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Psychological morbidity and quality of life in women with advanced breast cancer: A cross-sectional survey

Published online by Cambridge University Press:  29 June 2006

BRENDA GRABSCH ,
DAVID M. CLARKE ,
ANTHONY LOVE ,
DEAN P. McKENZIE ,
RAYMOND D. SNYDER ,
SIDNEY BLOCH ,
GRAEME SMITH  and
DAVID W. KISSANE
BRENDA GRABSCH
Affiliation:
University of Melbourne Centre for Palliative Care, Departments of Medicine and Psychiatry, St. Vincent's Hospital and Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia
DAVID M. CLARKE
Affiliation:
Monash University Department of Psychological Medicine, Monash Medical Centre, Clayton, Victoria, Australia
ANTHONY LOVE
Affiliation:
School of Psychological Sciences, LaTrobe University, Bundoora, Victoria, Australia
DEAN P. McKENZIE
Affiliation:
Monash University Department of Epidemiology & Preventive Medicine, Monash Medical School, Alfred Hospital, Prahran, Victoria, Australia
RAYMOND D. SNYDER
Affiliation:
Department of Oncology, St. Vincent's Hospital, Melbourne, Victoria, Australia
SIDNEY BLOCH
Affiliation:
University of Melbourne Centre for Palliative Care, Departments of Medicine and Psychiatry, St. Vincent's Hospital and Peter MacCallum Cancer Institute, Melbourne, Victoria, Australia
GRAEME SMITH
Affiliation:
Monash University Department of Psychological Medicine, Monash Medical Centre, Clayton, Victoria, Australia
DAVID W. KISSANE
Affiliation:
Department of Psychiatry and Behavioral Sciences, Memorial Sloan-Kettering Cancer Center, New York, New York
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Abstract

Objective: Our purpose was to determine the frequency of psychiatric morbidity and to assess the quality of life of women with advanced breast cancer.

Methods: The 227 women in the sample were recruited in Melbourne, Australia, and were interviewed (prior to intervention) for a randomized controlled trial of supportive-expressive group therapy. The main outcome measures were DSM–IV psychiatric diagnoses plus quality of life data based on the EORTC QLQ-C30 (core) and QLQ-BR23 (breast module) instruments.

Results: Forty-two percent of the women (97/227) had a psychiatric disorder; 35.7% (81) of these had depression or anxiety or both. Specific diagnoses were minor depression in 58 women (25.6%), major depression in 16 (7%), anxiety disorder in 14 (6.2%), and phobic disorder in 9 (4%). Seventeen (7.5%) women had more than one disorder. In terms of quality of life, one-third felt less attractive, one-quarter were dissatisfied with their body image, and, in most, sexual interest had waned. Menopausal symptoms such as hot flashes affected less than one-third, whereas symptoms of lymphedema were experienced by 26 (11.5%).

Significance: Women with advanced breast cancer have high rates of psychiatric and psychological disturbance. Quality of life is substantially affected. Clinicians need to be vigilant in monitoring psychological adjustment as part of a comprehensive biopsychosocial approach.

Keywords

Advanced breast cancerDepressionAnxietyPsychosocial morbidityQuality of life
Type
Research Article
Information
Palliative & Supportive Care , Volume 4 , Issue 1 , March 2006 , pp. 47 - 56
Copyright
© 2006 Cambridge University Press

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