Elvira Valentina Lang MD, Presenter: Owner, Hypnalgesics, LLC, Brookline, MA

Nicole Flory PhD, Abstract Co-Author: Nothing to Disclose

Assess the level of distress in women waiting for radiological tests and procedures

Immediately prior to their procedures, 214 women in an IRB approved research project completed the State Trait Anxiety Inventory (STAI), Impact of Events Scale (IES), Center for Epidemiologic Studies Depression Scale (CES-D), and Perceived Stress Scale (PSS). Women awaiting breast biopsy (N=112), hepatic chemo-embolization (N=42), and uterine fibroid embolization (N=60) were included. Normative data for non-clinical samples list cut-off points for the STAI ≤ 35, the IES ≤ 8, the CES-D ≤ 15, and the PSS ≤ 13.Data was analyzed with MANOVA and post-hoc Tukey hsd tests. Results are reported in means (95% confidence intervals).

Breast biopsy patients reported significantly higher levels of anxiety with STAI scores of 48 (45-50) than women awaiting chemo-embolization (STAI 26 (22-29), p < 0.001) and fibroid embolization (STAI 24 (21-27), p < 0.001). Impact of events ratings were not significantly different among the three groups with IES scores of 26 (23-29) for breast biopsy patients, 23 (18-28) for chemo-embolization and 23 (18-27) for fibroid embolization patients. Also depressive mood levels were not significantly different for the three groups: CES-D scores were 15 (13-17) for breast biopsy patients, 14 (11-18) prior to chemo-embolization and 12 (9-15) prior to fibroid embolization. Perceived stress ratings of breast biopsy patients were significantly higher (18 (16-19)) than those of chemo-embolization patients (15 (16-19), p < 0.01), but not significantly different from those of women awaiting fibroid embolization (16 (14-18), p = 0.23).

Awaiting breast biopsy proved a greater stressor in terms of anxiety and perceived stress than awaiting much riskier invasive treatment of known cancer and elicited comparable levels of depressive mood and impact on life. This suggests that the invasiveness of the procedure has less influence on patients’ anxiety than uncertainty of outcome. This is supported by the finding that stress levels did not differ among women who were treated for known benign disease and those treated for known cancer.

Physicians are advised to set aside their own notions about “minor” and “major” procedures and appreciate the distress associated with uncertain diagnosis

Lang, E, Flory, N, Distress in the Radiology Waiting Room.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9012458.html