Psychological Distress and Drawing Tests among Women with Breast Cancer

Abstract

BackgroundThe aim of this study was to evaluate the use of the Diagnostic Drawing Series (DDS) as a screening tool for the breast cancer patients with psychological distress.MethodsAll of 64 patients with breast cancer participated in this study. Patients' depressive and anxiety symptoms were assessed using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) when the DDS was applied to the partipicants.ResultsDepressed patients used more enclosure in the Feeling drawings (P = 0.002) and tilt in Free drawings (P = 0.048). Patients with anxiety drew a picture over 67% of the paper (P = 0.015) in Tree drawing and more medium pressure (P = 0.049) in Feeling drawings. Thirty four subjects (77.3%) of unstable emotion group used over 67% of the space (P = 0.002). More Landscapes were observed in the Feeling drawings of unstable patients (P = 0.042).ConclusionThese results suggested that DDS could be used as a supplemental screening tool for psychological distress in breast cancer patients.

Drawing Test Form for Depression: The Development of Drawing Tests for Predicting Depression Among Breast Cancer Patients

“…Similar the previous study, 22 enclosure in DFA was associated with depression. The DFA has separate check boxes to evaluate enclosure and surrounded, but we unite those two items as a single item of Surrounded, since symbolic meanings of both items were similar in art therapy psychological and physical defense.…”

“…If the lines were short, lacking pen pressure, or if no lines were used in the drawing, it was deemed to be a drawing response characteristic of a depressed patient, and was scored as 1. Based on the study by Kim et al [ 22 ], breast cancer patients with depression showed mostly moderate pen pressure, unlike psychiatric patients with depression. Pen pressure was classified into three levels with the following scores: weak pen pressure=1, medium pen pressure=0.5, and strong pen pressure=0.…”

“…Drawings that had a tilted vertical-axis to any direction, right and left, were also associated with depression [ 22 ]. Tilt was evaluated based on the DFA’s criteria.…”

“…Drawings that had a tilted vertical-axis to any direction, right and left, were also associated with depression. 22 Tilt was eval-uated based on the DFA's criteria. However, because the DFA did not provide a clear justification behind the 15-degree evaluation standard, in this study we checked drawings as tilted if the vertical axis was tilted at least 5-degrees to the left or right.…”