Objectives: The Distress Thermometer (DT) is a validated and widely used screening
tool to identify clinically relevant distress in cancer patients. It is unclear, to which extend
subjectively perceived distress measured by the DT is related to objective burden (mental
disorder). We therefore examine the co-occurrence of a mental disorder for different DT
thresholds and explore the diagnostic properties of the DT in detecting a mental disorder.
Methods: In this multicenter cross-sectional study, we included 4,020 patients with
mixed cancer diagnoses. After selection of relevant cases, weighting procedure and
imputation of missing data we evaluated the data of N = 3,212 patients. We used the DT
to assess perceived distress and the standardized Composite International Diagnostic
Interview for Oncology (CIDI-O) to assess the 4-week prevalence of mental disorders.
The association between distress and any mental disorder (MD) is calculated using
Pearson correlations. Relative risks for MD in patients with/without distress and the
co-occurrence of distress and MD were calculated with Poisson regression. To assess
the operating characteristics between distress and MD, we present the area under
the curve (AUC).
Results: 22.9% of the participants had a cut-off DT level of 5 and were affected by
MD. Each level of distress co-occurs with MD. The proportion of patients diagnosed
with MD was not greater than the proportion of patients without MD until distress levels
of DT = 6 were reached. The correlation between DT and MD was r = 0.27. The ROCanalysis
shows the area under curve (AUC) = 0.67, which is classified as unsatisfactory.
With increasing distress severity, patients are not more likely to have a mental disorder.
Conclusion: Our results suggests viewing and treating cancer-related distress as a
relatively distinct psychological entity. Cancer-related distress may be associated with
an increased risk for a mental disorder and vice versa, but the overlap of both concepts
is very moderate.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:84451 |
| Date | 31 March 2023 |
| Creators | Ernst, Jochen, Friedrich, Michael, Vehling, Sigrun, Koch, Uwe, Mehnert-Theuerkauf, Anja |
| Publisher | Frontiers Research Foundation |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 1664-1078, 660588 |
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