Prevalence of psychological distress and use of support services by cancerpatients at Sydney hospitals

Objective: The study aimed to estimate the prevalence of anxiety and depres sion within a cross section of cancer patients in the Sydney region, and to assess the use of and degree of satisfaction with available support servic es. Method: A survey was conducted at oncology outpatient departments of four S ydney hospitals. Participants completed the Hospital Anxiety and Depression Scale (HADS) and a questionnaire seeking information on their use of patie nt support services, as well as demographic and clinical information. Results: A total of 504 valid questionnaires were returned. Using a cut-off score of 11 on the HADS, the prevalence of clinically significant anxiety and depression was 11.5% and 7.1% respectively; 17% of patients had receive d individual counselling while 6.5% had attended support groups. The majori ty of patients who had attended counselling or support groups reported them to have been 'extremely' or 'reasonably' helpful (86% and 83% respectively ). Of the patients who were experiencing clinically significant anxiety or depression, 75% had not received any counselling or psychological treatment . The main factors which predicted clinically significant anxiety or depres sion were: restricted activity levels, advanced disease, a non-English-spea king background and being female. Conclusions: While the prevalence of clinically significant anxiety or depr ession detected by the HADS was reasonably low, a substantial number of pos sible cases were identified. The majority of affected patients were not acc essing counselling or psychological treatment. Systematic screening of onco logy patients at hospital entry might enable more immediate identification of clinically affected patients, who could then be referred for further tes ting or psychological treatment.