POST-GENETIC TEST RESULT ANXIETY AND DEPRESSION IN ONCOLOGIC PATIENTS SUSPECTED FOR HEREDITARY BREAST AND OVARY CANCER (HBOC) OR LYNCH SYNDROME (LS)

The diagnosis and treatment of cancer can represent changes and impacts, resulting in different emotional reactions. Approximately 10% of the cancers may be hereditary, and through genetic testing it is possible to identify carriers of mutations which increase the risk of developing neoplasia. The knowledge about genetic mutation into a family may contribute to greater vulnerability to anxiogenic and depressive symptoms, as well as distress, guilt and fear. This work aims to evaluate the association between anxiety and depression levels in suspected HBOC or LS patients submitted to genetic tests and associate them with clinical, sociodemographic and psychiatric history. A cross-sectional, quantitative study has been accomplished, in which a total of 71 patients tested for HBOC and LS syndrome have been assessed for anxiety and depression levels after receiving the genetic test result. The Hospital Anxiety and Depression Scale (HADS) (Zigmond and Snaith, 1983) validated in Portuguese (Botega et al., 1995) has been used immediately after the subjects received the genetic results. The collected information has been analyzed according to sociodemographic variables, exposure to cancer risk factors and psychiatric and family history of cancer using X2 or Fishers exact tests (p < 0.05, SPSS20.0 for Windows). For HBOC, 48.3% (29/60) of the patients presented a pathogenic mutation in BRCA1/2 and for LS, 72.7% (8/11) of the patients presented pathogenic mutations in MLH1/MSH2/MSH6/PMS2. The average levels of anxiety and depression for HBOC were 5.97 ± 3.67 and 4.93 ± 3.61, and 5.00 ± 3.77 and 5.18 ± 3.79 for LS, respectively. A direct association between moderate anxiety levels (> 6) and personal history of psychiatric illness (p = 0.045) has been observed in patients with suspected HBOC and moderate depression levels (> 6) and personal history of psychiatric illness (p = 0.049) in patients with suspected LS. The positive result of a pathogenic mutation has not been associated with the modification of anxiety or depression levels in patients with HBOC or LS. The results demonstrate that patients with a previous psychiatric history are more prone to present symptoms of anxiety and depression. An approach of psychosocial aspects as well as psychological support must be used to prevent and minimize possible emotional impacts after the genetic test result. Acknowledgments: Programa Nacional de Apoio à Atenção Oncológica (PRONON) of the Ministry of Health for the financial support.