Reichelt Jon G, Møller Pål, Heimdal Ketil, Dahl Alv A
Section for Hereditary Cancer, Department for Medical Genetics, Rikshospitalet-Radiumhospitalet Medical Center, 0310, Oslo, Norway.
Fam Cancer. 2008;7(3):245-54. doi: 10.1007/s10689-008-9182-z. Epub 2008 Jan 25.
The aim of this longitudinal study was to explore both levels of and factors predictive of psychological and cancer-specific distress in women with demonstrated BRCA1 mutations belonging to families with hereditary breast/ovarian cancer (HBOC).
We included 214 women from HBOC families who had BRCA1 testing, and who were examined with a mailed questionnaire at pre-test (T1), 6 weeks after getting the test result (T2) and 18 months later (T3). Self-rating instruments for psychological distress, cancer-specific distress and personality traits were used.
Hardly any significant changes were observed concerning the levels of psychological and cancer-specific distress from T1 via T2 to T3 for the total group or those with carrier or non-carrier status, while women with cancer had a significant reduction of cancer-specific distress over time. The pre-test levels of psychological and cancer-specific distress were significant and strong predictors of these types of distress at T3. The personality trait of neuroticism made a significant contribution to both types of distress at pre-test, and a small separate contribution to distress at T3. Carrier status, history of personal cancer, pre-test levels of optimism or multidimensional health locus of control did not significantly predict distress at T3.
Genetic testing or test results were not found to induce psychological or cancer-specific psychological distress at long-term. Neuroticism had a decisive influence at both pre-test and long-term levels of distress.
这项纵向研究的目的是探究遗传性乳腺癌/卵巢癌(HBOC)家族中携带已证实的BRCA1突变的女性的心理困扰和癌症特异性困扰水平及其预测因素。
我们纳入了214名来自HBOC家族且进行了BRCA1检测的女性,她们在检测前(T1)、获得检测结果6周后(T2)以及18个月后(T3)通过邮寄问卷进行调查。使用了心理困扰、癌症特异性困扰和人格特质的自评工具。
从T1到T2再到T3,总体组或携带或非携带状态的女性在心理困扰和癌症特异性困扰水平方面几乎没有观察到任何显著变化,而患有癌症的女性随着时间推移癌症特异性困扰显著降低。检测前的心理困扰和癌症特异性困扰水平是T3时这些类型困扰的显著且强有力的预测因素。神经质人格特质在检测前对两种类型的困扰都有显著贡献,在T3时对困扰也有小的单独贡献。携带状态、个人癌症病史、检测前的乐观水平或多维健康控制点均未显著预测T3时的困扰。
未发现基因检测或检测结果会在长期引发心理或癌症特异性心理困扰。神经质在检测前和长期困扰水平方面都有决定性影响。