Psychiatry Research EG

Breast cancer is one of the most common cancers encountered throughout the world; it is the second most common cancer diagnosed worldwide after lung cancer as well as the most frequent cancer that affects the psychological condition of women [1,2]. In Egypt, it accounts for 35.1% of female cancers [3]. Besides the worries related to prognosis and survival, impaired body image and breast loss have negative effects on the patients; these negative effects may in turn cause anxiety and depression that may require psychotherapy and medical treatment [4]. Anxiety and depression are the most common psychological problems encountered in patients with cancer. Anxiety is mainly related to uncertainty about the diagnosis, the side effects of chemotherapy or radiotherapy treatment, lack of social or personal control, progressive physical deterioration, and thoughts of impending death [5]. It is known that the prevalence of depression among cancer patients is often underestimated, partly because many symptoms of depression, such as fatigue, weight loss, loss of appetite, or sleep disruption, closely mirror the psychological effects of cancer [6]. The prevalence of depression varies between 8 and 36% depending on the site of cancer, the diagnostic criteria, and the rating scales used [7]. Coping strategies represent behavioral and cognitive efforts to deal with stressful encounters [8]. Coping has also been found to predict long-term psychological adjustment and quality of life in patients with breast cancer [9]. It is defined as ongoing cognitive and/or behavioral efforts to manage external and/or internal demands that are considered as taxing or exceeding the resources of the individual [10]. In patients with breast cancer, the ability to cope with the problems caused by the disease is related to various variables, such as age, education, personal characteristics, career, marriage, and children, stage and treatment, degree of change in quality of life, and the social support network available [11]. Coping strategies are classified either as problem-focused or emotion-focused, delineating the function of coping as dealing with the problem or with its emotional and physiological outcomes, respectively [8,10]. Taken collectively, the findings indicate that engagement-type coping strategies, namely problem solving, information seeking, cognitive restructuring, and emotional ventilation are positively associated with better long-term outcomes and quality of life [9,12,13]. In addition to problem-focused coping, women often use distraction methods, turning to social support and faith or religion [14]. However, disengagement-type coping strategies or coping through behavioral or cognitive avoidance such as denial, self-criticism, and social withdrawal are inversely associated with health-related quality of life [15,16]. Consistent evidences have indicated that coping styles play an important role in the survival of patients with breast cancer, and they should be encouraged to adopt particular coping styles to improve survival, lifestyle, and reduce rates of recurrence of cancer [14].