Document Type : Research articles


1 Demiroglu Bilim University Medical Faculty, Florence Nightingale Hospital, Department of Psychiatry, Istanbul, Turkey. Assit. Prof.

2 Florence Nightingale Hospital, Department of Psychiatry, Istanbul, Turkey. PhD.

3 Etiler Memorial Hospital, Department of General Surgery, ?stanbul, Turkey. Prof. Dr.

4 ?stanbul University Medical Faculty, Department of General Surgery, ?stanbul, Turkey. Prof. Dr.

5 Biruni University Medical Faculty, Department of Physical Therapy and Rehabilitation, ?stanbul, Turkey. Assoc. Prof.

6 Demiroglu Bilim University, Faculty of Health Science, Department of Nutrition and Dietetic, ?stanbul, Turkey. Assist. Prof.

7 Van Yuzuncu Yil University, Faculty of Agriculture, Department of Biometri and Genetics, Van, Turkey. Prof. Dr

8 Florence Nightingale Hospital, Department of Radiation Oncology, ?stanbul, Turkey. Assoc. Prof.

9 Florence Nightingale Hospital, Department of Nuclear Medicine, ?stanbul, Turkey. Specialist Dr.

10 Maltepe University, Faculty of Humanities and Social Science, ?stanbul, Turkey. Assist. Prof.

11 Florence Nightingale Hospital, Department of Radiology, ?stanbul, Turkey. Specialist Dr.

12 Demiro?lu Bilim University, Faculty of Medicine, Florence Nightingale Hospital, Department of General Surgery, ?stanbul, Turkey. Assist. Prof

13 ?stanbul Bilgi University, Faculty of Health Science, Department of Physical Therapy and Rehabilitation, ?stanbul, Turkey. Assoc. Prof.

14 Florence Nightingale Hospital, Department of Medical Oncology, ?stanbul, Turkey. Assoc. Prof.


Background: Coronavirus disease 2019 (COVID-19) has spread rapidly across the globe through coughing, sneezing, droplet inhalation, and contact.
Objectives: The current study aimed to assess the impact of the fear of COVID-19 infection on functionality in women with breast cancer.
Methods: The present study included women with diagnosed breast cancer (n=75) under treatment in Istanbul Florence Nightingale Hospital and healthy (n=69) women( a total of 144 volunteers). The participants were asked to fill out the Sociodemographic Data Form, Anxiety Sensitivity Index-3 (ASI-3), and Fear of COVID-19 Scale to evaluate the impact of fear of infection and cleaning behavior due to COVID-19 on functionality.
Results: No statistically significant difference was found between the women with and without diagnosed breast cancer regarding the impact of fear of COVID-19 infection on all functionality parameters (all parameters: P>0.05). In the breast cancer group, the effect of Covid-15 anxiety and cleaning behavior on functionality performance was significantly higher in participants with underlying disease (P=0.044, P=0.013) and smoking (P=0.0234, P=0.0147).
Conclusion: As evidenced by the results of this study, smoking and the presence of comorbidity in breast cancer patients may have a negative effect on the functionality effect of fear of Covid-19 infection. In terms of psychiatric intervention, the parameters affected by functionality should be considered.


  1. Banerjee DD. The other side of covıd-19: ımpact on obsessive compulsive disorder (ocd) and hoarding. Psychiatry Res. 2020;288:112966. doi: 10.1016/j.psychres.2020.112966 [PMID: 32334276]
  2. Silva RM, Shavitt RG, Costa DL. Obsessive-compulsive disorder during the COVID-19 pandemic. Braz J Psychiatry. 2021;43(1):108. doi: 10.1590/1516-4446-2020-1189 [PMID: 32578691]
  3. Taylor S. The Psychology Of Pandemics: Preparing for the next global outbreak of ınfectious disease. Newcastle upon Tyne; Cambridge Scholars Publishing, first eddition; 2019.
  4. Tsamakis K, Gavriatopoulou M, Schizas D, Stravodimou A, Mougkou A, Tsiptsios D, et al. Oncology during the COVID-19 pandemic: challenges, dilemmas and the psychosocial impact on cancer patients. Oncol Lett. 2020;20(1):441-447.doi: 10.3892/ol.2020.11599 [PMID: 32565968]
  5. Citgez B,  Yigit B, Capkinoglu E, Yetkin SG. Management of breast cancer during the COVID-19 Pandemic. Sisli Etfal Hastan Tip Bul. 2020;54(2):132-135. doi: 10.14744/SEMB.2020.23326 [PMID: 32617049]
  6. Smith BL, Nguyen A, Korotkin JE, Kelly BN, Specht MC, Spring LM, et al.  A system for risk stratification and prioritization of breast cancer surgeries delayed by the COVID-19 pandemic: preparing for re-entry. Breast Cancer Res Treat. 2020;183:515-524.doi:10.1007/s10549-020-05792-2 [PMID: 32712878]
  7. Onder G, Rezza G, Brusaferro S. Case-fatality rate and characteristics of patients dying in relation to COVID-19 in Italy. JAMA. 2020;323(18):1775-1776.doi: 10.1001/jama.2020.4683 [PMID: 32203977]
  8. Liang W, Guan W, Chen R, Wang W, Li J, Xu K, et al. Cancer patients in SARS-CoV-2 infection: a nationwide analysis in China. Lancet Oncol. 2020;21(3):335-337.doi:10.1016/S1470-2045(20)30096-6 [PMID: 32066541]
  9. Goodman WK, Price LH, Rasmussen SA, Mazure C, Fleischmann RL, Hill CL et al. The Yale–Brown obsessive–compulsive scale-Idevelopment, use, and reliability. Arch Gen Psychiatry. 1989;46:1006-1011. doi: 10.1001/archpsyc.1989.01810110048007 [PMID: 2684084]
  10. Taylor S, Zvolensky MJ, Cox BJ, Deacon B, Heimberg RG, Ledley DR, et al. Robust dimensions of anxiety sensitivity: development and initial validation of the Anxiety Sensitivity Index-3. Psychol Assess. 2007;19(2):176-188.doi: 10.1037/1040-3590.19.2.176 [PMID: 17563199]
  11. Mantar A, Yemez B, Alkın T. The validity and reliability of the Turkish version of the anxiety sensitivity index-3. Turk Psikiyatri Derg. 2010;21(3):225-234. [PMID: 20818510]
  12. Adams TG, Kelmendi B, Brake CA, Gruner P, Badour CL, Pittenger C. The role of stress in the pathogenesis and maintenance of obsessive-compulsive disorder. Chronic Stress. 2018;2: 247054701875804. doi:10.1177/2470547018758043 [PMID: 29527593] 
  13. Ghassemzadeh H, Mojtabai R, Khamseh A, Ebrahimkhani N, Issazadegan AA, Saif-Nobakht Z. Symptoms of obsessive-compulsive disorder in a sample of Iranian patients. Int J Soc Psychiatry. 2002;48(1):20-28. doi:10.1177/002076402128783055. [PMID: 12008904]
  14. Elliott CM, Radomsky AS. Mental contamination: The effects of imagined physical dirt and immoral behaviour. Behav Res Ther. 2012;50(6):422-427.doi: 10.1016/j.brat.2012.03.007 [PMID: 22534580]
  15. Davide P, Andrea P, Martina O, Andrea E, Davide D, Mario A. The impact of the COVID-19 pandemic on patients with OCD: effects of contamination symptoms and remission state before the quarantine in a preliminary naturalistic study. Psychiatry Res. 2020;291:113213.doi: 10.1016/j.psychres.2020.113213. [PMID: 32535508]
  16. Özmen V, Özmen T, Doğru V. Breast cancer in Turkey; an analysis of 20.000 patients with breast cancer. Eur J Breast Health. 2019;15(3):141-146. doi: 10.5152/ejbh.2019.4890 [PMID: 31312788]
  17. Payne DK, Sullivan MD, Massie MJ. Women’s psychological reactions to breast cancer. Semin Oncol. 1996;23(1 suppl 2):89-97. [PMID: 8614852]
  18. Al-Azri M, Al-Awisi H, Al-Moundhri M. Coping with a diagnosis of breast cancer-literature review and implications for developing countries. Breast J. 2009;15(6):615-622.doi: 10.1111/j.1524-4741.2009.00812.x [PMID: 19686231]
  19. Schubart JR, Emerich M, Farnan M,   Smith JS,  Kauffman GL, Kass RB. Screening for psychological distress in surgical breast cancer patients. Ann Surg Oncol. 2014;21(10):3348-3353.doi: 10.1245/s10434-014-3919-8 [PMID: 25034820]
  20. Burgess C, Cornelius V, Love S, Graham J,  Richards M, Ramirez A. Depression and anxiety in women with early breast cancer: five year observational cohort study. BMJ. 2005;330(7493):702.doi:10.1136/bmj.38343.670868.D3 [PMID: 15695497]
  21. Carreira H, Williams R, Müller M, Harewood R,  Stanway S, Bhaskaran K. Associations between breast cancer survivorship and adverse mental health outcomes: a systematic review. JNCI. 2018;110(12):1311-1327.doi: 10.1093/jnci/djy177 [PMID: 30403799]
  22. Angst J, Gamma A, Endrass J, Goodwin R, Ajdacic V, Eich D, et al. Obsessive-compulsive severity spectrum in the community: prevalence, comorbidity, and course. Eur Arch Psychiatry Clin Neurosci. 2004;254:156-164.doi: 10.1007/s00406-004-0459-4 [PMID: 15205969]
  23. Shen CC, Hu LY, Hu YW, Chang WH, Tang PL, Chen PM, et al. The risk of cancer in patients with obsessive-compulsive disorder: a nationwide population-based retrospective cohort study. Medicine. 2016;95(9):e2989.doi: 10.1097/MD.0000000000002989 [PMID: 26945419]
  24. Fineberg NA, Van Ameringen M, Drummond L, Hollander E, Stein DJ, Geller D, et al. How to manage obsessive-compulsive disorder (OCD) under COVID-19: a clinician’s guide from the international college of obsessive compulsive spectrum disorders (ICOCS) and the obsessive-compulsive and related disorders research network (OCRN) of the European college of neuropsychopharmacology. Compr Psychiatr. 2020;100:152174.doi: 10.1016/j.comppsych.2020.152174 [PMID: 32388123]