Recognition of distress and psychiatric morbidity in cancer patients: a multi-method approach

Keller, Monika; Sommerfeldt, Sabine; Fischer, Charlotte; Knight, Lucie; Riesbeck, Mathias; Löwe, Bernd; Herfarth, Ch.; Lehnert, Thomas

doi:10.1093/annonc/mdh318

Cited by 211 publications

(186 citation statements)

References 29 publications

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“…Similar to the rates of referral to services in the study by Keller and colleagues [43], less than one-third of patients (29.3%) with clinically-significant levels of distress in the present sample reported an interest in receiving help for their symptoms. Our results indicate a relationship between distress level and interest in support services; however, previous research did not find such a relationship between distress level and interest in services [44].…”

Section: Discussionsupporting

confidence: 87%

“…Keller and colleagues recently conducted a study investigating both identification of distressed patients and rates of referral to support services in a sample of patients with mixed cancer diagnoses. Their results suggest that even if distress is recognized by the medical staff, only a small percentage of patients with distress (31%) were actually referred for services [43].…”

Section: Discussionmentioning

confidence: 99%

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Distress screening in a multidisciplinary lung cancer clinic: Prevalence and predictors of clinically significant distress

et al. 2007

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SummaryScreening for distress in cancer patients is recommended by the National Comprehensive Cancer Network, and a Distress Thermometer has previously been developed and empirically-validated for this purpose. The present study sought to determine the rates and predictors of distress in a sample of patients being seen in a multidisciplinary lung cancer clinic. Consecutive patients (N = 333) were recruited from an outpatient multidisciplinary lung cancer clinic to complete the Distress Thermometer, an associated Problem Symptom List, and two questions about interest in receiving help for symptoms. Over half (61.6%) of patients reported distress at a clinically significant level, and 22.5% of patients indicated interest in receiving help with their distress and/or symptoms. Problems in the areas of family relationships, emotional functioning, lack of information about diagnosis/treatment, physical functioning, and cognitive functioning were associated with higher reports of distress. Specific symptoms of depression, anxiety, pain and fatigue were most predictive of distress. Younger age was also associated with higher levels of distress. Distress was not associated with other clinical variables, including stage of illness or medical treatment approach. Similar results were obtained when individuals who had not yet received a definitive diagnosis of lung cancer (n = 134) were excluded from analyses; however, family problems and anxiety were no longer predictive of distress. Screening for distress in a multidisciplinary lung cancer clinic is feasible and a significant number of patients can be expected to meet clinical criteria for distress. Results also highlight younger age and specific physical and psychosocial symptoms as predictive of clinically-significant distress. Identification of the presence and predictors of distress are the first steps toward appropriate referral and treatment of symptoms and problems that contribute to cancer patients' distress.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Distress screening in a multidisciplinary lung cancer clinic: Prevalence and predictors of clinically significant distress

et al. 2007

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“…Because clinicians often fail to identify those who are distressed [43][44][45], the use of a standardized screening questionnaire may be useful and efficient. Pre-as well as post-surgery professional psychosocial support can help individuals in making a well-balanced decision about undergoing surgery, facilitate the adaptation to the operation, and prevent feelings of regret [46].…”

Section: Discussionmentioning

confidence: 99%

Psychological distress and use of psychosocial support in familial adenomatous polyposis

et al. 2009

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Objective: Familial adenomatous polyposis (FAP) is characterized by multiple adenomas in the colorectum with a high risk to develop colorectal cancer. It is unclear whether individuals at risk of FAP experience distress due to this potentially life-threatening disease. This nationwide study assessed: (1) the prevalence of psychological distress; and (2) the need for and use of specialized professional psychosocial support.Methods: In this cross-sectional study, all individuals from families at high risk for FAP registered at the Netherlands Foundation for the Detection of Hereditary Tumours were invited to complete a questionnaire assessing, among other issues, generalized, cancer-specific and FAP-specific distress.Results: In total, 525 individuals completed the questionnaire. Approximately 20% of the respondents had moderate to severe levels of FAP-specific distress. Levels of generalized distress were comparable to the general Dutch population. Significantly more individuals with a FAP diagnosis had frequent cancer worries than those at risk of FAP or non-carriers (p 5 0.02). Distress levels were more strongly associated with psychosocial variables (e.g. perceived cancer risk), than with sociodemographic or clinical variables. Up to 43% of the variance in distress could be explained by all variables combined. Of those moderately to severely distressed, 26% had received specialized professional psychosocial support, while 30% of those did not receive the support they wanted.Conclusions: A substantial minority of individuals reported moderate to severe distress levels associated with FAP. However, only one-third of those received specialized professional psychosocial support. We recommend the use of a screening questionnaire to identify individuals in need of such support.

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“…As cancer patients' distress has been shown to be often underestimated by their physicians and nurses [19][20][21][22][23][24][25][26], and as very few cancer centers organize systematic screenings of distress, patients' use of psychological interventions is mainly influenced by their desire for psychological support. Little is known to date however about the proportion of patients desiring psychological support from professionals in cancer care and about factors associated with this desire.…”

Section: Introductionmentioning

confidence: 99%

Cancer patients' desire for psychological support: prevalence and implications for screening patients' psychological needs

et al. 2009

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Objectives: To investigate cancer patients' desire for psychological support and to identify patients' sociodemographic, disease-related and psychological factors associated with this desire.Methods: The study is part of a multicenter, cross-sectional study assessing cancer patients' needs and desire for psychological support. Patients completed the Hospital Anxiety and Depression Scale, the Ways of Coping Checklist, the Cancer Rehabilitation Evaluation System and reported their desire for psychological support.Results: Among the 381 included patients, women (26%) desired psychological support significantly more often than men (11%) (po0.001). Patients' desire for psychological support was associated with being younger (OR 5 0.94; po0.001 for women and OR 5 0.93; p 5 0.007 for men) and having a support-seeking coping (OR 5 1.10; p 5 0.010 for women and OR 5 1.36; p 5 0.003 for men). Other contextual factors such as difficulties encountered and treatment modalities were diversely associated with women and men's desire for psychological support. Neither women's, nor men's psychological distress was associated with their desire for psychological support.Conclusions: One female cancer patient out of four and one male cancer patient out of ten desire psychological support. Results emphasize the need to screen not only for cancer patients' distress but also for their desire for psychological support. This will allow implementing psychological interventions according to patients' needs and desire.

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Recognition of distress and psychiatric morbidity in cancer patients: a multi-method approach

Abstract: Since a remarkable proportion of distressed patients remained unrecognised by the medical staff, only systematic screening of patients upon admission allows timely support to those who are most in need.

Cited by 211 publications

References 29 publications

Distress screening in a multidisciplinary lung cancer clinic: Prevalence and predictors of clinically significant distress

Distress screening in a multidisciplinary lung cancer clinic: Prevalence and predictors of clinically significant distress

Psychological distress and use of psychosocial support in familial adenomatous polyposis

Cancer patients' desire for psychological support: prevalence and implications for screening patients' psychological needs

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