Quantifying mental disorders in patients with cancer
Patients with cancer exhibit high levels of psychological distress.
High levels of psychological distress are known to exist among patients with cancer. In this study, German researchers sought to provide realistic estimates of psychosocial distress in patients with cancer by providing reliable epidemiologic data.1 It is the largest to date that uses a fully standardized, diagnostic face-to-face interview to assess the mental and emotional health of patients with cancer.
More than 2,100 patients were interviewed at inpatient and outpatient care centers to determine how many patients with cancer experienced a clinically meaningful level of mental or emotional distress that meets strict diagnostic criteria. The mental disorders investigated included anxiety, depressive disorders, and adjustment disorders during the previous 4 weeks.
One or more mental disorders were diagnosed in 32% of the cancer patients.1 Anxiety disorders (11.5%) and mood disorders (6.5%) were the most prevalent. The highest 4-week prevalence occurred in patients with breast cancer (42%).1
The prevalence of these disorders varied by cancer type. Prevalence was higher among patients with breast cancer (42%), head and neck cancer (41%), and malignant melanoma (39%).1 It was lowest in patients with prostate cancer (22%), stomach cancers (21%), and pancreatic cancer (20%).1
At least one clinically meaningful mental health issue was experienced by 32% of patients, whereas prevalence of mental health issues in the general population is 18% to 20%.1 A mood disorder, such as major depression, occurred in 6.5% of the patients interviewed. An anxiety disorder was experienced by 11.5% of patients during the 4-week period prior to the interview. This is slightly higher than the 9% seen in the general population.1
An adjustment disorder was diagnosed in 11% of the patients, meaning a predominantly mixed anxiety-depressive syndrome that persisted for at least 4 weeks in response to a significant life event, such as a cancer diagnosis.1 Adjustment disorders are seldom assessed in the general population, and this rate is likely to have significantly contributed to the prevalence rate of mental disorders in this population of patients with cancer.
These findings can likely be generalized to the United States, explained lead author Anja Mehnert, PhD, a professor of psychosocial oncology at the University of Leipzig in Germany.1 She stated that the prevalence of mental health diagnoses is similar between the two countries.