title: Emotional functioning of patients with neurofibromatosis tumor suppressor syndrome.
abstract: OBJECTIVE
  Although patients with neurofibromatosis are predisposed to multiple nerve sheath tumors that can develop anywhere in the body and cause significant morbidity (e.g., hearing loss; pain), little research has examined emotional correlates of neurofibromatosis. The purpose of this study was to examine emotional functioning among adult patients with neurofibromatosis.
  
  
  METHODS
  A total of 248 patients with neurofibromatosis (neurofibromatosis 1, neurofibromatosis 2, or schwannomatosis) who received care at a specialized clinic completed validated measures to assess symptoms of depression and anxiety, level of perceived stress, and self-esteem.
  
  
  RESULTS
  Patients with neurofibromatosis reported significantly more symptoms of depression and anxiety, higher levels of perceived stress, and lower levels of self-esteem as compared with general population norms. No significant differences were found among patients with neurofibromatosis 1, neurofibromatosis 2, and schwannomatosis, and emotional functioning was not significantly associated with disease severity. However, increased symptoms of depression and anxiety, higher levels of perceived stress, and lower levels of self-esteem were associated with a higher frequency of self-reported medical visits in the past year (P values ≤0.05).
  
  
  CONCLUSIONS
  Neurofibromatosis appears to be associated with reduced emotional functioning. Although further research is needed, these findings suggest a role for a multidisciplinary treatment approach to address emotional distress among adult patients with neurofibromatosis.
authors.affiliation: Department of Neurology and Cancer Center, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Daphne L
authors.initials: DL
authors.lastname: Wang
authors.forename: Kelly B
authors.initials: KB
authors.lastname: Smith
authors.forename: Sonia
authors.initials: S
authors.lastname: Esparza
authors.forename: Fawn A
authors.initials: FA
authors.lastname: Leigh
authors.forename: Alona
authors.initials: A
authors.lastname: Muzikansky
authors.forename: Elyse R
authors.initials: ER
authors.lastname: Park
authors.forename: Scott R
authors.initials: SR
authors.lastname: Plotkin
mesh_terms: D000328:Adult; D000342:Affective Symptoms / Q000523:psychology*; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009442:Neurilemmoma / Q000523:psychology*; D017253:Neurofibromatoses / Q000523:psychology*; D009456:Neurofibromatosis 1 / Q000523:psychology*; D016518:Neurofibromatosis 2 / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D012878:Skin Neoplasms / Q000523:psychology*