Orthorexia nervosa in breast cancer survivors: The role of disease characteristics and psychological aspects (GOIRC 02-2019).

Abstract

e24092 Background: Orthorexia Nervosa (ON), although not yet considered as a full-blown psychopathological disorder, is defined as altered thoughts and behaviours related to healthy eating and its prevalence is increasing in general population. Surviving cancer is a condition that may affect patients behaviour and mental status leading to beliefs that may affect everyday life to avoid cancer recurrence. Among these, eating behaviour is mostly represented in cancer survivors. The aim of the present study is to evaluate the prevalence and characteristics of ON among breast cancer (BC) survivors. Methods: This observational study enrols adult patients attending the outpatient clinic at the Oncology Division of Modena University Hospital. Patients with a BC diagnosis that have concluded the surgical, radiotherapy and chemo and/or targeted therapy treatment phase were considered eligible. Ongoing hormonal adjuvant therapy was permitted. Socio-demographic, clinical variables (stage, year of diagnosis, hormone receptor status, HER2 status, proliferation index, treatment) were collected on an anonymized database. Moreover, three psychometric measurements were administered to patients: the Hospital Anxiety-Depression Scale (HADS), the Personality Inventory for DSM-5 Brief Form (PID-5-BIF) and the ORTO-R, a 6-item self-administered tool that is the most used scale to measure ON. Results: Data were collected from 137 patients. Mean age was 62.4 years and (± 10.3) and the mean BMI was 26.3 (± 5.2). Sixty-six percent of patients were diagnosed with stage I disease, 28% with stage II and 6% with stage III disease. Thirty percent of patients received adjuvant chemotherapy, 89% hormonal therapy and 15.5% anti-HER2 targeted therapy. The ORTO-R mean score was 12.2 ± 3.8. The prevalence of psychiatric symptoms at the HADS was 36.5%. The ORTO-R score was found to correlate negatively to age of patients (the older, the less the score at ORTO-R, p = 0.001) and positively to 3 of the constructs of personality at the PID-5-BF, disinhibition, psychoticism and negative affect. Interestingly, ORTO-R was poorly associated to cancer variables, such as stage, hormone receptors, treatments, phenotype (luminal, HER2 positive, triple negative), lifestyle and psychiatric symptomatology. Conclusions: Eating behaviours among cancer patients may be influenced by psychological aspects and need to be addressed during follow-up. Further investigations are needed to evaluate correlation with BC specific characteristics.[Table: see text]