The Distress Thermometer as an ultra-short screening tool: A first validation study for mixed-cancer outpatients in Singapore

The prevalence and predictors of subsyndromal anxiety and depression in adult Asian cancer patients across the first year of diagnosis

“…These prevalence rates are higher than those in the local general population, supporting research suggesting Asian cancer patients are more anxious and depressed relative to those in the general population . These prevalence rates are also higher than those in a local cancer inpatient population and those at first outpatient visit to the oncologist . Although there may be measurement differences, this study used locally‐validated interview‐based thresholds for caseness of anxiety and depression, which are arguably more representative.…”

“…Participants who were single were found to be better protected against subsyndromal depression at the same time point. Although this may seem counterintuitive, much of Singapore's financial and healthcare policies are centered around Confucian values of family support and filial piety . Relative to married participants, those who were single may therefore not be burdened by the guilt at having to depend on their nuclear family (e.g., spouse or children) for support, and may not have familial obligations to those that depend on their survival.…”

“…The HADS consists of two subscales (anxiety, HADS‐A; and depression, HADS‐D), each with seven items rated on a four‐point Likert‐type scale that assesses anxious and depressive symptomatology. The HADS has previously been validated for use in a local population of newly‐diagnosed cancer patients …”

“…Such symptoms may often go undetected and untreated even over time, leading to persistent distress . This is worrying given that, in Singapore at least, levels of subsyndromal anxiety and depression in cancer outpatients were between 15% and 16% at first visit to the oncologist, and 80% reported at least one unmet emotional concern . It is imperative to document longitudinally the prevalence rates of subsyndromal anxiety and depression in Asian patients before these symptoms develop into comorbid psychiatric disorders that pose a greater risk for downstream management, and attempt to identify patients at risk for anxiety and depression early in the cancer journey …”

Psychosocial concerns of cancer patients in Singapore

“…Cancer clinics in Singapore have started incorporating the Distress Thermometer (DT) to screen for distress in clinical settings . The DT measures an approximation of patients' personal distress, and has proven effective in screening for such distress in patients locally and elsewhere in Asia .…”