Psychosocial morbidity and its correlates in cancer patients of the Mediterranean area: findings from the Southern European Psycho-Oncology Study

Abstract

Background: A few and partial data are available on psychosocial morbidity among cancer patients in Mediterranean countries. As a part of a more general investigation (Southern European Psycho-Oncology Study-SEPOS), the rate of psychosocial morbidity and its correlation with clinical and cultural variables were examined in cancer patients in Italy, Portugal and Spain. Methods: A convenience sample of cancer outpatients with good performance status and no cognitive impairment were approached. The Hospital Anxiety-Depression scale (HAD-S), the Mini-Mental Adjustment to Cancer scale (Mini-MAC), and the Cancer Worries Inventory (CWI) were used to measure psychological morbidity, coping strategies and concerns about illness. Results: Of 277 patients, 34% had pathological scores (bborderline casesQ plus btrue casesQ) on HAD-S Anxiety and 24.9% on HAD-S Depression. Total psychiatric bcasenessQ was 28.5% and 16.6%, according to different HAD cut-offs (14 and 19, respectively). Significant relationships of HAD-S Anxiety, HAD-S Depression, HAD-S Total score, with Mini-MAC Hopeless and Anxious Preoccupation, and CWI score were found. No differences emerged between countries on psychosocial morbidity, while some differences emerged between the countries on coping mechanisms. Furthermore, Fatalism, Avoidance and marginally Hopeless were higher compared to studies carried out in English-speaking countries. Limitations: The relatively small sample size and the good performance status prevent us to generalize data on patients with different cancer sites and advanced phase of illness. Conclusions: One-third of the patients presented anxiety and depressive morbidity, with significant differences in characteristics of coping in Mediterranean countries in comparison with English-speaking countries. D

Do spirituality and faith make a difference? Report from the Southern European Psycho-Oncology Study Group

“…The details of the project and its main results are presented elsewhere (Grassi et al, 2004(Grassi et al, , 2010Gil et al, 2005;Travado et al, 2005). In summary, the study was conducted in three countries of the European Union (EU), namely Italy (Hospital S. Anna, Ferrara), Spain (Hospital Duran I Reynalds, Barcelona) and Portugal (Hospital S. José, Lisbon), and in a non-EU country (Switzerland, Lugano Hospital).…”

“…The patients' socio-demographic and clinical characteristics are presented in Table 1. More details about the sample are reported elsewhere (Grassi et al, 2004). In summary, there were 212 women (69%) and 95 men (31%) (mean age 56.73 +13.3), 41% were retired, and 72% of the patients were married.…”

Physician-patient communication among Southern European cancer physicians: The influence of psychosocial orientation and burnout

“…All the doctors were invited to a meeting in which detailed information on the SEPO study was given. The general aims of the research were presented, as reported elsewhere (Grassi et al, 2004), including the aspect relative to the assessment of physicians' characteristics in terms of communications skills, psychosocial orientation, and burnout symptoms. The same methodology was followed in the three hospital centers.…”

Use of distress and depression thermometers to measure psychosocial morbidity among southern European cancer patients

“…This study is a part of a larger investigation (Southern European Psycho-Oncology Study-SEPOS) that evaluated psychosocial implications of cancer in southern European countries [26,27] and the efficacy of a training model in helping physicians to recognize their patients' psychosocial morbidity [28]. The main purpose of the study presented here was to assess the validity of two simple instruments in cancer settings in a cultural context where no data are available on the application of "emotional" thermometers.…”