Post-traumatic stress disorder symptoms and associated factors in breast cancer patients during the first COVID-19 lockdown in France

Feriel Yahi; Justine Lequesne; Olivier Rigal; Adeline Morel; Marianne Leheurteur; Jean-Michel Grellard; Alexandra Leconte; Bénédicte Clarisse; Florence Joly; Sophie Lefèvre-Arbogast

doi:10.3389/fpsyg.2022.768043

Post-traumatic stress disorder symptoms and associated factors in breast cancer patients during the first COVID-19 lockdown in France

Front Psychol. 2022 Sep 15:13:768043. doi: 10.3389/fpsyg.2022.768043. eCollection 2022.

Authors

Affiliations

¹ Clinical Research Department, Centre François Baclesse, Caen, France.
² Department of Health, University of Caen Normandie, Caen, France.
³ Department of Medical Oncology, Centre Henri Becquerel, Rouen, France.
⁴ Department of Medical Oncology, Centre François Baclesse, Caen, France.
⁵ INSERM U1086 ANTICIPE, Caen, France.

Abstract

Introduction: We aimed to study post-traumatic stress disorder (PTSD) symptoms in breast cancer (BC) patients during the coronavirus disease (COVID-19) pandemic.

Materials and methods: We included BC patients receiving medical treatment during the first COVID-19 lockdown in France. PTSD symptoms were evaluated using the Impact of Event Scale-Revised (IES-R) questionnaire. Quality of life [Functional Assessment of Cancer Therapy-General (FACT-G)], cognitive complaints [Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog)], insomnia [Insomnia Severity Index (ISI)], and psychosocial experiences during lockdown were also evaluated. Multivariable logistic regression was used to identify clinical factors (from medical records) and psychosocial factors (from questionnaires) associated with PTSD symptoms.

Results: Among the 253 included BC patients (mean age: 58), 46% had metastatic cancer and 52% were treated by chemotherapy alone. COVID-19-induced adjustments in medical oncology practices were experienced by 27% of patients (mainly teleconsultations). No case of COVID-19 was reported; 23% of BC patients had PTSD symptoms. Compared to other patients, patients with PTSD symptoms had more fears relative to COVID-19 infection (83 vs. 60%, p = 0.009), had more feeling of isolation (69 vs. 41%, p = 0.003), and had more prescription or increased use of psychotropic drugs (49 vs. 20%, p = 0.001). In the multivariable model adjusted for clinical factors, fears relative to COVID-19 and increased use of psychotropic drugs were independently associated with PTSD symptoms (OR [95% CI] = 3.01 [1.20-8.44] and 3.45 [1.48-8.17], respectively). Besides, patients with PTSD symptoms had poor quality of life (QoL), and more cognitive complaints and insomnia.

Conclusion: Post-traumatic stress disorder symptoms were observed in 23% of BC patients during the first COVID-19 lockdown in France. Psychological supports are needed for patients treated during the COVID-19 pandemic.

Keywords: COVID-19; breast cancer; post-traumatic stress disorder (PTSD); psychological distress; quality of life.