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AMBULATORY ANESTHESIOLOGY

Hypnosis Decreases Presurgical Distress in Excisional Breast Biopsy Patients

Julie B. Schnur, PhD^*, Dana H. Bovbjerg, PhD^*, Daniel David, PhD, Kristin Tatrow, PhD, Alisan B. Goldfarb, MD, Jeffrey H. Silverstein, MD^||¶, Christina R. Weltz, MD, and Guy H. Montgomery, PhD^*

From the *Department of Oncological Sciences, Mount Sinai School of Medicine, New York City, New York; Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania; Department of Rehabilitation Psychology, Good Shepherd Hospital, Allentown, Pennsylvania; and Departments of Surgery, ||Anesthesiology, ¶Geriatrics and Adult Development, Mount Sinai School of Medicine, New York City, New York.

Address correspondence and reprint requests to Dr. Julie Schnur, Department of Oncological Sciences, Box 1130, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, New York City, NY 10029-6574. Address e-mail to julie.schnur{at}mssm.edu.

Abstract

BACKGROUND: Excisional breast biopsy is associated with presurgical psychological distress. Such distress is emotionally taxing, and may have negative implications for postsurgical side effects and satisfaction with anesthesia. We investigated the ability of a brief hypnosis session to reduce presurgical psychological distress in excisional breast biopsy patients.

METHODS: Ninety patients presenting for excisional breast biopsy were randomly assigned to receive either a 15-minute presurgery hypnosis session (n = 49, mean age: 46.4 (95% CI: 42.3–50.4)) or a 15-minute presurgery attention control session (n = 41, mean age: 45.0 (95% CI: 40.8–49.2)). The hypnosis session involved suggestions for increased relaxation and decreased distress. The attention control session involved nondirective empathic listening. Presurgery distress was measured using visual analog scales (VAS) and the short version of the Profile of Mood States (SV-POMS). Data were analyzed using analysis of variance and ² procedures.

RESULTS: Groups did not differ in terms of the following: demographics (age, education, ethnicity, marital status, all P’s > 0.28); medical variables (presurgery diagnosis, previous excisional biopsy, previous breast cancer, all P’s > 0.11); or preintervention distress (SV-POMS P > 0.74) assessed on the day of surgery. Postintervention, and before surgery, patients in the hypnosis group had significantly lower mean values for presurgery VAS emotional upset (16.5 vs 38.2, P < 0.0001, d = .85), VAS depressed mood (6.6 vs 19.9, P < 0.02, d = .67), and SV-POMS anxiety (10.0 vs 5.0, P < 0.0001, d = 0.85); and significantly higher levels for VAS relaxation (75.7 vs 54.2, P < 0.001, d = –0.76) than attention controls.

CONCLUSIONS: The study results indicate that a brief presurgery hypnosis intervention can be an effective means of controlling presurgical distress in women awaiting diagnostic breast cancer surgery.