Psychosocial intervention as a component of routine breast cancer care-who participates and does it help?

Women who participated in the hospital psychosocial support groups following breast cancer surgery were compared with non-participants. The Hospital Anxiety and Depression Scale and the EORTC quality of life questionnaire were used to measure emotional distress and quality of life at the time of diagnosis and after 12 months. The General Life Orientation Test-Revised was used to measure dispositional optimism. Of 165 women, 87% reported that they had been invited to participate, and 66% participated. The salient predictor for participating in support group was optimism (OR 0.89 CI: 95% 0.83-0.98, p=0.01). No significant difference was found between the prevalence of anxiety and depression caseness at the time of diagnosis, but after 12 months, the prevalence of anxiety caseness was significantly lower among the participants than that among the non-participants (19% vs 34%, p=0.04). In conclusion, psychosocial intervention as a component of routine breast cancer care appears to have a long-term clinical beneficial effect on anxiety. For depression and quality of life, the study is inconclusive. Self-selection may prevent patients at risk of adverse outcome to participate in support groups.