Distress In Young Women Research Articles

Prevalence and predictors for fertility-related distress among 1010 young adults 1.5 years following cancer diagnosis – results from the population-based Fex-Can Cohort study

Background Cancer treatment during reproductive ages may negatively impact fertility and there is a need of firm knowledge about the prevalence and predictors of fertility-related distress. The aim was to examine fertility-related distress in a population-based sample of young women and men recently treated for cancer and to identify predictors for this outcome. Material and methods This nationwide cohort study included 1010 individuals (694 women and 316 men), mean age 34.5 ± 4.9 and 32.1 ± 5.5, respectively, diagnosed with breast, cervical, ovarian, testicular cancers, brain tumors or lymphoma at ages 18–39 in Sweden. Participants completed a survey 1.5-year post-diagnosis to assess fertility-related distress (RCAC), emotional distress (HADS) and self-efficacy, as well as sociodemographic and clinical factors and fertility preservation. Logistic regression was used to examine associations between explanatory factors and high fertility-related distress (RCAC subscale mean >4). Results Many participants (69% of women and 47% of men) had previous children and about half reported a wish for future children. High fertility-related distress was more prevalent among women (54%) than men (27%), and women were more likely than men to report distress concerning all but one RCAC dimension after adjustment for sociodemographic factors. Use of fertility preservation was unevenly distributed (15% of women and 71% of men) and was not associated with decreased fertility-related distress. In multivariable logistic regression models, a wish for future children, being single, not having previous children, symptoms of anxiety and low self-efficacy regarding one’s ability to handle threats of infertility were associated with high fertility-related distress. Conclusion This nationwide study found a high prevalence of fertility-related distress in young women and men recently treated for cancer and identified sociodemographic and psychological predictors. Fertility preservation was not found to act as a buffer against fertility-related distress, indicating the continuous need to identify strategies to alleviate fertility distress following cancer.

Excess healthcare costs of psychological distress in young women: Evidence from linked national Medicare claims data.

The prevalence of mental health disorders in young adults is increasing, yet there is limited empirical evidence on its economic consequences. We contribute to the literature by estimating the healthcare costs of psychological distress using panel data of young women (aged 18-23years with a 5-year follow-up) from the Australian Longitudinal Study on Women's Health and linked administrative data from Medicare Australia. Our empirical strategy is based on the classical two-part model of healthcare costs with individual specific fixed-effects. We complement our analysis with a test for selection on unobservables to address potential concerns of endogeneity. We find that young women with psychological distress have 15% higher annual healthcare costs (excluding hospital costs) than women with no psychological distress. A large proportion of these costs is driven by the use of antidepressants and the services of psychiatrists and psychologists. We further find that women with psychological distress have higher out-of-pocket costs on these mental health related services compared to non-mental health specific services. Additionally, we show that the effect of psychological distress on healthcare costs is highest during the first 6months of onset, which gradually decreases afterwards. The findings justify the importance of policy initiatives towards early prevention and treatment of psychological distress, especially among young women.

Age and gender effects on non-suicidal self-injury, and their interplay with psychological distress

IntroductionNSSI (non-suicidal self-injury) is an important public health issue, with high prevalence and associations with future mental illness and suicide. To date, no large single study has tested age and gender effects on NSSI and their interplay with psychological distress. MethodNSSI and psychological distress were ascertained by questionnaire in a community study of 2368 young people aged 14–25; proportions at each age and of each gender were approximately equal. ResultsThere was a significant quadratic interaction between age and gender on last month NSSI prevalence (p = 0.025): NSSI was more common in females ages 16–19, but there were no significant gender differences at younger/older ages. General distress partially mediated the effects of age and gender on NSSI. The association between general distress and NSSI was not significantly moderated by age, gender nor their interactions. ConclusionsGender difference in NSSI is not a static gap, but evolves across time, widening in mid-adolescence and disappearing by early adulthood. Part of the reason for that gender gap being present at those ages is the increase levels of distress in young women at those ages. There was no evidence that the effects of general distress on NSSI differed by age/gender.

Fertility preservation in young breast cancer patients: A population-based study.

90 Background: Treatment-related infertility is an important cause of distress in young women with breast cancer (YWBC) that is preventable by fertility preservation (FP) prior to initiating therapy. This study assesses FP service use by YWBC in Quebec (Canada). Methods: Administrative claims for women ≤ 40 diagnosed between 01-04-2012 and 31-03-2018 were identified using Quebec’s universal health services database (RAMQ). Access to and use of FP services were ascertained by identifying claims for a visit with an obstetrician/gynecologist (OB/GYN) ≤ 90 days of diagnosis, followed by claims for ovarian stimulation, ovule harvesting or artificial insemination. Patient, disease and treatment-related predictors were estimated using logistic regression. Results: 1 616 YWBC were treated. Mean age was 36 (SD 4.1), 72.1% had a CCI = 0, 84.5% were urban residents, and 72.2% experienced some form of socioeconomical disadvantages. Stage distribution was: 0.93%, 68.8, and 30.3% for stages 0, 1-2, and 3 respectively. 53.0% had a mastectomy, 40.8% received chemotherapy (CT), 70.7% received radiotherapy, 20.9% initiated anti-estrogen therapy. 387 YWBC consulted an OB/GYN within 90 days of diagnosis and 155 subsequently received FP services. Predictors associated with FP use included: decreased age (OR= 0.82, 95CI = 0.79-0.86), type of surgery (OR = 0.46, CI = 0.22-0.97), social isolation (OR =1.39, 95CI = 0.99-1.96) and receipt of chemotherapy (OR = 1.74, 95CI = 1.10-2.76). Conclusions: Only 23.9% of eligible YWBC in Quebec accessed FP specialists. Of these, 40.1% chose to move forward with FP. These findings raise important questions on how to optimize access to FP expertise. [Table: see text]

Psychological distress in young Australian women by area of residence: findings from the Australian Longitudinal Study on Women's Health

Background: The association between psychological distress and area of residence has been extensively discussed and debated. However, the focus has been largely on men and area of residence is often dichotomised to urban and rural. The aim of this study is to examine the association between psychological distress and area of residence in young Australian women using a broader geographical measure.Methods: Data were from 8961 women aged 19–26 in the 1989–95 cohort of the Australian Longitudinal Study on Women's Health in 2015. The association between area of residence (measured by the Modified Monash Model) and psychological distress (measured by the K10), adjusted for demographic factors, indicators of socioeconomic position and health behaviour characteristics, was analysed using logistic regression.Results: Women in regional centres had lower odds of high to very high psychological distress compared with women in metropolitan areas (adjusted odds ratio 0.73 (95% confidence interval 0.60–0.89)). Women living in large rural towns, medium rural towns and small rural towns/remote/very remote communities had similar levels of psychological distress as women living in metropolitan areas.Limitations: ALSWH uses self-report questionnaires which may introduce potential self-report bias. The small sample size in areas outside of metropolitan areas resulted in the need to collapse small rural towns, remote communities and very remote communities into one category.Conclusions: The subtle regional differences in levels of psychological distress in young women in Australia highlights the importance of the link between health and where people live and suggests further work is required to understand the regional differences and encourage location specific mental health services.

Diet, Exercise, Lifestyle, and Mental Distress among Young and Mature Men and Women: A Repeated Cross-Sectional Study.

Customization of mental health therapies needs to consider the differences in degree of brain maturity between young (18–29 years) and mature (30 years or older) adults as well as brain morphology among men and women. The aim of this study was to identify the significant dietary and lifestyle contributors to mental distress in these sub-populations. Independent repeated cross-sectional sampling was performed for over a 5-year period (2014–2019) to collect data from different populations at different time-points and seasons. A backward stepwise regression analysis was used on 2628 records. Mental distress in young women was associated with high consumption of caffeine and fast-food, and it was negatively correlated with moderate-high levels of exercise as well as frequent breakfast consumption. Mature women shared several common factors with young women; however, high fruit consumption was negatively associated with mental distress. For young men, high exercise, moderate consumption of dairy, and moderate-high intake of meat were negatively associated with mental distress. In addition, high fast-food and caffeine consumption were positively associated with mental distress in young men. For mature men, strong negative associations between higher education, moderate intake of nuts and mental distress surfaced. Our results support the need to customize dietary and lifestyle recommendations to improve mental wellbeing.

Re: The Prevalence of Sexual Dysfunctions and Sexually Related Distress in Young Women: A Cross-Sectional Survey.

Re: The Prevalence of Sexual Dysfunctions and Sexually Related Distress in Young Women: A Cross-Sectional Survey.

Anthropometric indicators as predictors of pelvic floor muscle distress in young women.

To identify anthropometric indicators that could predictpelvic floor muscle distress (PFMD) in young women. A cross-sectional study was conducted, whose sample consisted of 54 women aged between 18 and 35 years. The Pelvic Floor Distress Inventory was used to assess the PFMD. The anthropometric indicators evaluated were body mass index (BMI) being measured the weight and height, body fat percentage (skinfolds), waist circumference (WC), waist-to-hip ratio (WHR), and relative fat mass (RFM), which is calculated from height and WC. Descriptive and inferential statistics (Spearman correlation, simple linear regression, and receiver operating characteristic curve) were used, with a significance level of 5%. The PFMD and the anthropometric indicators BMI (r = .43), body fat percentage (r = .42), WC (r = .46), WHR (r = .49), and RFM (r = .48) showed a positive and moderate correlation (P < .01). In all, 24%, 23%, 20%, and 18% of the PFMD can be credited to RFM, WC, WHR, and body fat percentage, respectively. The cut-off point for RFM was 38.44 for the symptom of pressure in the lower abdomen and 36.24 for symptom of stress urinary incontinence and incomplete emptying of the bladder. Anthropometric indicators of body fat percentage, WC, WHR, and RFM can be predictors of PFMD in young women minimally symptomatic.

The prevalence of sexual dysfunctions and sexually related distress in young women: a cross-sectional survey

To document the prevalence of female sexual dysfunctions (FSDs) and factors associated with FSDs and sexually related personal distress in premenopausal women. Community-based cross-sectional study. Eastern states of Australia. Women aged 18-39 years. Not applicable. Women were classified as having sexually related personal distress if they had a Female Sexual Distress Scale-Revised score of ≥11, and as having an FSD if they had a low Profile of Female Sexual Function desire, arousal, orgasmic function, responsiveness, or sexual self-image domain score plus sexually related personal distress. Sociodemographic factors associated with an FSD were examined by means of multivariable logistic regression. The prevalence of sexually related personal distress was 50.2%. Sexually related personal distress without dysfunction affected 29.6%, and 20.6% had at least one FSD. The proportions of women with self-image, arousal, desire, orgasm, and responsiveness dysfunction were 11.1%, 9%, 8%, 7.9%, and 3.4% respectively. Sexual self-image dysfunction was associated with being overweight, obese, living together, not married, married, breastfeeding, and taking a psychotropic medication. Psychotropic medication was significantly associated with all FSDs. Independent risk factors for nonspecific sexually related personal distress included psychotropic medication., sexual inactivity, and infertility treatment. That one-half of young Australian women have sexually related personal distress and one in five women have at least an FSD, with sexual self-image predominating, is concerning. The high prevalence of distress signals the importance of health professionals being adequately prepared to discuss sexual health concerns.

The self-reported perceptions of the repercussions of the disease and its treatments on daily life for young women with breast cancer and their partners

Purpose: This study aimed to compare the self-reported perceptions of the repercussions of the disease and its treatments and emotional distress in young women with breast cancer and their partners.Design: Cross-sectional study using self-reported questionnaires.Sample: 491 couples in which women were aged <45 years when diagnosed with non-metastatic breast cancer in four different groups of treatment: during chemotherapy with or without Trastuzumab; under Trastuzumab with or without hormone therapy; during hormone therapy; and during the follow-up period.Methods: Patients and partners completed a questionnaire assessing their self-reported perceptions of the disease and treatments (Patient YW-BCI and Partner YW-BCI for the partners) and their emotional distress (CESD; STAI).Findings: Patients reported more difficulties than partners in the management of child(ren) and everyday life, body image and sexuality, negative affectivity about the disease and apprehension about the future, career management, and finances. While the difficulties were generally more marked in the chemotherapy and Trastuzumab groups than in the hormone therapy and follow-up groups, the negative affectivity about the disease and apprehension about the future was high in all four groups, especially in patients. The partners reported more difficulties in sharing with close relatives, and even more in those groups reflecting the latest treatment phases. No difference appeared between patients and partners in couple cohesion and deterioration of relationships with relatives. Partners were less anxious than patients but as depressed as them.Conclusions: Difficulties of patients and partners seem particularly severe in the early care pathway, maybe reflecting better adjustment in women under surveillance and their partners. A longitudinal study will substantiate this finding and enable a better identification of some explanatory processes of these differences and similarities in the daily self-reported repercussions of the disease throughout the cancer care pathway.Implications for psychosocial oncology: It seems important to support young women with breast cancer and their partners, as our results evidence distress in both and differences according to the type of treatment the woman is currently receiving. Healthcare providers need consistent methods to identify and respond to couples’ distress and reduce significant disparities in support.

Does access to an information-based, breast cancer specific website help to reduce distress in young women with breast cancer? Results from a randomised trial.

To assess the effectiveness of a purpose-built information-based website to reduce distress among young women with breast cancer. A total of 337 participants (Intervention Group [IG] n=202; Usual Care Group [UCG] n=177) returned the completed baseline questionnaires (T1). Details regarding accessing the website were provided to IG participants. Follow-up questionnaires were completed: (a) 3months (T2) and (b) 6months after baseline (T3). Outcomes included anxiety and depression (primary outcomes), quality of life (QoL) and unmet information needs. About 70% of the IG accessed the website, typically only once (median: 1, range 1-15), spending a median of 19min (range: 1-315) on the site. Mean levels of anxiety and depression did not differ between the two groups at T1, T2 or T3. While improvement in total QoL was greater in the IG than UCG between T1 and T2, QoL scores did not differ between groups at T3. The number of unmet needs did not differ between the two groups at T3. The intervention was not effective in reducing anxiety, or depression in this group of women. As a high number of unmet needs were identified, other strategies for addressing these needs of young women with breast cancer are needed.

Women treated for gynaecological cancer during young adulthood – A mixed-methods study of perceived psychological distress and experiences of support from health care following end-of-treatment

ObjectiveTo investigate the prevalence and predictors of cancer-related distress in younger women treated for gynaecological cancer, and to explore women's needs and experiences of psychosocial support following end-of-treatment. MethodsData were collected from 337 gynaecological cancer survivors, 19–39years at diagnosis, using a study-specific questionnaire and the Swedish Quality Register of Gynaecologic Cancer. Predictors of distress were investigated with multivariable logistic regression analysis. Open-ended questions were analysed with content analysis. ResultsThe prevalence of cancer-related distress was 85% (n=286) including fear of cancer-recurrence (n=175, 61%), anxiety (n=152, 53%), depression (n=145, 51%), fear of death (n=91, 32%), concerns regarding sexuality (n=87, 34%) and fertility (n=78, 27%), and changed body image (n=78, 27%). Multi-modal treatment (OR 2.25, 95% CI 1.13–4.49) and a history of psychological distress (OR 3.44, 95% CI 1.41–8.39) predicted cancer-related distress. The majority of women experiencing distress also reported a need for support after end-of-treatment (n=205, 71%). One-third of those receiving support reported the received support as inadequate (n=55, 34%). Eight categories described reasons for not seeking support, e.g., lacked strength to seek professional support and too busy managing every-day life and, wanted help but did not know who to turn to. Four categories described reasons for not receiving sought support e.g., found it difficult to openly express feelings, psychosocial care was under-dimensioned, insufficient and unprofessional. ConclusionResults identify the importance of support and longer-term follow-up for young survivors of gynaecological cancer. The support needs to be organised to meet this group's specific needs.

Improvements in emotion regulation following mindfulness meditation: Effects on depressive symptoms and perceived stress in younger breast cancer survivors.

Mindfulness meditation reduces psychological distress among individuals with cancer. However, mechanisms for intervention effects have not been fully determined. This study tested emotion regulation strategies as mediators of intervention effects in a sample of younger women treated for breast cancer, a group at risk for psychological distress. We focused on two distinct strategies targeted by the intervention-rumination and self-kindness-and further examined the broader construct of mindfulness as a potential mediator. Women (n = 71) with Stage 0-III breast cancer diagnosed at or before age 50 who had completed cancer treatment were randomly assigned to a 6-week mindfulness intervention or wait-list control group. Assessments occurred at study entry, postintervention, and a 3-month follow-up. In single mediator analyses, increases in self-kindness (CIB [-7.83, -1.93]), decreases in rumination (CIB [-5.05, -.31]), and increases in mindfulness (CIB [-6.58, -.82]) each mediated reductions in depressive symptoms from pre- to postintervention. Increases in self-kindness also mediated reductions in perceived stress (CIB [-5.37, -.62]) from pre- to postintervention, and increases in self-kindness (CIB [-5.67, -.22]) and in mindfulness (CIB [-5.51, -.16]) each mediated intervention effects on perceived stress from preintervention to 3-month follow-up. In multiple mediator analysis, only self-kindness mediated intervention effects on depressive symptoms from pre- to postintervention (CIB [-6.41, -.61]), and self-kindness and mindfulness together mediated intervention effects on perceived stress from preintervention to follow-up (CIB [-6.77, -.35]). Self-kindness played a consistent role in reducing distress in younger women with breast cancer. The efficacy of this understudied emotion regulation strategy should be evaluated in other clinical populations. (PsycINFO Database Record

Quality of Life and Psychological Adjustment of Women Living with 46,XY Differences of Sex Development.

Progressive care improvement for differences of sex development (DSD), regarding diagnosis communication, psychological, medical and surgical management has been claimed. To assess clinical management, quality of life (QoL) and the general psychosocial adjustment of individuals with 46,XY DSD. Some differences related to age at diagnosis are investigated. Cross-sectional study using standardized questionnaires. Forty-three Caucasian females with 46,XY DSD (self declared diagnoses: complete androgen insensitivity syndrome, n = 34; complete gonadal dysgenesis, n = 1; 5α-reductase deficiency, n = 4; Leydig cell hypoplasia, n = 1; unknown diagnosis, n = 3; age years: 31.5 ± 9.6 [range 18-57 years]). University Hospitals. Subjects were required to fill in questionnaires (ABCL, WHOQOL, dedicated 17-item questionnaire). Academic and socioeconomic data were compared with those of the Italian population. QoL and psychological data were compared with those of a comparison group (46,XX healthy females: n = 43; age, years: 34.5 ± 9.7, range 22-51 years). Present sample of women living with 46,XY DSD were well adapted and were higher achievers than controls, both in educational and professional life. They showed good QoL, but they appeared less satisfied in psychological and social areas. They had borderline mean scores and statistically higher scores than the comparison group for depression, anxiety, internalizing and externalizing problems. Younger persons living with a 46,XY DSD showed better psychosocial adjustment than older ones. Younger women showed lower age at diagnosis communication. Psychological support was more often proposed at the time of diagnosis communication to younger individuals, and they undertook it more frequently than older ones. Italian people living with 46,XY DSD were well adapted and successful; they reported a good QoL but showed higher degree of psychological distress than the comparison group. Lower psychological distress in younger women could indicate some positive effects of changes in management.

Psychological distress in women with breast and gynecological cancer treated with radical surgery

The objective of this study is to compare psychological distress (body image disturbance,self-esteem, depression, and anxiety) in women with breast or gynecological cancer treated by radical surgery. Additionally, another objective is to analyze the association between psychological distress and sociodemographic characteristics, medical history, and social support to produce a prediction model for the outcome measures. A cross-sectional study was carried out with 100 women who had undergone radical surgery for breast or gynecological cancer. Both groups were divided into the following: younger than 50 years old and 50 years old or older. Body Image Scale, Rosenberg's Self-Esteem Scale, Beck Depression Inventory, and Beck Anxiety Inventory were used. Age had a significant main effect on psychological distress but the type of cancer did not.Younger women showed significantly greater distress than older women (p-values<0.001). A significant interaction between age and type of cancer was found, indicating that older women with breast cancer had worse body image and more depression than those with gynecological cancer (p-values 0.001); no significant differences were found between younger groups.The prediction model for increased body image disturbance and depression included the joint effect of the following variables: being younger, inactive occupational status, and post-adjuvant therapy side effects. For lower self-esteem, the variables were: being younger, post-adjuvant therapy side effects,and dissatisfaction with social support. And for higher anxiety, the sole variable included was post-adjuvant therapy side effects. Both mastectomy and hysterectomy/oophorectomy cause similar psychological distress in younger women, but mastectomy causes greater distress in older women than hysterectomy/oophorectomy.

Quality of life and psychosocial distress in young women with advanced breast cancer.

e20508 Background: Little is known about the quality of life (QOL), prevalence and predictors of psychosocial distress in young women with advanced breast cancer (ABC). Methods: As part of an ongoing longitudinal multi-center study of women aged &lt; 40 with newly diagnosed breast cancer, we identified women with ABC. Using baseline survey and medical chart data, we assessed QOL (measured by the Medical Outcomes Study Short Form-36 [SF-36], with norm based means [NBM] &lt;47 indicating a clinically meaningful worsening QOL compared to the general population), and evaluated relationships between demographic and clinical variables and psychosocial distress (measured by the Hospital Anxiety and Depression Scale [HADS], with higher scores indicating more distress). Demographic and clinical factors were tested in univariate models. Factors with a p &lt; 0.2 were evaluated in multivariate models to determine factors associated with anxiety or depression (HADS subscale scores &gt;11). Results: Of the 725 women who completed a baseline survey, 40 had ABC. Median age of ABC diagnosis was 37 (range 23-40). Median time between diagnosis and survey completion was 143 days. Other than general health (NBM 56.8) and role limitations due to emotional problems (NBM 53.8), SF-36 subscale scores of young women with ABC were lower compared to the general population, especially, bodily pain (NBM 27.4), social functioning (NBM 33.5) and mental health (NBM 44.3) scores. Physical and mental component summary NBM scores were 44.3 and 45.8 respectively. 30% (12/40) were anxious and 10% (4/40) were depressed according to HADS. The 4 depressed women also met criteria for anxiety. Women who were more financially comfortable were less anxious (OR 0.07, p=0.04). Logistic regression identified no other factors associated with anxiety, and no factors were associated with depression. Conclusion: QOL is impaired in young women with recently diagnosed ABC, particularly from bodily pain and disruption to social functioning. Many young ABC patients are anxious, while few are depressed. This study will be expanded to include young women who progressed to ABC. Further research is warranted to evaluate interventions to improve QOL and psychosocial distress in this population.

Do cancer and treatment type affect distress?

We examined differences in distress levels and Distress Thermometer (DT) cutoff scores between different cancer types. The effect of socio-demographic and illness-related variables on distress was also examined. One thousand three hundred fifty patients (response = 51%) completed questions on socio-demographic and illness-related variables, the Dutch version of the DT and Problem List, and the Hospital Anxiety and Depression Scale. Receiver operating characteristics analyses were performed to determine cancer specific cutoff scores. Univariate and multivariate effects of socio-demographic and illness-related variables (including cancer type) on distress were examined. Prostate cancer patients reported significantly lower DT scores (M = 2.5 ± 2.5) and the cutoff score was lower (≥ 4) than in patients with most other cancer types (M varied between 3.4 and 5.1; cutoff ≥ 5). Multivariate analyses (F = 10.86, p < .001, R(2) = 0.08) showed an independent significant effect of four variables on distress: intensive treatment (β = .10, any (combination of) treatment but surgery only and 'wait and see'); a non-prostate cancer type (β = -.17); the interaction between gender and age (β = -.12, highest distress in younger women as compared with older women and younger and older men); and the interaction between cancer type and treatment intensity (β = .08, lowest scores in prostate cancer patients receiving non-intensive treatment as compared with their counterparts). Distress and cutoff score in prostate cancer patients were lower than in patients with other cancer types. Additionally, younger women and patients receiving treatment other than surgery only or 'wait and see' are at risk for higher distress. These results can help identify patients possibly in need of referral to professional psychosocial and/or allied health care.

Surgical treatment of breast cancer in young women

Surgical treatment is a fundamental aspect in the proper management of breast cancer. It is not only the mainstay of loco-regional treatment, but it also allows disease staging and optimization of adjuvant chemotherapy through histopathological and immunohistochemical analysis of the biopsied tissue. From a strict oncologic point of view, surgical treatment of breast cancer in young women does not differ greatly from that in older women, but the physical consequences of large breast resections can have a major impact on self image, and can result in significant emotional and psychosocial distress in younger women [1]. Moreover, the fact that the majority of women in this age group are of childbearing age calls for the need to consider distinct aspects of surgical treatment [2, 3]. When choosing between a conservative or a more radical surgical approach, it is also important to bear in mind that breast tumors in younger patients tend to be strongly associated with a family history of breast cancer, and therefore patients have an increased risk for carrying BRCA1 or BRCA2 (BRCA1/2) mutations [4]. In confirmed cases of BRCA1/2 mutations, risk-reducing salpingooophorectomy has been demonstrated to be the best strategy [5]. In patients with these mutations and established disease, radical mastectomy (RM), instead of breast-conserving surgery (BCS), is the most sensible approach [6]. Surgical treatment in localized disease

Prevalence and Predictors of Distress in Young Women with Newly Diagnosed Early Stage Breast Cancer.

Abstract Background: Previous research suggests that young women are at high risk for psychological distress after a breast cancer diagnosis. We sought to identify factors associated with overall distress, anxiety, and depression in this vulnerable population.Materials and Methods: We have surveyed women age ≤40 with recently diagnosed stage I-III breast cancer in an ongoing prospective multi-center cohort study started in late 2006. The baseline survey includes the Hospital Anxiety and Depression Scale (HADS) as well as sociodemographic and medical history items. Medical record and central pathology review were also performed. Women with HADS scores &amp;gt;14 were considered distressed, and those with scores &amp;gt;10 on the anxiety or depression subscales were considered anxious or depressed, respectively. We conducted multivariate logistic regression modeling to determine predictors of anxiety, depression, and overall distress.Results: The first 258 eligible women who completed the baseline survey are included in this analysis. Median age at diagnosis was 37 years. Seventy-six percent were married, 90% white, 83% college educated, 66% had children, 99% were medically insured, and 60% were employed full time prior to diagnosis. Fifty-two percent of women reported their finances as comfortable. Forty-eight percent reported a household income over $100,000 per year, and only 15% reported an income less than $50,000. Comfortable finances and higher reported income were strongly correlated (Spearman's correlation coefficient = 0.51, p&amp;lt;0.0001). Fifty-four women (21%) reported substantial anxiety, 22 (9%) depression, and 107 (41%) distress by HADS score. Multivariate logistic regression models revealed that women with less than comfortable finances were more likely to be distressed (OR 3.1, 95% CI 1.7-5.6, p=0.0001), anxious (OR 2.4, 95% CI 1.2-4.9, p=0.0139), or depressed (OR 3.3, 95% CI 1.1-10.3, p=0.0375). Women with more advanced stage (stage II or III) breast cancer were also more likely to be anxious (OR 2.3, 95% CI 1.0-5.3, p=.0477). Grade, race, education, mastectomy, chemotherapy, fulltime employment, marital status, whether a woman has children, family history of cancer, and alcohol consumption were not found to be statistically significantly associated with anxiety, depression, or overall distress.Discussion: In this large cohort of young women with early breast cancer, distress is common. Financial status was the only sociodemographic factor that was consistently associated with baseline anxiety, depression, and overall distress. These results suggest that it may be important to target psychosocial interventions including financial counseling early in the course of care, especially given that financial stressors may worsen over time. Future research is needed to develop effective interventions to reduce distress in young women with newly diagnosed breast cancer. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1067.

Effects of SP6 acupressure on pain and menstrual distress in young women with dysmenorrhea

This study aims to evaluate the effects of Sanyinjiao (SP6) acupressure in reducing the pain level and menstrual distress resulting from dysmenorrhea. Forty participants with dysmenorrhea were assigned to either the acupressure group (n = 19) or the control group (n = 21). The acupressure group received 20 min of SP6 acupressure during the initial intervention session and was taught to perform the technique for them to do twice a day from the first to third days of their menstrual cycle, 3 months subsequent to the first session. In contrast, the control group was only told to rest. Outcomes were measured through (1) the Pain Visual Analogue Scale (PVAS), (2) the Short-Form McGill Pain Questionnaire (SF-MPQ), and (3) the Short-Form Menstrual Distress Questionnaire (SF-MDQ). There was a statistically significant decrease in pain score for PVAS (p = 0.003) and SF-MPQ (p = 0.02) immediately after the 20 min of SP6 acupressure. In the self-care periods, significant reduction of PVAS (p = 0.008), SF-MPQ (p = 0.012), and SF-MDQ (p = 0.024) scores was noted in the third month of post-intervention. SP6 acupressure has an immediate pain-relieving effect for dysmenorrhea. Moreover, acupressure applied to the SP6 acupoint for 3 consecutive months was effective in relieving both the pain and menstrual distress level resulting from dysmenorrhea.