title: Assessment of mental health literacy in patients with breast cancer.
abstract: BACKGROUND
  Psychosocial distress is often underdiagnosed and undertreated among breast cancer patients due to the poor recognition of the associated symptoms and inadequate knowledge of the treatments available.
  
  
  OBJECTIVE
  To evaluate the mental health literacy of breast cancer patients by assessing (1) their ability to recognize the symptoms of anxiety, fatigue, depression, and cognitive disturbances, and (2) their knowledge of help-seeking options and professional treatments.
  
  
  METHODS
  In this multi-center, cross-sectional study, early-stage breast cancer patients receiving chemotherapy underwent four assessments to measure their levels of anxiety, depression, fatigue, and cognitive disturbances. With the aid of cancer-specific vignettes, a questionnaire was administered to evaluate their mental health literacy.
  
  
  RESULTS
  Fifty-four patients were recruited (77.7% Chinese, aged 52.7 ± 8.5 years). Clinically significant anxiety (15.1%), fatigue (27.8%), and cognitive disturbances (25.9%) were more prevalent than depression (5.6%). Although the majority of the patients could recognize the symptoms of fatigue accurately (75.9%), less than half could identify those of anxiety (35.2%), depression (48.1%), and cognitive disturbances (48.1%). Patients were more receptive to help from their family members (score: 3.39 out of 4.00) and oncologists (score: 3.13) than from other mental health specialists, such as psychiatrists (score: 2.26) and psychologists (score: 2.19) in the management of their psychosocial distress. Approximately half of the patients indicated that embarrassment and fear were their main barriers to seeking professional treatment (55.6%).
  
  
  CONCLUSIONS
  Our results suggest that the mental health literacy of breast cancer patients was inadequate. Intervention and management strategies could be implemented to teach these patients about evidence-based treatments and professional help that are specific to mental disorders.
authors.affiliation: Department of Pharmacy, National University of Singapore, Singapore Department of Pharmacy, National Cancer Centre Singapore, Singapore.
authors.forename: Yin Ting
authors.initials: YT
authors.lastname: Cheung
authors.affiliation: Department of Pharmacy, National University of Singapore, Singapore.
authors.forename: Ying Ying
authors.initials: YY
authors.lastname: Ong
authors.affiliation: Department of Pharmacy, National University of Singapore, Singapore Department of Pharmacy, National Cancer Centre Singapore, Singapore.
authors.forename: Terence
authors.initials: T
authors.lastname: Ng
authors.affiliation: Department of Psychosocial Oncology, National Cancer Centre Singapore, Singapore.
authors.forename: Yee Pin
authors.initials: YP
authors.lastname: Tan
authors.affiliation: Department of Psychosocial Oncology, National Cancer Centre Singapore, Singapore.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Fan
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
authors.forename: Choi Wan
authors.initials: CW
authors.lastname: Chan
authors.affiliation: School of Nursing, The Hong Kong Polytechnic University, Hong Kong.
authors.forename: Alex
authors.initials: A
authors.lastname: Molassiotis
authors.affiliation: Department of Pharmacy, National University of Singapore, Singapore Department of Pharmacy, National Cancer Centre Singapore, Singapore phaac@nus.edu.sg.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Chan
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D005190:Family / Q000523:psychology; D005260:Female; D057220:Health Literacy / Q000379:methods*; D006801:Humans; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology*; D008603:Mental Health; D008875:Middle Aged; D011795:Surveys and Questionnaires
keywords: Breast cancer; anxiety; chemobrain; cognitive disturbance; depression; fatigue; mental health literacy