Distress and neuroticism may be predictive factors for long term emotional distress for patients who experience them at the time or within 3 months of a cancer diagnosis, according to a study published in Psycho-Oncology.

Patients who receive cancer diagnoses understandably experience high rates of emotional distress; approximately 50% of patients with newly diagnosed cancer report clinically significant anxiety and/or depression. Many patients eventually report an improvement and recovery from symptoms approximately within 1 year after diagnosis, but why some patients continue to experience long-term distress has yet to be understood.

For this systematic review, investigators analyzed 39 papers (including 36 prospective studies) that evaluated predictors of emotional distress among patients with cancer.

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Results revealed that socio-demographic, clinical predictors (eg, age and gender; socioeconomic status; clinical, treatment, and tumor characteristics; physical health), and social predictors (eg, relationship status and social network, perceived social support, negative life events) were not predictive of long-term distress.

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Thirty of the 39 papers investigated the impact of baseline distress on long-term distress; most revealed that distress was the largest and only significant predictor of long-term distress. Five of 13 papers that studied the effect of personality on long-term distress found that neuroticism (upon controlling for baseline distress), was predictive of 12-month emotional distress, depression, anxiety, and trauma symptoms.

Other psychological factors, such as self-esteem, coping, perceived control, illness/treatment perceptions, metacognitive beliefs, and personality (with the exception of neuroticism) were not found to be predictive of long-term distress.

Although the review identifies baseline distress and neurotic personality as predictive factors of long-term distress, the authors noted that there is a need to identify the factors that not only predict but also maintain distress. They concluded that “future research, based on testable theory, will need to adopt more sophisticated longitudinal designs and statistical methodology so that it can disentangle the persistence of distress from its causation.”


Book SA, Salmon P, Hayes G, Byrne A, Fisher PL. Predictors of emotional distress a year or more after diagnosis of cancer: a systematic review of the literature [published online January 10, 2018]. Psycho-Oncol. doi: 10.1002/pon.4601