The prevalence of psychological distress by cancer site

Zabora, James; BrintzenhofeSzoc, Karlynn; Curbow, Barbara; Hooker, Craig M.; Piantadosi, Steven

doi:10.1002/1099-1611(200101/02)10:1<19::aid-pon501>3.3.co;2-y

Cited by 667 publications

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“…Those studies evaluating different tumor entities separately have remarkably high depression rates associated with specific tumor types in common. In particular patients with pancreatic, lung, oropharyngeal and breast cancer are seriously affected by emotional burden and major depression [10,11,13,14]. In this respect pancreatic cancer is the tumor entity with the highest incidence rate of depression among all other tumors of the digestive system [15-17].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore the focus has to be on evaluation of psychological and cognitive symptoms like hopelessness, loss of ambition, anhedonia or suicidal ideation [18,38,39]. To meet these demands assessment instruments like the Distress Thermometer, the Brief Symptom Inventory ( BSI ), the Symptom Checklist 90-R ( SCL-90 ) or the Problem Common Checklist have been designed [9,14,28,40]. The currently most established self-assessment instruments are the Becks Depression Inventory ( BDI ) and the Hospital Anxiety and Depression Scale (HADS) questionnaire .…”

Section: Discussionmentioning

confidence: 99%

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Pancreatic cancer and depression: myth and truth

Mayr

Schmid

2010

BMC Cancer

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BackgroundVarious studies reported remarkable high incidence rates of depression in cancer patients compared with the general population. Pancreatic cancer is still one of the malignancies with the worst prognosis and therefore it seems quite logical that it is one of the malignancies with the highest incidence rates of major depression.However, what about the scientific background of this relationship? Is depression in patients suffering from pancreatic cancer just due to the confrontation with a life threatening disease and its somatic symptoms or is depression in this particular group of patients a feature of pancreatic cancer per se?DiscussionSeveral studies provide evidence of depression to precede the diagnosis of pancreatic cancer and some studies even blame it for its detrimental influence on survival. The immense impact of emotional distress on quality of life of cancer patients enhances the need for its early diagnosis and adequate treatment. Knowledge about underlying pathophysiological mechanisms is required to provide the optimal therapy.SummaryA review of the literature on this issue should reveal which are the facts and what is myth.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pancreatic cancer and depression: myth and truth

Mayr

Schmid

2010

BMC Cancer

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“…Various studies have demonstrated high levels of depression and anxiety in cancer patients using a variety of assessment methods [1,3,4,6-8]. Depression is a challenge to study in cancer patients as symptoms occur over a range of spectrum being different in different patients [4,9].…”

Section: Introductionmentioning

confidence: 99%

Assessment of depression and anxiety in adult cancer outpatients: a cross-sectional study

et al. 2010

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BackgroundThe prevalence of anxiety and depressive disorders in cancer patients and its associated factors in Pakistan is not known. There is a need to develop an evidence base to help introduce interventions as untreated depression and anxiety can lead to significant morbidity. We assessed the prevalence of depression and anxiety among adult outpatients with and without cancer as well as the effect of various demographic, clinical and behavioral factors on levels of depression and anxiety in cancer patients.MethodsThis cross-sectional study was carried out in outpatient departments of Multan Institute of Nuclear Medicine and Radiotherapy and Nishtar Medical College Hospital, Multan. Aga Khan University Anxiety and Depression Scale (AKUADS) was used to define the presence of depression and anxiety in study participants. The sample consisted of 150 diagnosed cancer patients and 268 participants without cancer (control group).ResultsThe mean age of cancer patients was 40.85 years (SD = 16.46) and median illness duration was 5.5 months, while the mean age of the control group was 39.58 years (SD = 11.74). Overall, 66.0% of the cancer patients were found to have depression and anxiety using a cutoff score of 20 on AKUADS. Among the control group, 109 subjects (40.7%) had depression and anxiety. Cancer patients were significantly more likely to suffer from distress compared to the control group (OR = 2.83, 95% CI = 1.89-4.25, P = 0.0001). Performing logistic regression analysis showed that age up to 40 years significantly influenced the prevalence of depression and anxiety in cancer patients. There was no statistically significant difference between gender, marital status, locality, education, income, occupation, physical activity, smoking, cancer site, illness duration and mode of treatment, surgery related to cancer and presence of depression and anxiety. Cancers highly associated with depression and anxiety were gastrointestinal malignancies, chest tumors and breast cancer.ConclusionsThis study highlights high prevalence rates of depression and anxiety in cancer patients. Younger age was associated with a higher likelihood of meeting criteria for psychological morbidity. The findings support screening patients for symptoms of depression and anxiety as part of standard cancer care and referring those at a higher risk of developing psychological morbidity for appropriate care.

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“…Approximately 30% of cancer patients report ongoing clinically significant distress [5,7-9]. Although psychological intervention can reduce patient distress and improve quality of life [10], health professionals often fail to diagnose distress [9].…”

Section: Introductionmentioning

confidence: 99%

Feasibility of brief psychological distress screening by a community-based telephone helpline for cancer patients and carers

et al. 2010

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BackgroundUp to one-third of people affected by cancer experience ongoing psychological distress and would benefit from screening followed by an appropriate level of psychological intervention. This rarely occurs in routine clinical practice due to barriers such as lack of time and experience. This study investigated the feasibility of community-based telephone helpline operators screening callers affected by cancer for their level of distress using a brief screening tool (Distress Thermometer), and triaging to the appropriate level of care using a tiered model.MethodsConsecutive cancer patients and carers who contacted the helpline from September-December 2006 (n = 341) were invited to participate. Routine screening and triage was conducted by helpline operators at this time. Additional socio-demographic and psychosocial adjustment data were collected by telephone interview by research staff following the initial call.ResultsThe Distress Thermometer had good overall accuracy in detecting general psychosocial morbidity (Hospital Anxiety and Depression Scale cut-off score ≥ 15) for cancer patients (AUC = 0.73) and carers (AUC = 0.70). We found 73% of participants met the Distress Thermometer cut-off for distress caseness according to the Hospital Anxiety and Depression Scale (a score ≥ 4), and optimal sensitivity (83%, 77%) and specificity (51%, 48%) were obtained with cut-offs of ≥ 4 and ≥ 6 in the patient and carer groups respectively. Distress was significantly associated with the Hospital Anxiety and Depression Scale scores (total, as well as anxiety and depression subscales) and level of care in cancer patients, as well as with the Hospital Anxiety and Depression Scale anxiety subscale for carers. There was a trend for more highly distressed callers to be triaged to more intensive care, with patients with distress scores ≥ 4 more likely to receive extended or specialist care.ConclusionsOur data suggest that it was feasible for community-based cancer helpline operators to screen callers for distress using a brief screening tool, the Distress Thermometer, and to triage callers to an appropriate level of care using a tiered model. The Distress Thermometer is a rapid and non-invasive alternative to longer psychometric instruments, and may provide part of the solution in ensuring distressed patients and carers affected by cancer are identified and supported appropriately.

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The prevalence of psychological distress by cancer site

Cited by 667 publications

References 0 publications

Pancreatic cancer and depression: myth and truth

Pancreatic cancer and depression: myth and truth

Assessment of depression and anxiety in adult cancer outpatients: a cross-sectional study

Feasibility of brief psychological distress screening by a community-based telephone helpline for cancer patients and carers

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