Cognitive responses and psychiatric disorder in women with operable breast cancer

Abstract

AbstractThe relationships between patient characteristics, cognitive responses and psychiatric disorder have been examined in 105 women with operable breast cancer in the 6 months around the time of diagnosis. Patients underwent interview‐based psychosocial assessments at approximately 6 and 20 weeks post diagnosis. Information concerning patient characteristics was obtained at the 6 week assessment. Cognitive responses were assessed using a newly developed schedule at both the 6 and 20 week assessments. Psychiatric disorder from one month prior to diagnosis to five months post diagnosis was assessed at 20 weeks using the Present State Examination and Bedford College Rating Criteria. The point prevalence of psychiatric disorder (borderline and full case) was 48% at 6 weeks and 17% at 20 weeks post diagnosis. The period prevalence for the 6 months around the time of diagnosis was 66%, with 37% of women experiencing psychiatric disorder which was unresolved 6 weeks after diagnosis (persistent psychiatric disorder).The patient characteristics independently associated with psychiatric disorder included age < 50 (p = 0.05), lack of an intimate relationship (p = 0.05) and having previous psychological difficulties (p = 0.07). The frequencies of the cognitive responses assessed were generally similar at 6 and 20 weeks. So too was the extent to which each individual response was reported by each patient at each time point. Lack of optimism was significantly associated with psychiatric disorder at 20 weeks (p = 0.04), but not at 6 weeks post diagnosis. None of the other cognitive responses assessed were related to psychiatric disorder at either assessment.