Psychiatric morbidity and pattern of coping among a sample of Egyptian women in early versus recurrent stage of breast cancer

الملخص EN

omen with breast cancer have been known to present with high rates of psychiatric disorders, distressing symptoms and stressful experiences that mobilize different coping strategies and may require social support.

Objectives: To describe the psychiatric morbidity, pattern of coping, and social support in a sample of Egyptian patients with breast cancer in the early postoperative and recurrent stages.

Materials and Methods: A descriptive cross-sectional study was conducted with 100 female breast cancer patients from the Breast Cancer follow-up clinic at Ain Shams University Hospitals; 75 patients were in the early postoperative (Group-A) while 25 patients were in the recurrence stage (Group-B).

All participants were evaluated using the Structured Clinical Interview for DSM Axis-I Disorders (SCID I).

Further assessment was done using Beck Depression Inventory (BDI) to assess the severity of depression, the Manifest Taylor Anxiety Scale (MTAS) to assess anxiety state, the Dealing with Illness Coping Inventory to assess the pattern of coping, and the Medical Outcome Study (MOS) Social Support Survey to assess the perceived social support.

Results: Higher rates of psychiatric morbidity reaching 76% of patients with recurrent breast cancer met the criteria for a psychiatric diagnosis compared to 54.7% of patients in the early stages.

The spectrum of the current DSM-IV psychiatric diagnoses differed significantly between the two groups: 44% of the recurrent group had major depression compared to 17.3% in patients with post-operative early stage, the latter groups showed a high rate of anxiety disorders (29.3%) and sub-syndromal depressive symptoms (40%).

The recurrent cases scored higher in Beck Depression Inventory (BDI) while the early cases scored higher in Manifest Taylor Anxiety Scale (MTAS).

Active coping methods were frequently used by all patients; however, Avoidance Coping method (P=0.01) and Passive Resignation strategy (P=0.005) were significantly used more by the recurrent group.

All types of social support were equally served for both groups; however, the recurrent group received more significant practical support.

Conclusion: In the current study, Egyptian breast cancer patients demonstrated a high prevalence of psychiatric disorders, with mild to moderate symptom severity.

In both early and recurrent stages some coping patterns may be influenced by the psychopathology and the stage of illness.

Generally, patients received adequate emotional and practical support.

Our findings provided the rationale for developing a program that facilitates early recognition and management of such high rate of psychiatric morbidity among women with breast cancer.