Physical symptom burden and its association with distress, anxiety, and depression in breast cancer Journal Article


Authors: McFarland, D. C.; Shaffer, K. M.; Tiersten, A.; Holland, J.
Article Title: Physical symptom burden and its association with distress, anxiety, and depression in breast cancer
Abstract: Background: Physical symptom burden and psychologic symptoms are highly prevalent in women with breast cancer. The Distress Thermometer and Problem List (DT&PL) is commonly used in oncology clinics to screen for distress and its accompanying Physical Problem List (PPL) identifies pertinent physical symptoms. Objective: We sought to identify physical symptoms found on the PPL and evaluate whether they are associated with psychologic symptoms in women with breast cancer. Methods: Patients (n=125) with breast cancer (Stage 0–IV) completed the DT&PL and the Hospital Anxiety and Depression Scale. They reported bother from any of 22 PPL items on the DT&PL. PPL items were assessed for their associations with distress, Hospital Anxiety and Depression Scale-anxiety, and Hospital Anxiety and Depression Scale-depression. The total number of PPL items endorsed per patient was evaluated for associations with psychologic outcomes, controlling for relevant demographic factors. Results: Most physical problems were associated with depression (n = 13, 87%), and anxiety (n = 8, 53%), but fewer were associated with distress (n = 4, 27%). In multivariate analyses, a higher total number of problems was associated with younger age (p = 0.03) and more depressive symptoms (p < 0.001). Conclusion: Physical symptom burden detected by the DT&PL co-occurs with depression most commonly and to a lesser extent anxiety and distress in women with breast cancer. Depression is associated with more types of physical symptoms and a total number of physical symptoms. The endorsement of multiple PPL items on the DT&PL should prompt an evaluation for depression. Similarly, depression should prompt the evaluation and treatment of physical symptom burden. © 2018 Academy of Consultation-Liaison Psychiatry
Keywords: breast cancer; depression; anxiety; distress; physical symptom burden
Journal Title: Psychosomatics
Volume: 59
Issue: 5
ISSN: 0033-3182
Publisher: Elsevier Science, Inc.  
Date Published: 2018-09-01
Start Page: 464
End Page: 471
Language: English
DOI: 10.1016/j.psym.2018.01.005
PROVIDER: scopus
PMCID: PMC6067989
PUBMED: 29525522
DOI/URL:
Notes: Article -- Export Date: 1 November 2018 -- Source: Scopus
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MSK Authors
  1. Jimmie C B Holland
    304 Holland
  2. Kelly M Shaffer
    22 Shaffer