Psychosomatic Medicine
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Psychosomatic Medicine 70:677-687 (2008)
© 2008 American Psychosomatic Society

ORIGINAL ARTICLES

Long-Term Trajectories of Psychological Adaptation Among Women Diagnosed With Gynecological Cancers

Sharon Manne, PhD, Christine Rini, PhD, Stephen Rubin, MD, Norman Rosenblum, MD, Cynthia Bergman, MD, Mitchell Edelson, MD, Enrique Hernandez, MD, John Carlson, MD and Thomas Rocereto, MD

From the Fox Chase Cancer Center (S.M., C.B., M.E.), Cheltenham, Pennsylvania; Department of Oncological Sciences (C.R.), Mt. Sinai School of Medicine, New York, NY; Department of Obstetrics & Gynecology (S.R.), Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania; Department of Obstetrics and Gynecology (N.R.), Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Obstetrics, Gynecology and Reproductive Sciences and Department of Pathology and Laboratory Medicine (E.H.), Temple University School of Medicine, Philadelphia, Pennsylvania; Department of Medicine (J.C.), Drexel University School of Medicine, Philadelphia, Pennsylvania; and the Department of Medicine (T.R.), Cooper University Hospital-Camden, Camden, New Jersey.

Address correspondence and reprint requests to Sharon Manne, Fox Chase Cancer Center, 510 Township Line Road, First Floor, Cheltenham, PA 19012. E-mail: Sharon.Manne{at}fccc.edu

Objective: Women diagnosed with gynecological cancers may cope with a difficult treatment regimen that includes multiple abdominal surgeries and courses of chemotherapy and/or radiation. Little attention has been paid to identifying what factors place women at risk for long-term problems with psychological adaptation. The goal of the present study was to identify a set of demographic, medical, and predisposing factors as well as cognitive and social processing strategies that predict the trajectory of psychological distress and well-being among women diagnosed with gynecological cancer.

Methods: One hundred thirteen women on active treatment for gynecological cancer completed measures at baseline, 3, 6, and 9 months afterward.

Results: Women with poorer physician-rated performance status and self-reported functional impairment, women who were Caucasian, women who have received previous psychological treatments, women who were less expressive of positive emotions, women who had unsupportive friends and family, and women who were less able to find something positive in the cancer experience reported poorer adaptation.

Conclusions: This study identified a set of risk factors for poor long-term psychological adaptation among women diagnosed with gynecological cancers. Healthcare professionals working with these women can use these risk factors to screen for patients who may require additional psychological services.

Key Words: gynecological cancer • depressive symptoms • trajectories of change • coping

Abbreviations: ECOG = Eastern Cooperative Oncology Group.






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Copyright © 2008 by the American Psychosomatic Society