Abstract
BackgroundThe surgical treatment of breast cancer involves various psychological consequences, which differ according to individual characteristics. Our study aimed to identify the role that cognitive schemas had in triggering anxiety and depressive symptoms in patients diagnosed with breast cancer that underwent oncological and plastic surgery treatment.Methods64 female patients, diagnosed with breast cancer from an Oncology and Plastic Surgery Hospital, were selected to participate in this study between March–June 2018. They were divided into two groups: I. 28 patients who underwent mastectomy surgery; II. 36 patients, who required mastectomy and, subsequently, also chose to undergo breast reconstruction surgery. For the purposes of evaluating a possible change in mental health status, we employed two assessment scales: the Young Cognitive Schema Questionnaire - Short Form 3 (YSQ-S3) and the Romanian version of the Depression Anxiety Stress Scale – 21 (DASS-21R).ResultsParticipants who underwent mastectomy and subsequent breast reconstruction surgery employed cognitive schemas that did not generate symptoms of depression or anxiety. In contrast, the cognitive schemas found in women who refused reconstructive breast surgery were significantly correlated with the presence of anxiety-depressive symptoms. The cognitive schema domain of ‘disconnection and rejection’ correlated uncertainly with the presence of anxiety-depressive symptoms for the group with breast reconstruction (Spearman’s ρ = 0.091, p = 0.644), while for the other group the correlation was moderate-strong (Spearman’s ρ = 0.647, p < 0.01). Negative emotional schemas were significantly correlated with the presence of anxiety-depressive symptoms (Spearman’s ρ = 0.598, p < 0.01) in the group of participants without reconstructive surgery.ConclusionA correct identification of dysfunctional cognitive schemas and coping mechanisms at the commencement of the combined treatment in breast cancer patients could serve as an indicator for the evolution of their mental health, therefore assisting professionals in establishing the most suitable psychological, psychotherapeutic and psychiatric intervention plan.
Highlights
Breast cancer appears to be the leading cause of death in women, as it represents the most common type of cancer diagnosed in this demographic category [1, 2]
The purpose of our study was to analyze the relationship between maladaptive cognitive schemas and the presence of anxiety and depression in women diagnosed with breast cancer
The study sample included two distinct groups, namely, group I, consisting of 28 participants with breast cancer, who underwent a mastectomy followed by reconstructive breast surgery and group II, consisting of 36 participants with breast cancer, who underwent a mastectomy, but refused to have subsequent reconstructive breast surgery (Table 1)
Summary
Breast cancer appears to be the leading cause of death in women, as it represents the most common type of cancer diagnosed in this demographic category [1, 2]. It causes a multitude of difficulties within the patientsfamilies, their social system, as well as for the wider public health system. Depressive symptoms in women with breast cancer are reported extremely often, because of a multitude of factors, such as: the manifestation of the disease itself, pain and fatigue, the change in self-image, the impact on their sexual intimacy, the lack of expected support, the fear and the need to adjust to the new situation. Our study aimed to identify the role that cognitive schemas had in triggering anxiety and depressive symptoms in patients diagnosed with breast cancer that underwent oncological and plastic surgery treatment
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