Reaction to Illness Scale and Bone Marrow Transplantation : from experimental study to psychotherapeutic intervention

Background and aims: Psychiatric comorbidities and psychosocial issues have been linked to poor treatment outcomes in cancer patients. The purpose of the present study was to assess quality of life and adjustment to illness of patients undergoing Bone Marrow Transplantation (BMT). Moreover, we tried to identify specific psychological interventions for BMT patients, analyzing correlations among psychometric and clinical variables. Methods: 123 patients suffering from blood cancers and referred to BMT were consecutively recruited in the study. Adjustment to illness was evaluated by means of the Reaction to Illness Scale (RIS). The assessment of psychological distress and psychiatric comorbidities was conducted through somministration of MMPI, STAI X1- X2 and BDI scales. Clinical variables were evaluated at baseline (TO) and after 24 months (T1). Results: The correlation between RIS and psychometric variables showed a statistically significant association between denial of illness and both higher scores in BDI (F=10.09, p<0.01), STAI X1 (F=10.34, p<0.01) and STAI X2 (F=5.86, p<0.01). A longer course of illness was significantly associated with denial of illness (F = 13.54, p<0.01) and influenced patient’s ability of self reflection (F = 6.55, p<0.01) and adjustment to illness (F = 6.55, p<0.05). Higher ability of self reflection correlated with a good clinical compliance (F = 3.97, p<0.05), whereas adjustment to illness correlated with both good clinical (F = 4.25, p<0.05) and pharmacological compliance (F = 6.94, p<0.01) and course of illness (F = 6.10, p<0.05). Conclusions: These findings suggest the need for psychotherapeutic interventions to facilitate and enhance adjustment.