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      Anxiety and Depression in Women Newly Diagnosed with Breast Cancer and Waiting for Surgery: Prevalence and Associations with Socio-Demographic Variables

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          Abstract

          Background and Objectives: Cancer is a threatening-life disease with a significant psychological burden. The psychological morbidity varies according to the phases of the illness and is influenced by multiple socio-demographic factors, that are useful to consider in order to identify the categories of patients most at risk of developing psychiatric disorders. The present study analyzes, in a sample of women newly diagnosed with breast cancer, the relationships between their levels of anxiety and depression and several socio-demographic characteristics. The study was cross-sectional. Materials and Methods: Four hundred and seventy eight women newly diagnosed with breast cancer completed the Hospital Anxiety and Depression Scale during the pre-surgical phase. Results: Findings show that almost 40% of the sample had clinically relevant anxious symptoms and about a quarter of the sample had significant depressive symptoms. Their prevalence was higher in widows. Moreover, depressive symptoms were higher in older women and anxious symptoms were higher in patients with a lower educational level. In the pre-surgical phase, women can suffer from clinically relevant anxiety and depression, especially the widows, older women, and women with a lower educational level. Conclusions: Identifying the most psychologically vulnerable patients, due to specific socio-demographic characteristics, is essential in order to provide adequate psycho-oncological treatments to the categories of patients, who are most at risk of developing psychopathological concerns.

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          The Hospital Anxiety and Depression Scale

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            Detecting psychological distress in cancer patients: validity of the Italian version of the Hospital Anxiety and Depression Scale.

            The psychometric properties of the Italian version of the Hospital Anxiety and Depression Scale and its utility as a screening instrument for anxiety and depression in a non-psychiatric setting were evaluated. The questionnaire was administered twice to 197 breast cancer patients randomised in a phase III adjuvant clinical trial: before the start of chemotherapy and at the first follow-up visit. The presence of psychiatric disorders was evaluated at the follow-up visit using the Structured Clinical Interview for DSM-III-R in 132 patients. Factor analyses identified two strictly correlated factors. Crohnbach's alpha for the anxiety and depression scales ranged between 0.80 and 0.85. At follow-up, 50 patients (38%) were assigned a current DSM-III-R diagnosis, in most cases adjustment disorders (24%) or major depressive disorder (10%). Receiver operating characteristics (ROC) analysis was used to test the discriminant validity for both anxiety and depressive disorders. The comparison of the areas under the curve (AUC) between the two scales did not show any difference in identifying either anxiety (P = 0.855) or depressive disorders (P = 0.357). The 14-item total scale showed a high internal consistency (alpha = 0.89 and 0.88) and a high discriminating power for all the psychiatric disorders (AUC = 0.89; 95% CI = 0.83-0.94). The cut-off point that maximised sensitivity (84%) and specificity (79%) was 10. These results suggest that the total score is a valid measure of emotional distress, so that the Italian version of HADS can be used as a screening questionnaire for psychiatric disorders. The use of the two subscales as a 'case identifier' or as an outcome measure should be considered with caution.
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              Hospital Anxiety and Depression Scale (HADS) accuracy in cancer patients

              The Hospital Anxiety and Depression Scale (HADS) is a self-report questionnaire designed to screen anxious and depressive states in patients in non-psychiatric settings. In spite of its large use, no agreement exists in literature on HADS accuracy in case finding. The present research addresses the issue of HADS accuracy in cancer patients, comparing its two subscales (HADS-A and HADS-D) against tools not in use in psychiatry, which are able to detect prolonged negative emotional states.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Medicina (Kaunas)
                Medicina (Kaunas)
                medicina
                Medicina
                MDPI
                1010-660X
                1648-9144
                07 May 2021
                May 2021
                : 57
                : 5
                : 454
                Affiliations
                [1 ]Department of Psychology, Università di Torino, 10124 Torino, Italy; cristina.civilotti@ 123456unito.it (C.C.); beatrice.bianciotto@ 123456edu.unito.it (B.B.)
                [2 ]Clinical Psychology Unit, Department of Neuroscience, University of Turin, “Città della Salute e della Scienza” Hospital of Turin, 10126 Turin, Italy; rossana.botto@ 123456unito.it (R.B.); brigitta.leonardis@ 123456edu.unito.it (B.D.L.); mstanizzo@ 123456cittadellasalute.to.it (M.R.S.)
                Author notes
                [* ]Correspondence: daniela.acquadro@ 123456unito.it ; Tel.: +39-011-6702262
                [†]

                Cristina Civilotti and Rossana Botto contributed equally to this paper.

                Author information
                https://orcid.org/0000-0003-1251-6955
                https://orcid.org/0000-0002-9924-4093
                https://orcid.org/0000-0003-1249-7520
                Article
                medicina-57-00454
                10.3390/medicina57050454
                8148592
                34066935
                d8e6e68a-ee4a-4b30-b638-898623e25101
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 24 March 2021
                : 04 May 2021
                Categories
                Article

                breast cancer,anxiety,depression,distress,socio-demographic characteristics,diagnosis

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