title: Rehabilitation of women with gynaecological cancer: the association between adult attachment, post-traumatic stress disorder and depression.
abstract: We hypothesised that being diagnosed with gynaecological cancer influences adult attachment and occurrence of depression and post-traumatic stress disorder (PTSD). The main aim of the study was to assess changes in the attachment dimensions, PTSD and depression from baseline to 5-month post-treatment. Further, we evaluated the association between attachment avoidance/anxiety dimensions and PTSD/depression among women newly diagnosed with ovarian, endometrial, or cervical cancer.
  
  
  
  Consecutive Danish-speaking women aged 20 to 75 years and treated surgically for primary gynaecological cancer were eligible. All patients were offered a rehabilitation programme consisting of two face-to-face sessions and two phone calls carried out by a nurse. Patients were asked to complete the Revised Adult Attachment Scale, the Harvard Trauma Questionnaire and the Major Depression Inventory at baseline and at 5-month follow-up. In all, 151 women consent to participate in the sessions where 51 fulfilled Revised Adult Attachment Scale questionnaire and contribute with socio-demographic data.
  
  
  
  We found significant positive changes within the attachment anxiety dimension among women with ovarian cancer, a significant reduction of PTSD among endometrial cancer patients and insignificant changes in depression among all cancer types. The attachment anxiety dimension significantly increased the odds for PTSD and depression.
  
  
  
  Depression and PTSD were prevalent among ovarian and cervical cancer patients. The adjustment of rehabilitation according to patients' attachment anxiety dimension contains possibilities for indirect impact on PTSD and depression symptoms. Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Institute of Clinical Research, Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark.|Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark.
authors.forename: K
authors.initials: K
authors.lastname: Adellund Holt
authors.affiliation: Department of Obstetrics and Gynaecology, Odense University Hospital, Odense, Denmark.|Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark.
authors.forename: P T
authors.initials: PT
authors.lastname: Jensen
authors.affiliation: Department of Public Health, National Research Centre of Cancer Rehabilitation, Research Unit of General Practice, University of Southern Denmark, Odense, Denmark.
authors.forename: D
authors.initials: D
authors.lastname: Gilså Hansen
authors.affiliation: National Center of Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Elklit
authors.affiliation: Research Unit of Gynaecology and Obstetrics, University of Southern Denmark, Odense, Denmark.
authors.forename: O
authors.initials: O
authors.lastname: Mogensen
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D003718:Denmark; D003863:Depression / Q000209:etiology / Q000523:psychology*; D005260:Female; D005833:Genital Neoplasms, Female / Q000150:complications / Q000523:psychology* / Q000628:therapy; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000523:psychology*; D011795:Surveys and Questionnaires