Associated factors with psychological distress in Moroccan breast cancer patients: A cross-sectional study.
OBJECTIVE
To estimate the prevalence of psychological distress (PD) in Moroccan breast cancer patients, and to determine clinical and social demographic factors associated with PD.


METHODS
It was a cross-sectional study where we included all female breast cancer patients that did not have other malignancies. Judgment criteria were based on the Hospital Anxiety and Depression Scale (HADS), and the Distress Thermometer (DT). Threshold values of 15 and 3 were fixed to detect patients on PD by the HADS and the DT, respectively. We analyzed data by calculation of Cronbach's alpha coefficient for the reliability of measurements, and by simple and multiple logistic regressions.


RESULTS
446 women were enrolled. Cronbach's alpha coefficient was 0.801, 0.669 and 0.639 respectively for the HADS, HAD-A and HAD-D questionnaires. 120 patients (26.9%) had a HADS global score ≥15. HAD-A and HAD-D sub-scores were ≥11 in 25 (5.6%) and 30 (6.7%) patients respectively. In multivariate analysis, adjusted for the education level, marital status, taking analgesic and/or anxiolytic treatment, and current treatment type; we found that the occurrence of a distant metastasis [OR = 14.427 p < 0.001], lack of social family support [OR = 4.631 p < 0.001], living a difficult emotional [OR = 2533 p = 0.034] and/or financial [OR = 2.09 p = 0.037] situation, and younger (<50 years) age [OR = 2.398 p = 0.002], were independent associated factors with PD as assessed by the HADS.


CONCLUSIONS
Social family support, emotional and financial difficulties should be investigated in all Moroccan breast cancer patients, especially among younger ones, in order to detect those at risk of PD and offer them appropriate support.
Department of Radiotherapy, National Institute of Oncology, Mohammed V University, Rabat, Morocco. Electronic address: berhili.soufiane@gmail.com.
Soufiane
S
Berhili
Department of Radiotherapy, National Institute of Oncology, Mohammed V University, Rabat, Morocco.
Selma
S
Kadiri
Laboratory of Biostatistics, Clinical Research and Epidemiology, Faculty of Medicine, Department of Periodontology, Faculty of Dental Medicine, Mohammed V University, Rabat, Morocco.
Amal
A
Bouziane
Department of Radiotherapy, National Institute of Oncology, Mohammed V University, Rabat, Morocco.
Abdallah
A
Aissa
Department of Radiotherapy, National Institute of Oncology, Mohammed V University, Rabat, Morocco.
Elamin
E
Marnouche
Department of Radiotherapy, National Institute of Oncology, Mohammed V University, Rabat, Morocco.
Etienne
E
Ogandaga
Department of Radiotherapy, National Institute of Oncology, Mohammed V University, Rabat, Morocco.
Yassine
Y
Echchikhi
Department of Radiotherapy, National Institute of Oncology, Mohammed V University, Rabat, Morocco.
Asmae
A
Touil
Department of Radiotherapy, National Institute of Oncology, Mohammed V University, Rabat, Morocco.
Hasna
H
Loughlimi
Department of Radiotherapy, National Institute of Oncology, Mohammed V University, Rabat, Morocco.
Ibtissam
I
Lahdiri
Department of Radiotherapy, National Institute of Oncology, Mohammed V University, Rabat, Morocco.
Sanae
S
El Majjaoui
Department of Radiotherapy, National Institute of Oncology, Mohammed V University, Rabat, Morocco.
Hanan
H
El Kacemi
Department of Radiotherapy, National Institute of Oncology, Mohammed V University, Rabat, Morocco.
Tayeb
T
Kebdani
Department of Radiotherapy, National Institute of Oncology, Mohammed V University, Rabat, Morocco.
Noureddine
N
Benjaafar
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D009018:Morocco; D015999:Multivariate Analysis; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012307:Risk Factors; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires
Anxiety; Associated factors; Breast cancer; Depression; Distress thermometer; HADS; Psychological distress