Psychological distress in cancer outpatients: a prospective cohort study

Abstract Introduction and aims Psychological distress is common in cancer patients. It can be viewed as a continuum from no symptoms at one end to psychiatric diagnoses such as major depression at the other. While major depression is likely to persist and to require treatment, there is much we need to know about patients with milder symptoms of distress. This study aimed to: (1) Describe the course of distress over 7 months in patients with clinically significant distress (HADS ≤15) at routine symptom monitoring but who did not meet criteria for major depression, (2) Determine whether demographic and clinical characteristics and severity and short-term persistence of initial distress predict significant distress at 7 months. Methods 326 patients with a relatively good prognosis (>12 months) were recruited from two specialist NHS Cancer Centres in Scotland, UK. Patients completed the HADS at routine symptom monitoring on touch screen computers and at 1, 2, 4 and 7 months by telephone. Results Preliminary results showed that more than a third of patients (36%) had clinically significant distress at 7 months. The data is currently being analysed to look at the characteristics of patients with persistent distress at 7 months. These results will be presented at the conference. Conclusion A substantial group of patients with significant distress at routine symptom monitoring, but who do not meet criteria for major depression, have distress that persists over 7 months. These patients might benefit from treatment for their symptoms and services should be developed for these patients.