Table 16Studies of Distress After Genetic Testing

Author, year, quality ratingN, study designMutation statusGenetic counselingComparisonMeasures of distressBreast cancer worryAnxietyDepression
Current report
Arver et al, 2004235
NA
63; pre-postPositive or negativeGenetically trained oncologist and oncology nurse
  1. Pretest
  2. 2 months post results
  3. 1 year post results
HADS, SF-36NRX
decrease C & B vs. A
0
Dagan and Shochat, 2009236
Fair
73; case-controlPositive or negativeUnknown
  1. Carriers (n=17)
  2. Noncarriers (n=20)
  3. Age-matched controls (n=36)
HR-QOL, CRW, BSIX
higher A & B vs. C
00
Ertmanski et al, 2009237
NA
56; pre-postPositiveUnknown
  1. Pretest
  2. 1 month post results
  3. 1 year post results
STAI, IESNR0NR
Foster et al, 2007238
Fair
154; prospective cohortPositive or negativeUnknown
  1. Carriers (n=53)
  2. Noncarriers (n=101)
GHQ, CWS-RX
decrease over time for A & B
X
increase over time for A & B
NR
Geirdal et al, 2005240
Good
10,244; prospective cohortPositive or unknownUnknown
  1. Positive (n=68)
  2. Not tested but FBOC (n=176)
  3. Not tested, age-matched controls (n=10,000)
HADS, GHQ, BHS, IESNRX
higher B vs. A
X
higher B vs. A
Geirdal and Dahl, 2008239
Good
242; prospective cohortPositive or unknownUnknown
  1. Positive (n=68)
  2. Not tested, but FBOC (n=174)
HADS, COPENRX
higher B vs. A
NR
Kinney et al, 2005243
Poor
52; prospective cohortPositive or negativeCertified genetic professional
  1. Carriers (n=NR)
  2. Noncarriers (n=NR)
STAI, IES, CES-DNRX
decrease B only over time
NR
Low et al, 2008244
Fair
47; prospective cohortPositive, true negative, or uncertain (grouped with true negative)Genetic counselor
  1. Positive (n=7)
  2. True negative + uncertain (n=40)
IES-R, COPE, PTGINRX
higher A vs. B
NR
Metcalfe et al, 2012249
NA
17; pre-postPositiveUnknown
  1. Pretest
  2. 1 year post results
  3. 2 years post results
IESX
increase B vs. A & C
NRNR
Reichelt et al, 2004245
Good
209; prospective cohortPositive, negative, or unknownMedical geneticist or experienced genetic counselor
  1. Carriers (n=141)
  2. Noncarriers (68)
HADS, GHQ, BHS, IESNR00
Reichelt et al, 2008246
NA
181; pre-postPositive or true negativeGenetic counselor
  1. Pretest
  2. 6 weeks post results
  3. 18 months post results
HADS, IESNR00
van Dijk et al, 2006248
Good
132; prospective cohortPositive, true negative, or uninformativeUnknown
  1. Positive (n=22)
  2. True negative (n=41)
  3. Uninformative (n=69)
IES, NSIX
higher A vs. B & C
X
higher A vs. B & C
NR
Prior report
Meiser et al, 2002250
Good
143; prospective cohortPositive or negativeUnknown
  1. Carriers (n=30)
  2. Noncarriers (n=59)
  3. Not tested (n=51)
BDI, IES, MBSS, STAI, NSIX
higher A vs. C
X
lower B vs. A & C
X
lower B vs. A & C

X = statistically significant; 0 = studied but not significant.

Abbreviations: BDI = Beck Depression Inventory; BHS = Beck Hopelessness Scale; BSI = Brief Symptom Inventory; CES-D = Center for Epidemiologic Studies-Depression Scale; COPE = Emotional Approach Coping Scale; CRW = Cancer-Related Worry Scale; CWS-R = Cancer Worry Scale-Revised; FBOC = familial breast and/or ovarian cancer; GHQ = General Health Questionnaire; HADS = Hospital Anxiety and Depression Scale; HR-QOL = Health Related-Quality of Life; IES = Impact of Events Scale; IES-R = Impact of Events Scale-Revised; MBSS = Miller Behavioral Style Scale; NA = not applicable; NR = not reported; NSI = not standardized instrument; PTGI = Post-Traumatic Growth Inventory; SF-36 = Swedish SF-36 Health Survey; STAI = State-Trait Anxiety Inventory.

From: 3, RESULTS

Cover of Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer
Risk Assessment, Genetic Counseling, and Genetic Testing for BRCA-Related Cancer: Systematic Review to Update the U.S. Preventive Services Task Force Recommendation [Internet].
Evidence Syntheses, No. 101.
Nelson HD, Fu R, Goddard K, et al.

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