523:psychology; D005260:Female; D005817:Genetic Counseling / Q000523:psychology*; D020022:Genetic Predisposition to Disease / Q000523:psychology*; D006801:Humans; D008016:Life Change Events; D008297:Male; D008327:Mammography / Q000523:psychology; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology*; D012017:Referral and Consultation; D012537:Scandinavian and Nordic Countries; D013315:Stress, Psychological