Prevalence and correlates of distress in Chinese women with benign breast disease

Abstract

Purpose: Breast cancer patients often experience high levels of psychological distress, but there is limited research on the psychological distress status of patients with benign breast diseases. This study aims to investigate the psychological distress levels and influencing factors among patients with benign breast disease (BBD). Methods: A cross-sectional study was conducted on BBD patients admitted to a tertiary medical center in China between November 2022 and May 2023. Patient-reported distress and problems were assessed using the distress thermometer (DT) and the 42-item Problem List by the National Comprehensive Cancer Network. Descriptive statistics, chi-square test or Fisher's exact test, and multivariate logistic regression analyses were performed. Receiver operating characteristic analysis was used to evaluate the diagnostic accuracy of the DT in comparison to the Hospital Anxiety and Depression Scale (HADS) and to determine an optimal cutoff score for the DT in this specific population. Results: Among the 255 BBD patients, the mean psychological distress score was 3.69±1.96. The prevalence of psychological distress (≥4 points) was 52%. The main factors causing psychological distress were worry or anxiety (43.5%), fear (21.2%), pain (7.1%), sleep problems (6.7%), and child care responsibilities (5.1%). Multiple logistic regression analysis revealed that age, education, employment, and BI-RADS classification were factors associated with psychological distress in BBD patients. ROC curve analyses showed that a DT cutoff score of 4 had an area under the ROC curve of 0.88 and 0.7 when compared to HADS-A and HADS-D, respectively, indicating good overall accuracy. Conclusions: Patients with benign breast disease also experience significant psychological burden, which requires attention from healthcare professionals. Targeted health education and psychological counseling should be provided to these patients.