Impact of distress screening algorithm for psycho-oncological needs in neurosurgical patients

// Marion Rapp 1, * , Stephanie Schipmann 2, * , Kira Hoffmann 1 , Rainer Wiewrodt 3 , Hans-Jakob Steiger 1 , Marcel Kamp 1 , Walter Stummer 2 , Dorothee Wiewrodt 2, * and Michael Sabel 1, * 1 Department of Neurosurgery, Heinrich-Heine-University, Duesseldorf, Germany 2 Department of Neurosurgery, University Hospital Muenster, Muenster, Germany 3 Pulmonary Division, Dpt. of Medicine A, University Hospital Muenster, Muenster, Germany * These authors have contributed equally to this work Correspondence to: Marion Rapp, email: marion.rapp@med.uni-duesseldorf.de Keywords: psychooncology; distress; brain surgery; screening; algorithm Received: April 11, 2018     Accepted: June 09, 2018     Published: August 03, 2018 ABSTRACT Background: Cerebral tumors are associated with high rates of anxiety, depression and reduced health related quality of life. Nevertheless psychooncological screening instruments are neither implemented nor well defined in the daily routine of neurosurgical departments. Therefore, we tried (1) to identify a suitable screening algorithm for neurosurgical patients, (2) to define clinical risk factors for increased distress and (3) to analyze the optimal screening time point. Results: Between October 2013 and January 2015 472 elective neurosurgical in-patients (median age 55.85 years) of the neurosurgical departments of the University Hospitals Duesseldorf and Muenster were prospectively included into this study. Regarding their diagnosis 244 (51.7%) patients were identified with malignant lesions and 228 (48.3%) patients with benign lesions. Increased distress was diagnosed in 63.1% of all patients via DT, in 13.6% via HADS and 27.8% via PO-Bado. Combining the cut-off criteria with the problem list increased sensitivity (90%) and specificity (70%) of the DT assessment. Regarding risk factors pre-existing psychiatric disorders, ataractic medication and a decreased clinical performance status were associated with increased distress. Patients and methods: Patients with diagnosis of an intracranial lesion with elective surgical indication were screened for psychological distress via three assessment-instruments the Hospital Anxiety and Depression Scale (HADS), the Distress Thermometer (DT), and the Basic Documentation for Psycho-Oncology (PO-Bado). Screening results were correlated with clinical and demographic data. Conclusion: Postoperative distress screening for neurosurgical patients is important independent from the neurosurgical diagnosis. The DT represents a suitable, non time-consuming instrument for daily routine in a neurosurgical department.