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Uncertainty of Diagnosis Tied to Increased Patient Anxiety

Awaiting diagnosis has more influence on patients' distress than an invasive, risky procedure

THURSDAY, June 30 (HealthDay News) -- Women awaiting diagnostic breast biopsy or invasive treatment experience increased stress levels, but only those awaiting biopsy have increased anxiety, according to a study published in the July issue of Radiology.

Nicole Flory, Ph.D., and Elvira V. Lang, M.D., from Harvard Medical School in Boston, investigated distress and anxiety levels in 214 women awaiting diagnostic procedures (112 awaiting breast biopsy, 60 awaiting uterine fibroid embolization, and 42 awaiting hepatic chemoembolization). The patients, aged between 18 and 86 years, completed four standard tests measuring distress levels just before their procedures: the State Trait Anxiety Inventory (STAI), the Impact of Events Scale (IES), the Center for Epidemiologic Studies Depression Scale (CES-D), and the Perceived Stress Scale (PSS).

The investigators found abnormally elevated mean PSS, IES, and CES-D scores in all three groups, but highly abnormal anxiety levels were only seen in the breast biopsy group. The mean STAI score was significantly higher in the breast biopsy group than in women awaiting hepatic chemoembolization, and fibroid embolization (mean score, 48, 26, and 24, respectively). The IES ratings and the CES-D score were not significantly different in the three patient groups. The average PSS rating of patients awaiting breast biopsy were significantly higher than those awaiting hepatic chemoembolization, but not significantly different from those awaiting fibroid embolization.

"Awaiting breast biopsy and diagnosis proved a greater stressor in terms of anxiety and perceived stress than did awaiting much riskier invasive treatment," the authors write. "This finding suggests that the invasiveness of the procedure has less influence on patients' distress than does uncertainty of outcome."

One of the study authors disclosed a financial relationship with a patient care company.

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