Krankheitsverarbeitung bei Patientinnen mit Brustkrebs
The questions of the meaning of psychosocial factors and especially of coping behavior for the course of cancerous diseases have found increasing interest in psychosomatic research in the past several years. The results of studies already carried out to this topic are contradictous. Several studies indicate, that the course of disease in cancer patients reacting anxious and depressive are more unfavorable than in patients with a hopeful attitude toward their disease. In other studies these interdependences between psychic and somatic factors could not be found.
First results of a prospective research project of 107 breast cancer patients show, that the development of coping strategies of the individual patients are rather different. Somatic datas as stage of lymph-nodes, kind of surgery and additional treatments as radiation therapy or chemotherapy are of less importance for the coping process than cognitive attitudes of the patients toward their disease. When the course of the cancerous disease is favorable, the emotional and cognitive engagement in the disease decrease over time. In case of local recidivation or distant metastases however anxiety and depression increase distinctly.
With regard to the interdependences between the development of coping strategies for the one part and the course of somatic disease for the other part the preliminary results are as follows. The rate of progredience, measured by local recidivations, distant metastases, and cases of death is higher in the group of patients with continiously high scores for anxiety and depression than in the group with low scores. It remains to be seen, if further datas of our research project confirm this first findings or not. The question whether interdependences exist between the kind of coping behavior and the course of a cancerous disease will occupy the psychosomatic research still for some years.