Distress, psychiatric syndromes, and impairment of function in women with newly diagnosed breast cancer

BACKGROUND. Emotional distress and psychiatric syndromes are prevalent in the breast cancer population at large. However, to date there is a paucity of literature specifically concerning presurgical breast cancer patients. METHODS. The authors assessed 236 newly diagnosed patients at the time of their presurgical consultation at the Comprehensive Breast Cancer Program of Dartmouth-Hitchcock Medical Center in Lebanon, NH. RESULTS. Of patients in this study, 41% rated their distress in the clinically significant range on the Distress Thermometer (ie, > 5, 0-10 scale). Nearly one-half (47%) of patients met established thresholds for positivity on 1 or more screens for distress or psychiatric disorders. Prevalence rates were 11% for major depression (60% of these patients were moderately severe to severely depressed) and were 10% for post-traumatic stress disorder (PTSD). Emotional symptoms markedly interfered with daily function in both groups. Of depressed patients, 56% were already taking a psychotropic medication, yet they still met screening criteria for major depression. CONCLUSIONS. Emotional distress and psychiatric syndromes (major depression and PTSD) were prevalent in this population. Markedly impaired function was evident for both depressed and PTSD patients. Future research should refine current screening procedures and develop interventions to better address emotional distress and psychiatric disorders in newly diagnosed breast cancer patients.