[show abstract][hide abstract] ABSTRACT: Being recalled for further diagnostic procedures after an abnormal screening mammogram (ASM) can evoke a high state anxiety with lowered quality of life (QoL). We examined whether these adverse psychological consequences are found in all women with benign breast disease (BBD) or are particular to women referred after ASM. In addition, the influence of the anxiety as a personality characteristic (trait anxiety) was studied. Between September 2002 and February 2010 we performed a prospective longitudinal study in six Dutch hospitals. Women referred after ASM or with a palpable lump in the breast (PL), who were subsequently diagnosed with BBD, were included. Before diagnosis (at referral) and during follow-up, questionnaires were completed examining trait anxiety (at referral), state anxiety, depressive symptoms (at referral, one, three and 6 months after diagnosis), and QoL (at referral and 12 months). Women referred after ASM (N=363) were compared with women with PL (N=401). A similar state anxiety score was found in both groups, but a lower psychological QoL score at 12 months was seen in the ASM group. In women with not-high trait anxiety those in the ASM group were more anxious with more depressive symptoms at referral, and reported impaired psychological QoL at referral and at 12 months compared with the PL group. No differences were found between ASM and PL in women with high trait anxiety, but this group scored unfavorably on anxiety, depressive symptoms and QoL compared with women with not-high trait anxiety. ASM evokes more anxiety and depressive symptoms and lowered QoL compared with women referred with PL, especially in women who are not prone to anxiety. Women should be fully informed properly about the risks and benefits of breast cancer screening programs. We recommend identifying women at risk of reduced QoL using a psychometric test.
Breast Cancer Research and Treatment 03/2012; 134(1):253-8. · 4.47 Impact Factor
[show abstract][hide abstract] ABSTRACT: PURPOSE: We analyzed health care utilization (HCU) and its predictors in the first year after the diagnostic process for breast cancer (BC) or benign breast disease (BBD) using questionnaires. The impact of trait anxiety on HCU was examined. RESULTS: In total 591 women were analyzed, 440 with BBD and 151 with BC. In women with BBD and high trait anxiety (HTA) increased HCU was found. In women with BC and HTA only more use of psychosocial care (PS) was found. HCU in BBD was predicted by lower Quality of Life (QoL) and (adjuvant) treatment predicted HCU in BC. CONCLUSIONS: The most important factors for higher HCU were HTA and lower QoL, especially in BBD. In women with BC increased PS use was seen in chronically anxious women. Therefore, it is important to identify these women using a psychometric test and to anticipate to their specific (mental) health care needs.
Breast (Edinburgh, Scotland) 02/2012; · 2.09 Impact Factor
[show abstract][hide abstract] ABSTRACT: To determine the relationship between pre-diagnosis state anxiety, depressive symptoms, and combined state anxiety and depressive symptoms (CADS) with quality of life (QOL), fatigue, state anxiety and depressive symptoms one and two years after surgery in women with breast cancer.
Women with breast problems referred to a Dutch outpatient clinic were recruited for the study. Participants (N=428) completed a set of questionnaires before diagnosis (Time0) and the women with breast cancer subsequently received questionnaires at 12 (Time1) and 24 months (Time2) after surgical treatment. The questionnaire set consisted of questionnaires on demographics, state anxiety, depressive symptoms, fatigue, QOL, neuroticism, and trait anxiety. Chi-square tests, independent samples T-tests, and multivariate linear regression analyses were used to do the analyses.
Before their diagnosis of breast cancer, 111 women (28%) had CADS. Of the CADS-group, a higher percentage had elevated levels of anxiety, depressive symptoms, and CADS at all follow-up moments than of the non-CADS-group. CADS-score at before diagnosis and neuroticism were the most important predictors of outcome measures at Time1 and Time2.
More than one in four women, who later received the diagnosis breast cancer, had elevated levels of both state anxiety and depressive symptoms (CADS) just before diagnosis. This factor was also a major predictor of QOL, state anxiety, depressive symptoms, and fatigue 12 and 24 months after surgery. This implies that women with a higher score on both state anxiety and depressive symptoms should be identified as soon as possible in the process of diagnosis and treatment of breast cancer using validated questionnaires or screening instruments. Only by identifying this group of patients, tailored psychological care can be accomplished.
Journal of affective disorders 02/2012; 136(3):895-901. · 3.76 Impact Factor
[show abstract][hide abstract] ABSTRACT: The aim of this study was to analyze the possible negative psychological consequences of a false positive screening mammogram (FPSM). We compared anxiety evoked by first (FSM) versus repeat screening mammogram (RSM). Questionnaires were completed prior to the diagnosis and during follow up.
No differences in anxiety, depressive symptoms, and Quality of Life (QoL) were found between FSM (N = 186) or RSM (N = 296) groups. All women experienced high anxiety before diagnosis was known. High trait anxiety was predictive for more anxiety, depressive symptoms, and lower QoL. Women with low score on trait anxiety were more momentary anxious in FSM group compared with RSM group (p = 0.048).
Negative psychological consequences after an FPSM are seen in all women. These effects are strengthened by personality and timing of the screening mammogram. All women should receive correct information concerning the negative psychological effects and should be offered psychosocial support if needed.
Breast (Edinburgh, Scotland) 09/2011; 21(1):83-8. · 2.09 Impact Factor
[show abstract][hide abstract] ABSTRACT: The objectives of this study were to examine the differences in health status (HS) of women with breast cancer (BC) at different moments in time, and between women scoring high and not high on trait anxiety, and to identify possible predictors of HS 6 and 12 months after surgery.
Patients (N = 223) completed a trait anxiety questionnaire before diagnosis. Women who received a diagnosis of BC completed a BC-specific HS questionnaire 1, 3, 6 and 12 months after surgery. ANCOVA for repeated measures and multiple regression analysis were used in the analyses.
Women scoring high on trait anxiety had significant (P < .005) lower Body image, worse Future perspective and Sexual functioning, and more Side-effects than women who did not score high on trait anxiety. At 6 and 12 months after surgery, the same aspects of HS were predicted by higher trait anxiety scores.
Higher scores on trait anxiety resulted in worse scores on four HS domains, indicating that there should be more attention for this group of patients, even before treatment starts.
Quality of Life Research 01/2011; 20(6):865-73. · 2.41 Impact Factor
[show abstract][hide abstract] ABSTRACT: El objetivo de este estudio instrumental fue comparar las propiedades psicométricas entre el Cuestionario de Calidad de Vida de la Organización Mundial de la Salud, Forma Breve (WHOQOL-BREF), datos derivado de WHOQOL-100 y datos directamente del WHOQOL-BREF y evaluar las propiedades psicométricas adicionales del WHOQOL-BREF en mujeres con problemas de pecho. Un grupo (n = 607) completó el WHOQOL-100 cuatro veces, otro grupo (n = 549) completó el WHOQOLBREF una vez. Los grupos fueron formados por mujeres con un nódulo palpable en el pecho o una anormalidad en la mamografía de cribado. Todas las participantes cumplimentaron medidas de ansiedad (STAI), síntomas depresivos (CES-D) y fatiga (FAS); las mujeres con cáncer de pecho completaron además una medida del estado de salud (EORTC QLQ-BR23). El Análisis confirmatorio del WHOQOL-BREF tomando los datos de ambos grupos mostró un ajuste razonablemente bueno. Los alfas de Cronbach superaron el 0,70 en ambos grupos, excepto en el área de relaciones sociales. La validez convergente fue demostrada por correlaciones de moderadas a altas entre las puntuaciones del FAS, STAI-Estado, EORTC QLQ-BR23, y las áreas física y psicológica del WHOQOL-BREF. La fiabilidad test-rest medida por la correlación fue buena. En resumen, los datos del WHOQOL-BREF derivado de WHOQOL-100 y datos directamente del WHOQOL-BREF son comparables, y el WHOQOL-BREF tiene buenas propiedades psicométricas en mujeres con problemas de pecho.
International Journal of Clinical and Health Psychology. 01/2011;