Abstract
Psychiatric illness associated with breast cancer still goes unrecognised and untreated. A prospective study was carried out on a consecutive series of 33 patients with early breast cancer. Patients were interviewed following their diagnosis and 3 to 6 months post-mastectomy. Patients also completed the General Health Questionnaire 60 (GHQ 60) and the Leeds Scales for the Self-Assessment of Anxiety and Depression.
Seven patients suffered from a depressive disorder at the post-operative interview. One patient suffered from an anxiety disorder. One of the depressed patients had received antidepressant medication from her general practitioner. The GHQ 60 was able to predict depressive illness in the post-operative period with a sensitivity of 71 per cent at the pre-operative diagnostic stage.
This study is consistent in its findings of increased psychiatric morbidity in early breast cancer patients in the months after surgery. It also highlights the usefulness of a self assessment questionnaire in predicting it.
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References
Harrell, H. C. To lose a breast. Am. J. Nursing 1972; 7: 676–677.
Sutherland, A. M. The psychological impact of cancer surgery Public Health Reports 1952; 67: 1139–1143.
Klein, R. Acrisis to grow on. Cancer 1971; 28: 1666–1671.
Markel, W. M. The American Cancer Society’s programme for the rehabilitation of the breast cancer patient. Cancer 1971; 28: 1676–1678.
Healey, J. E. Role of rehabilitation medicine in the care of the breast cancer patient. Cancer 1971; 28: 1660–1671.
Renneker, R., Cutler, M. Psychological problems of adjustment to cancer of the breast. JAMA 1952; 148: 833–838.
Maguire, G. P., Lee, E. G., Bevington, D. J. et al. Psychiatric problems in the first year after mastectomy. Br. Med. J. 1978; i: 963–965.
Bloom, J. R., Cook, M., Gates, C. et al. Psychological response to mastectomy. A prospective comparison study. Cancer 1987; 59: 189–196.
Greer, S., Morris, T., Pettingale, K. W. Psychological response to breast cancer. Effects on outcome. Lancet 1979; ii: 177–178.
Pettingale, K. W., Philalithis, A., Tee, D. E. H. et al. The biological correlates of psychological responses to breast cancer. J. Psychosom. Res. 1981; 35(5): 453–458.
Levy, S., Herberman, R., Lippman, M. et al. Correlation of stress factors with sustained natural killer cell activity and predicted prognosis in patients with breast cancer. J. Clin. Oncol. 1987; 5(3): 348–353.
Maguire, G. P., Tait, A., Brooke, M. et al. Effect of counselling on the psychiatric morbidity associated with mastectomy. Br. Med. J. 1980; 281: 1454–1456.
Torem, M., Saravay, S. M., Steinberg, H. Psychiatric liaison: benefits of an ‘active’ approach. Psychosomatics 1979; 20: 598–611.
Sensky, T., Cundy, T., Greer, S. et al. Referrals to psychiatrists in a general hospital: a comparison of two methods of liaison psychiatry. J. R. Soc. Med. 1985; 78: 463–468.
Hopwood, P., Howell, A., Maguire, P. Screening for psychiatric morbidity in patients with advanced breast cancer: prevalence measured by two self-report questionnaires. Br. J. Cancer 1991; 64: 349–352.
American Psychiatric Press (1987). Diagnostic and Statistical Manual of Mental Disorders (3rd edn revised) (DSM-III-R). Washington, DC: APA
Goldberg, D. P. The detection of psychiatric illness by questionnaire. Oxford University Press, London, 1972.
Snaith, R. P., Bridge, G. W. K., Hamilton, M. The Leeds Scales for the self-assessment of anxiety and depression. Psychological Test Publications, London, 1976.
Goldberg, D. P., Williams, P. Auser’s guide to the General Health Questionnaire (GHQ). NFER-NELSON, Berkshire, 1988.
Goldberg, D.P.& Hillier V.F. ‘A scaled version of the General Health Questionnaire’ Psychol. Med. 1979:9, 139–145.
Snaith, R. P., Bridge, G. W. K., Hamilton, M. The Leeds Scales for the self-assessment of anxiety and depression. Br. J. Psychiatry 1976; 128: 156–165.
Morris, T., Greer, H. S., White, P. Psychological and social adjustment to mastectomy: a two year follow-up study. Cancer 1977; 40: 2381–2387.
Ray, C. Psychological implications of mastectomy. Br. J. Clin. Psychology 1977; 161: 373–377.
Hughes, J. Emotional reactions to the diagnosis and treatment of early breast cancer. J. Psychosom. Res. 1982; 26: 277–283.
Dean, C. Psychiatric morbidity following mastectomy. Preoperative predictors and types of illness. J. Psychosom. Res. 1987; 31(3): 385–392
Plumb, M., Holland, J. Comparative studies of psychological functions in patients with advanced cancer. 1 Self-reported depressive symptoms. Psychosom. Med. 1977; 39: 264–276.
Steinberg, R., Torem, M., Saravay, S. M. An analysis of physician resistance to psychiatric consultations. Arch. Gen Psychiatr. 1980; 37: 1007–1012.
Rameriz, A. J. Liaison psychiatry in a breast cancer unit. J. R. Soc. Med. 1989; 82: 15–17.
Royal College of Physicians & Royal College of Psychiatrists. The psychological care of medical patients. Royal College of Physicians Publications Unit, London, 1995.
Mausell, E., Brisson J., Deschenes, L. Psychological distress after initial treatment of breast cancer. Assessment of potential risk factors. Cancer 1992; 20(1): 120–125.
Goldberg, D. P., Blackwell, B. Psychiatric illness in a suburban general practice. A detailed study using a new method of case identification. Br. Med. J. 1970; ii: 439–443.
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Farragher, B. Psychiatric morbidity following the diagnosis and treatment of early breast cancer. Ir. J. Med. Sc. 167, 166–0169 (1998). https://doi.org/10.1007/BF02937931
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DOI: https://doi.org/10.1007/BF02937931