Journal of Genetic Medicine

Korean Society of Medical Genetics and Genomics (대한의학유전학회)
권호 표지

Evaluation of Psychosocial Impact and Quality of Life in BRCA Mutation Family

BRCA 돌연변이 가계의 심리상태 및 삶의 질 평가

  • Han, Sang-Ah (Department of Surgery, Seoul National University, Bundang Hospital) ;
  • Kim, Sai-Rhee (Department of Surgery, Seoul National University, Bundang Hospital) ;
  • Kang, Eun-Young (Department of Surgery, Seoul National University, Bundang Hospital) ;
  • Kim, Jeong-Hyun (Mental Health and Behavioral Medicine services for Clinical Departments, Seoul National University, Bundang Hospital) ;
  • Ha, Tae-Hyeon (Department of Psychiatry, Seoul National University, Bundang Hospital) ;
  • Yang, Eun-Joo (Department of Rehabilitation Medicine, Seoul National University, Bundang Hospital) ;
  • Lim, Jae-Young (Department of Rehabilitation Medicine, Seoul National University, Bundang Hospital) ;
  • Han, Won-Shik (Seoul National University College of Medicine) ;
  • Noh, Dong-Young (Cancer research institute, Seoul National University College of Medicine) ;
  • Kim, Sung-Won (Department of Surgery, Seoul National University, Bundang Hospital)
  • 한상아 (분당 서울대학교병원 외과) ;
  • 김새리 (분당 서울대학교병원 외과) ;
  • 강은영 (분당 서울대학교병원 외과) ;
  • 김정현 (분당 서울대학교병원 신경정신과) ;
  • 하태현 (분당 서울대학교병원 신경정신과) ;
  • 양은주 (분당 서울대학교병원 재활의학과) ;
  • 임재영 (분당 서울대학교병원 재활의학과) ;
  • 한원식 (서울대학교 의과대학 외과학교실) ;
  • 노동영 (서울대학교 의과대학 암연구소) ;
  • 김성원 (분당 서울대학교병원 외과)
  • Received : 2010.03.24
  • Accepted : 2010.05.30
  • Published : 2010.03.01
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Abstract

Purpose: The aims of this study are to evaluate psychological impact and quality of life according to the cancer diagnosis and mutation status in Korean families with BRCA mutations. Materials and Methods: Seventeen affected carriers (AC), 16 unaffected carriers (UC) and 13 healthy non carriers (NC) from 13 BRCA mutation families were included in the study. Outcomes were compared with regard to depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory, STAI), optimism (Reevaluation of the Life Orientation test, LOT-R), knowledge of hereditary ovarian cancer, and quality of life (QoL) (SF-36v2 Health Survey, physical component score [PCS], mental component score [MCS]) among three groups. Result: Level of depression, optimism, and PCS were similar in AC, UC, and NC. Anxiety score was elevated in all three groups. MCS was significantly low in AC than in UC and NC (P=0.009, P=0.017). Knowledge of hereditary breast and ovarian cancer was high in AC than NC (P=0.001). MCS was significantly related to whether patient was affected by cancer (P=0.043) and has occupation (P=0.008) or not in multivariable analysis. Conclusion: From this cross sectional study, psychological adverse effect was not related to the carrier status of BRCA mutation. Elevated anxiety in BRCA family members was observed but, independent to affection and the type of genetic mutation. AC showed low mental QoL. Further effort to understand psychological impact and QoL of genetic testing in BRCA family members is required for follow-up in clinical aspects.

목 적: 본 연구는 한국인 BRCA 유전자 돌연변이 가계구성원들을 대상으로 암진단 및 돌연변이 보유 여부가 심리 상태와 삶의 질에 미치는 영향을 알아보기 위해 시행되었다. 대상 및 방법: BRCA 유전자 돌연변이를 가진 13가계에서 암에 이환된 보인자 17명, 이환되지 않은 보인자 16명, 건강한 비보인자 13명이 본 연구의 분석에 포함되었다. 이 세 군을 대상으로 우울, 불안, 낙관, 유전성 유방암관련 지식수준과 삶의 질을 설문을 통하여 평가하였다. 결 과: 설문시기는 유전자 검사 후 평균 21개월(6-35)로 세 군 간의 차이는 없었다(P=0.254). 세 군 간의 우울, 낙관, 육체적 삶의 질은 유사했다. 불안은 세 군 모두에서 일반인 보다 상승되어 있었다. 이환된 보인자의 정신적 삶의 질은 암에 이환된 보인자가 다른 두 군에 비해 유의하게 낮았다(P=0.009, P=0.017). 다변량 분석 결과 정신적 삶의 질에 영향을 미친 인자는 암이환여부(P=0.043)와 직업유무(P=0.008) 였다. 결 론: 같은 돌연변이 가계 내에서 돌연변이 유무는 우울, 불안, 낙관에서 심리적반작용을 일으키지 않았으나, 돌연변이 가계 구성원의 불안 수준은 돌연변이 유무에 관계 없이 높았다. 본 연구는 소규모 표본을 대상으로 한 단면적 연구이나, BRCA 유전자 검사에 수반될 수 있는 심리적 스트레스 및 그에 대한 대처법을 수립하는 데 기초연구로 의의를 가진다.

Keywords

References

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