Elsevier

Annals of Oncology

Volume 15, Issue 8, August 2004, Pages 1243-1249
Annals of Oncology

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

https://doi.org/10.1093/annonc/mdh318Get rights and content
Under an Elsevier user license
open archive

Abstract

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.

Keywords

cancer surgery
prevalence
psychiatric morbidity
psychosocial liaison service
recognition of distress
referral

Cited by (0)