Psychiatric morbidity following mastectomy: preoperative predictors and types of illness.

One hundred and twenty-two women with primary operable breast cancer were interviewed before, 3 months after and 12 months after mastectomy. Twenty-six percent of women had psychiatric symptoms 12 months after operation which justified a research diagnostic criteria diagnosis but most of the illnesses were mild; only 5% of women were regarded as being psychiatrically ill by a psychiatrist. The patients psychiatric state preoperatively, the treatment package received by the patient and the patient's marital relationship were related to psychiatric outcome three months after operation. The patient's psychiatric state preoperatively, her marital status, social class and menopausal status were all predictors of psychiatric outcome 12 months after operation. These results are discussed in terms of the practical way in which women at risk of psychiatric illness postmastectomy could be identified preoperatively by a nurse counsellor.