Effects of screening for psychological distress on patient outcomes in cancer: A systematic review

Meijer, Anna; Roseman, Michelle; Delisle, Vanessa C.; Milette, Katherine; Levis, Brooke; Syamchandra, Achyuth; Stefanek, Michael; Stewart, Donna E.; Jonge, Peter de; Coyne, James C.; Thombs, Brett D.

doi:10.1016/j.jpsychores.2013.01.012

Cited by 115 publications

(77 citation statements)

References 63 publications

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“…Moreover, demotivation may promote maladaptive depressive coping styles with a detrimental effect on survival 5 as well as potentially increase suicidal risk 6 . Notwithstanding depression is under-recognized in cancer population, limited evidence provides support for the routine screening of distress in cancer populations 7 . Importantly, the treatment of depression has been associated with increased survival in women with metastatic cancer 8 .…”

Section: Introductionmentioning

confidence: 99%

Depression in cancer: The many biobehavioral pathways driving tumor progression

Bortolato

Hyphantis

Valpione

et al. 2017

Cancer Treatment Reviews

223

179

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Major Depressive Disorder (MDD) is common among cancer patients, with prevalence rates up to four-times higher than the general population. Depression confers worse outcomes, including non-adherence to treatment and increased mortality in the oncology setting. Advances in the understanding of neurobiological underpinnings of depression have revealed shared biobehavioral mechanisms may contribute to cancer progression. Moreover, psychosocial stressors in cancer promote:(1) inflammation and oxidative/nitrosative stress; (2) a decreased immunosurveillance; and (3) a dysfunctional activation of the autonomic nervous system and of the hypothalamic-pituitary-adrenal axis. Consequently, the prompt recognition of depression among patients with cancer who may benefit of treatment strategies targeting depressive symptoms, cognitive dysfunction, fatigue and sleep disturbances, is a public health priority. Moreover, behavioral strategies aiming at reducing psychological distress and depressive symptoms, including addressing unhealthy diet and life-style choices, as well as physical inactivity and sleep dysfunction, may represent important strategies not only to treat depression, but also to improve wider cancer-related outcomes. Herein, we provide a comprehensive review of the intertwined biobehavioural pathways linking depression to cancer progression. In addition, the clinical implications of these findings are critically reviewed.

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Section: Introductionmentioning

confidence: 99%

Depression in cancer: The many biobehavioral pathways driving tumor progression

Bortolato

Hyphantis

Valpione

et al. 2017

Cancer Treatment Reviews

223

179

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“…Reasons for not screening are multifactorial [11] but lack of referral guidance is reported by clinicians to be a major deterrent [12]. A number of systematic reviews also report appropriate care after screening to be the most significant predictor of improved patient outcomes [13,14,15].…”

Section: Introductionmentioning

confidence: 99%

Developing a clinical pathway for the identification and management of anxiety and depression in adult cancer patients: an online Delphi consensus process

Shaw

Price

Clayton

et al. 2015

Support Care Cancer

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Purpose: People with cancer and their families experience high levels of psychological morbidity. However many cancer services do not routinely screen patients for anxiety and depression and there are no standardized clinical referral pathways. This study aimed to establish consensus on elements of a draft clinical pathway tailored to the Australian context. Methods:A two-round Delphi study was conducted to gain consensus among Australian oncology and psycho-oncology clinicians about the validity of 39 items that form the basis of a clinical pathway that includes screening, assessment, referral and stepped-care management of anxiety and depression in the context of cancer. The expert panel comprised 87 multidisciplinary clinician members of the Australian Psycho-oncology Cooperative Research Group (PoCoG). Respondents rated their level of agreement with each statement on a 5-point likert scale. Consensus was defined as >80% of respondents scoring within 2 points on the likert scale.Results: Consensus was reached for 21 of 39 items, and a further 15 items approached consensus except for specific contextual factors, after 2 Delphi rounds. Formal screening for anxiety and depression, a stepped care model of management and recommendations for inclusion of length of treatment and time to review were endorsed. Consensus was not reached on items related to roles and responsibilities, particularly those not applicable across cancer settings. Conclusions:This study identified a core set of evidence-and consensus-based principles considered essential to a stepped care model of care incorporating identification, referral and management of anxiety and depression in adult cancer patients.3

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“…Sin embargo, desde otros sectores se continúa recomendando su utilización (45,46) . Por otro lado, se ha comenzado a cuestionar el propio concepto de cribado de malestar emocional en pacientes oncológicos (47) , considerando que no reporta ningún beneficio con respecto al tratamiento habitual. Por ello, deberán minimizarse las tasas de falsos positivos detectados si se pretende demostrar que el TD es una medida útil y eficiente para la práctica clínica.…”

Section: Discussionunclassified

El termómetro del distrés como prueba de cribado de ansiedad y depresión en pacientes oncológicos recién diagnosticados

et al. 2014

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ResumenObjetivo: El Termómetro del Distrés (TD) es una de las pruebas de cribado de malestar emocional más utilizadas y estudiadas en pacientes oncológicos. Sin embargo, genera numerosos falsos positivos. Además, aún no ha sido convenientemente estudiado con población española, ni en muestras de pacientes recién diagnosticados. El presente estudio analiza el rendimiento diagnóstico del TD en una muestra española de pacientes oncológicos recién diagnosticados.Método: Se evaluó el rendimiento diagnós-tico del TD en una muestra de 135 pacientes con diagnóstico oncológico empleando como pruebas de referencia la Escala de Ansiedad y Depresión Hospitalaria (HADS) y una entrevista diagnóstica semiestructurada.Resultados: El TD mostró un rendimiento diagnóstico aceptable (Área Bajo la Curva, ABC=0,79) para detectar malestar emocional usando la HADS como referencia. El punto de corte óptimo fue de 4 puntos (Sensibilidad=0,89; Especificidad=0,56). El rendimiento diagnóstico del TD empleando la combinación de la entrevista clínica y la HADS como referencia fue bueno (ABC=0,86). El punto de corte óptimo fue de 6 puntos (Sensibilidad=0,82; Especificidad=0,76). AbstractObjective: The Distress Thermometer (DT) is one of the most used and studied screening tests of psychological distress in cancer patients. However, it includes many false positives. Furthermore, it has not been adequately studied with Spanish populations or with recently diagnosed patients. This research examines the diagnostic performance of the DT with a sample of Spanish recently diagnosed cancer patients.Method: The diagnostic performance of DT was assessed in a sample of 135 recently diagnosed cancer patients using the Hospital Anxiety and Depression Scale (HADS) and a semi-structured diagnostic interview as gold standard.Results: The diagnostic performance of DT was acceptable (AUC=0.79) to detect psychological distress using the HADS as gold standard. The optimal cut-off score was 4 (Sensitivity=0.89; Specificity=0.56). The diagnostic performance of DT using the HADS plus the diagnostic interview as gold standard was good (AUC=0.86).The optimal cut-off score was 6 (sensitivity=0.82; Specificity=0.76).Discussion: The DT is an appropriate screening test to detect anxiety and depressive disorders in recently diagnosed cancer

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Effects of screening for psychological distress on patient outcomes in cancer: A systematic review

Cited by 115 publications

References 63 publications

Depression in cancer: The many biobehavioral pathways driving tumor progression

Depression in cancer: The many biobehavioral pathways driving tumor progression

Developing a clinical pathway for the identification and management of anxiety and depression in adult cancer patients: an online Delphi consensus process

El termómetro del distrés como prueba de cribado de ansiedad y depresión en pacientes oncológicos recién diagnosticados

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