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Distress Disorder Histories Relate to Greater Physical Symptoms Among Breast Cancer Patients and Survivors: Findings Across the Cancer Trajectory

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Abstract

Background

Psychological disorders can substantially worsen physical symptoms associated with breast cancer diagnosis and treatment, reducing survivors’ quality of life and increasing recurrence risk. Distress disorders may be particularly detrimental given their physical correlates. Across two studies, we examined the relationship between a distress disorder history and physical symptoms pre- and post-adjuvant treatment — two important periods of the cancer trajectory.

Methods

Breast cancer patients awaiting adjuvant treatment (n = 147; mean age = 52.54) in study 1 and survivors 1–10 years post-treatment (n = 183; mean age = 56.11) in study 2 completed a diagnostic interview assessing lifetime presence of psychological disorders. They also rated their pain, fatigue, physical functioning, and self-rated health. Covariates included body mass index, age, cancer stage, menopause status, and physical comorbidities.

Results

Results from both studies indicated that a distress disorder history was associated with higher pain, fatigue, and sleep difficulties as well as lower self-rated health compared to those without such a history.

Conclusions

These findings suggest that breast cancer survivors with a distress disorder may be particularly at risk for more physical symptoms, poorer sleep, and worse self-rated health both prior to and following adjuvant treatment.

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Funding

Work on this project was supported by NIH grants R01CA186720, R01CA186251, T32 CA229114, and TL1TR002735.

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Authors and Affiliations

  1. School of Psychology, University of Southern Mississippi, 118 College Drive #5025, Hattiesburg, MS, 39406, USA

    Megan E. Renna

  2. Purdue University, West Lafayette, USA

    M. Rosie Shrout

  3. The Ohio State University, Columbus, USA

    Annelise A. Madison

  4. Yale School of Medicine, New Haven, USA

    Maryam Lustberg

  5. The Ohio State University College of Medicine, Columbus, USA

    Stephen P. Povoski, Doreen M. Agnese, Raquel E. Reinbolt, Robert Wesolowski, Nicole O. Williams, Bhuvaneswari Ramaswamy, Sagar D. Sardesai, Anne M. Noonan, Jeffrey B. VanDeusen, Daniel G. Stover, Mathew Cherian, William B. Malarkey, Michael Di Gregorio & Janice K. Kiecolt-Glaser

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  1. Megan E. Renna
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  2. M. Rosie Shrout
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Corresponding author

Correspondence to Megan E. Renna.

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All procedures performed in these studies were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Renna, M.E., Shrout, M.R., Madison, A.A. et al. Distress Disorder Histories Relate to Greater Physical Symptoms Among Breast Cancer Patients and Survivors: Findings Across the Cancer Trajectory. Int.J. Behav. Med. 30, 463–472 (2023). https://doi.org/10.1007/s12529-022-10115-4

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