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Annals of Oncology 15:1243-1249, 2004
© 2004 European Society for Medical Oncology

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

Background: This study aimed to determine the prevalence of psychiatric morbidity and distress among 189 consecutively recruited cancer patients upon admission to surgical oncology wards, and to investigate the recognition of distressed patients by medical staff.

Patients and methods: Assessment consisted of a diagnostic psychiatric interview (SCID, DSM-IV), patient-reported distress using a standardised questionnaire (Hospital Anxiety and Depression Scale), and physicians' and nurses' estimates of patients' distress. Twenty-eight per cent of patients were assigned a psychiatric diagnosis, with adjustment disorder predominating.

Results: Surgeons accurately recognised marked distress in 77% of patients with a psychiatric disorder and nurses did so in 75%. Because of low specificity, the positive predictive value was only 39% in surgeons and 40% in nurses. However, recognition of distress translated into referral to the psychosocial liaison service for only a minor proportion of distressed patients.

Conclusions: 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.

M. Keller1,*, S. Sommerfeldt1, C. Fischer1, L. Knight1, M. Riesbeck2, B. Löwe3, C. Herfarth4 and T. Lehnert4

1 Psychosocial Care Unit, 4 Department of Surgery, University Hospital, Heidelberg; 2 Rhine Clinics, Heinrich Heine University Hospital, Düsseldorf; 3 Department of Internal Medicine II (General Internal and Psychosomatic Medicine), Medical University Hospital, Heidelberg, Germany

* Correspondence to: Dr M. Keller, Psychosocial Care Unit, Department of Surgery, University Hospital, Im Neuenheimer Feld 155, D-69120 Heidelberg, Germany. Tel: +49-6221-562723; Fax: +49-6221-565250; Email: monika_keller{at}med.uni-heidelberg.de

Key words: cancer surgery, prevalence, psychiatric morbidity, psychosocial liaison service, recognition of distress, referral


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A. J. Mitchell
Pooled Results From 38 Analyses of the Accuracy of Distress Thermometer and Other Ultra-Short Methods of Detecting Cancer-Related Mood Disorders
J. Clin. Oncol., October 10, 2007; 25(29): 4670 - 4681.
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