Emotional state of patients in radiotherapy and how they deal with their disorder.

PURPOSE: The aim of the study was to record patients' symptoms of anxiety, depression and post-traumatic stress, as well as their subjective experience of illness, with different forms of radiotherapy and for different indications. The question is to be answered of whether more invasive techniques such as stereotactic radiotherapy involve greater stress or whether the psychological stress instead tends to be caused by the underlying disorder itself. PATIENTS AND METHODS: Questionnaires were given to 240 patients after conventional radiotherapy for a malignant underlying disorder, to 80 with a benign disorder, and to 67 patients following stereotactic radiotherapy. The German version of the Hospital Anxiety and Depression Scale (HADS-D) was used to measure anxiety and depression; the Post-Traumatic Symptom Scale (PTSS-10) was used to measure symptoms related to post-traumatic stress disorder (PTSD), and there were questions about patients' subjective experience of radiotherapy. RESULTS: 28% of all patients scored in the pathologic or borderline anxiety range; 26% were in the pathologic or borderline depression range. 22% of patients were above the diagnostic cutoff for the PTSS-10. No differences were evident between the three groups in terms of anxiety and stress-related symptoms. Women were significantly (p = 0.001) more severely affected by symptoms of PTSD and anxiety than men. No gender differences could be proven in terms of depression. In the HADS-D, patients with a benign underlying disorder had significantly (p < 0.05) lower depression values than the two other groups studied. CONCLUSION: Patients who had undergone stereotactic radiotherapy did not demonstrate higher values for anxiety, depression or PTS symptoms than patients treated with conventional radiotherapy. From the results submitted here it cannot be assumed that this form of treatment leads to an increased incidence of traumatic stress or even post-traumatic stress disorder (PTSD). All in all, it is the type of underlying disorder (malignant/benign), which affects the extent of psychological stress experienced by patients following radiotherapy.