title: Physical and psychological correlates of high somatic symptom severity in Chinese breast cancer patients.
abstract: We researched associations between somatic symptom severity (SSS), and physical and psychological factors in Chinese breast cancer patients.
  
  
  
  This multicenter cross-sectional study enrolled 255 Chinese breast cancer patients of different stages and treatment phases. They answered standard instruments assessing SSS (Patient Health Questionnaire [PHQ]-15), depression (PHQ-9), anxiety (General Anxiety Disorder [GAD]-7), health anxiety (Whiteley-7 [WI-7]), illness perception (Brief-Illness Perception Questionnaire [IPQ]), illness attribution (Illness Perception Questionnaire-Revised [IPQ-R]), and sense of coherence (Sense of Coherence [SOC]-9). Logistic regression was applied to identify the strongest correlates with SSS.
  
  
  
  Our sample of high (PHQ-15 ≥ 10) and low SSS differed significantly in the following physical and psychological variables: symptom duration (r = 0.339, P < .001), symptom-related disability (Karnofsky Index) (r = 0.182, P < .001), depression (r = 0.556, P < .001), anxiety (r = 0.433, P < .001), health anxiety (r = 0.400, P < .001), illness perception (r = 0.349, P < .001), psychological illness attributions (r = 0.217, P < .01), and sense of coherence (r = -0.254, P < .001). In an adjusted stepwise multiple binary logistic regression analysis, higher health anxiety (WI-7, B = 0.388, P = .002), higher depression (PHQ-9, B = 0.158, P < .001), younger age (B = -0.042, P = .048), higher impairment in daily life (B = 1.098, P = .010), and longer symptom duration (Wald = 18.487, P = .001) showed a significant association with high SSS; the model explained 55.1% of the variance.
  
  
  
  High somatic symptom burden in breast cancer is associated with physical and psychosocial features. The results are a basis for further research to evaluate the new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, SSD concept in cancer patients and to better operationalize psychobehavioral factors in this patient group.
authors.affiliation: Institute of Psychology, University of Freiburg, Freiburg, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Leonhart
authors.affiliation: Psycho-Oncology Department, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Psycho-Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Tang
authors.affiliation: Psycho-Oncology Department, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Psycho-Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Pang
authors.affiliation: Psycho-Oncology Department, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Psycho-Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors.forename: Jinjiang
authors.initials: J
authors.lastname: Li
authors.affiliation: Psycho-Oncology Department, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Psycho-Oncology, Peking University School of Oncology, Beijing Cancer Hospital & Institute, Beijing, China.
authors.forename: Lili
authors.initials: L
authors.lastname: Song
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Irmela
authors.initials: I
authors.lastname: Fischer
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Maike
authors.initials: M
authors.lastname: Koch
authors.affiliation: Division of Psychosocial Oncology, Department of Psychosomatic Medicine and Psychotherapy, TUM MEC, Klinikum rechts der Isar, Technical University Munich, Munich, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Wuensch
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.
authors.forename: Kurt
authors.initials: K
authors.lastname: Fritzsche
authors.affiliation: Department of General Internal Medicine and Psychosomatics, University of Heidelberg Medical Centre, Heidelberg, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Schaefert
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology; D044466:Asian People; D001943:Breast Neoplasms / Q000150:complications / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D011602:Psychophysiologic Disorders / Q000209:etiology / Q000523:psychology*; D060685:Sense of Coherence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: breast cancer; health anxiety; oncology; somatic symptom disorder; somatic symptom severity