Table 3. Estimates of psychological distress in time and effects of additional surgery and reconstruction failure.

	Anxiety 2)			Depression 2)			Cancer distress 3)
No covariate effects 1)	Estimate	d	P-value	Estimate	d	P-value	Estimate	d	P-value
Baseline	5.3			5.3			24.2
1 month	3.8	- 0.43	0.009	5.3	-0.01	0.953	16.1	- 0.65	<0.001
21 months	3.6	- 0.49	0.004	4.7	- 0.16	0.372	15.2	- 0.72	<0.001
Additional effects		4)			4)			4)
Additional surgery
Baseline	5.2	- 0.04	0.856	5.3	- 0.01	0.948	23.9	- 0.03	0.879
1 month	5.0	0.35	0.077	5.9	0.16	0.410	16.9	0.06	0.743
21 months	2.3	- 0.36	0.082	3.3	- 0.34	0.097	13.7	- 0.12	0.553
Total reconstruction failure
Baseline	7.0	0.46	0.177	6.0	0.17	0.622	30.8	0.53	0.136
1 month	5.3	0.42	0.217	9.2	0.96	0.006	23.3	0.58	0.090
21 months	4.5	0.28	0.473	5.1	0.09	0.812	20.4	0.42	0.272
10 years younger
Baseline	6.5	0.34	0.001	6.2	0.20	0.055	25.9	0.13	0.215
1 month	5.0	0.33	0.002	6.5	0.30	0.005	20.6	0.36	0.001
21 months	4.5	0.27	0.015	5.4	0.16	0.146	19.8	0.37	0.001

¹⁾ At mean age, without complications.

²⁾ HADS: Hospital Anxiety and Depression Scale (0–21), higher scores indicate higher anxiety and depression levels.

³⁾ IES: Impact of Event Scale (range 0–75), higher scores indicate higher distress levels.

⁴⁾ Cohen's d, effect size compared to estimates without covariate effects.

Two-sided p-values of < 0.0167 are considered significant.