The experience of anxiety and depression and their sequelae in breast cancer patients: effects of disease and treatment on patient self-esteem, body image, and the prevalence of hopelessness and suicidal ideation.

Abstract

Breast cancer continues to be one of the most commonly diagnosed cancers worldwide. Research suggests that the psychological needs of these patients are frequently unobserved and untreated as healthcare professionals may be insufficiently familiar with the prevalence of comorbid psychological features such as anxiety and depression and how these influence the experience of other psychological phenomena. The aim of this research was to examine the psychological effects of disease and treatment in women diagnosed with breast cancer and determine if these effects differed from those experienced by women with other cancers. While psychological distress in the form of depression and anxiety is well-documented in the literature, there is less specific reference to how these affect and mediate other concerns patients may experience during diagnosis and adjuvant treatment, namely the insult to body image and self-esteem through surgery and other treatment modalities and how these effects cumulatively inform the patient’s experience of hopelessness and possibly, suicidal ideation (SI). The aim was to identify if these forms of distress correlate, and to what degree, with a view to highlighting for oncology healthcare professionals the need to identify and treat those patients who are psychologically at risk. The samples of women with breast cancer (n=80) and other forms of cancer (n=80) was drawn from a population of outpatients receiving treatment at three private oncology clinics in the Durban, South Africa area. Convenience sampling was used and a battery of four questionnaires was completed by patients in addition to collection of relevant demographic data. The results suggest similarities and differences between the two groups. Whilst the two groups did not exhibit notable differences in overall levels of depression and self-esteem, there were significant differences in the experience of body image, with the breast group experiencing greater body image dysphoria. Likewise, in relation to stress, although both groups demonstrated elevated levels of stress in comparison to norms, the breast group evinced higher scores on psychological and behavioural responses to stress. These results suggest that breast cancer patients experience distress differently to patients with other forms of cancer, which may indicate areas for future research.