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Emotional Distress

By Lisa Schulmeister, MN, RN, ACNS-BC, OCN, FAAN
Emotional distress has long been associated with a cancer diagnosis and cancer treatment. However, the prevalence of emotional distress and related psychosocial effects, such as depression and anxiety, have not been fully studied. Researchers in Germany reported that 32% of 2,141 patients with cancer interviewed at inpatient and outpatient care centers experienced a clinically meaningful level of mental or emotional distress that met the strict diagnostic criteria for mental disorders, which included anxiety, depressive and adjustment disorders. The highest prevalence was found among patients with breast cancer (42%) and head and neck cancer (41%), followed by malignant melanoma (39%). The lowest prevalence was found among patients with prostate cancer (22%), stomach cancer (21%), and pancreatic cancer (20%). This study is notable in that it is a large study that used fully standardized, diagnostic face-to-face interviews to assess emotional distress.

In the four-week period prior to the interview, 11.5% of patients experienced an anxiety disorder, 11% met the criteria for an adjustment disorder, and 6.5% had signs of a mood disorder. The 11.5% rate of anxiety disorders, such phobia, panic or generalized anxiety disorder, was slightly higher than in the general population (9%), while the prevalence of other mental health diagnoses was similar to rates in the general population. The researchers noted that it was surprising that patients with a more treatable cancer, such as breast cancer, experienced more distress than people with cancers that are more challenging to treat, such as stomach and pancreatic cancer, and that more research is needed to interpret these findings.

Mehnert A et al. Four-Week Prevalence of Mental Disorders in Patients with Cancer Across Major Tumor Entities. Journal of Clinical Oncology. Published online before print October 6, 2014, doi:10.1200/JCO.2014.56.0086
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