RAPID SCREENING FOR PSYCHOLOGIC DISTRESS IN MEN WITH PROSTATE CARCINOMA - A PILOT-STUDY

BACKGROUND, As more oncology care is moved to the outpatient setting, the need for a rapid means for oncologists to identify patients with s ignificant distress has increased. Concurrent with this move has been the pressure to reduce time spent with each patient, adding to the lik elihood that a distressed patient will not be recognized and will rema in untreated in the current health care environment. METHODS. A pilot program was conducted in a prostate carcinoma oncology clinic to test the feasibility of a two-stage approach that identifies patients in si gnificant distress and refers them for treatment. Two pencil and paper self-report measures were used to detect psychologic distress in pati ents over the previous week: 1) The Hospital Anxiety and Depression Sc ale (HADS) and 2) ''The Distress Thermometer.'' Patients who scored ab ove an agreed upon cutoff score on either measure (HADS = 15+; Thermom eter = 5+) were referred to the psychiatric liaison in the clinic for evaluation. RESULTS. Compliance in filling out the measures was excell ent; only 8 of 121 patients (6.6%) refused. Thirty-one percent of eval uable patients were referred based on elevated scores. Seventeen of 29 patients actually were evaluated. Eight of 17 patients met Diagnostic and Statistical Manual (of Mental Disorders)-IV criteria for a psychi atric disorder. CONCLUSIONS. This approach for rapid screening for dis tress was acceptable in prostate carcinoma patients, although these ol der men were reluctant to agree to evaluation and treatment. This simp le screening method needs further testing and the identification of ba rriers on the part of the patient and oncologist that impede the ident ification of the most distressed patients. (C) 1998 American Cancer So ciety.