Department of Oncology and The Fisher Centerfor Familial Cancer Research, Lombardi Comprehensive Cancer Center, Georgetown University, 3300 Whitehaven Street, Northwest, Suite 4100, Washington, DC 20007, USA.
Cancer Epidemiol Biomarkers Prev. 2010 Mar;19(3):648-54. doi: 10.1158/1055-9965.EPI-09-0548. Epub 2010 Mar 3.
Responses following BRCA1/2 genetic testing are relevant for the comprehension of risk status and may play a role in risk management decision making. The objective of this study was to evaluate a psychosocial telephone counseling (PTC) intervention delivered to BRCA1/2 mutation carriers following standard genetic counseling (SGC). We examined the effect of the intervention on distress and the concerns related to genetic testing.
This prospective randomized clinical trial included 90 BRCA1/2 mutation carriers. We measured anxiety, depression, and genetic testing distress outcomes at intervention baseline and 6 and 12 months following disclosure. We evaluated the effects of SGC versus SGC plus PTC on psychological outcomes using intention-to-treat analyses through generalized estimating equations.
At 6 months, PTC reduced depressive symptoms (Z = -2.25, P = 0.02) and genetic testing distress (Z = 2.18, P = 0.02) compared with SGC. Furthermore, women in the intervention condition reported less clinically significant anxiety at 6 months (chi(2)(1) = 4.11, P = 0.04) than women who received SGC. We found no differences in outcomes between the intervention groups at the 12-month follow-up.
As an adjunct to SGC, PTC delivered following disclosure of positive BRCA1/2 test results seems to offer modest short-term benefits for distress and anxiety. These results build upon a growing literature of psychosocial interventions for BRCA1/2 carriers and, given the potential impact of affect on risk management decision making, suggest that some carriers may derive benefits from adjuncts to traditional genetic counseling.
BRCA1/2 基因检测后的反应与对风险状况的理解有关，并可能在风险管理决策中发挥作用。本研究的目的是评估在标准遗传咨询（SGC）之后为 BRCA1/2 突变携带者提供的心理社会电话咨询（PTC）干预措施。我们研究了该干预措施对困扰和与基因检测相关的担忧的影响。
这是一项前瞻性随机临床试验，共纳入 90 名 BRCA1/2 突变携带者。我们在干预开始时和披露后 6 个月和 12 个月测量了焦虑、抑郁和基因检测困扰的结果。我们通过广义估计方程的意向治疗分析评估了 SGC 与 SGC 加 PTC 对心理结果的影响。
在 6 个月时，与 SGC 相比，PTC 降低了抑郁症状（Z = -2.25，P = 0.02）和基因检测困扰（Z = 2.18，P = 0.02）。此外，与接受 SGC 的女性相比，干预组的女性在 6 个月时报告的焦虑症较少（chi(2)(1) = 4.11，P = 0.04）。在 12 个月的随访中，干预组之间没有发现结果的差异。
作为 SGC 的辅助手段，在公布 BRCA1/2 检测结果阳性后提供的 PTC 似乎为减轻困扰和焦虑提供了适度的短期益处。这些结果建立在针对 BRCA1/2 携带者的心理社会干预措施的不断增加的文献基础上，鉴于情感对风险管理决策的潜在影响，这表明一些携带者可能从传统遗传咨询的辅助措施中获益。
