Evaluation of mental and social adaptation of patients with breast cancer.

Abstract

e23167 Background: In 2018, in the N.N. Petrov National Medical Research Center of Oncology, there was conducted a study of the effectiveness of a mental and social adaptation of patients to the disease and treatment in the framework of The International Classification of Functioning, Disability and Health (ICF). Methods: The patients with breast cancer (n = 28, mean age 31 ±7) were examined at the stages of diagnosis and admission to the hospital. The basis of the study is the «Narcissism Evaluation Test», EORTC QLQ-C30, as well as the following ICF domains: Body function - global psychosocial functions (b122), temperament and personality functions (b126), energy and drive functions (b130), sleep functions (b134), attention functions (b140), psychomotor functions (b147), emotional functions (b152), thought functions (b160), higher-level cognitive functions (b164). Activity and participation- doing housework (d640), family relationships (d760), intimate relationships (d770), acquiring, keeping and terminating a job (d845). Results: The increase in values (7.26–13.61; p < 0.05) on the “Depersonalization” scale indicates an attempt to dissociate from threatening processes in oneself by means of dissociation and splitting, to preserve the coherence of the personality structure. This tendency can be viewed as an attempt by the patient to deny that destabilization affects his personality and lifestyle, which leads to the experience of melancholia as an attempt at destruction of Self-Concept. Such reactions are classified by us within the framework of psychogenic, i.e. conditionally normal in the situation of cancer, however, it was shown that the pathology of “psychogeny” significantly reduces the quality of life and social adaptation. For example, in 11 patients, there is a decrease in the quality of life (62.85; p < 0.05), disturbed sleep, emotions, energy and drive functions (b134, b152, b130), and there are difficulties in the resumption of labor activities (d845). Conclusions: Experiencing the threat to the integrity of Self-Concept launches psychological defenses, as a result of which a rapid regression of Self-Concept occurs before the primary narcissism. Psychogenic reactions during pathologization contribute to the patient’s social and mental maladjustment.