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A feasibility study of distress screening with psychometric evaluation and referral of cancer patients
Anderson, D. Vlachostergios, P. J. Simpson, L. Bruce, S. S. Fitzpatrick, N. Connell, J. Christodoulis, E. Kamposioras, K.
Anderson, D.
Vlachostergios, P. J.
Simpson, L.
Bruce, S. S.
Fitzpatrick, N.
Connell, J.
Christodoulis, E.
Kamposioras, K.
Abstract
To assess for associations of known psychometric scales GAD-7, PHQ-9, pc-PTSD-5 with demographics and clinical characteristics of cancer patients as well as identify their value in screening for distress and in guiding Psycho-Oncology evaluation. This prospective feasibility study employed three psychological testing questionnaires, specifically the GAD-7, PHQ-9, and PC-PTSD-5, for the purpose of distress screening. Patients with a diagnosis of colorectal cancer who scored highly on at least one psychometric scale (defined in previous studies of non-cancer populations as a GAD-7 score of 10 or above, a PHQ-9 score of 10 or above, or a PC-PTSD-5 score of 4 or above) were offered a referral for further assessment in the Psycho-Oncology service and triaged via a semi-structured interview. The relationship between patients' demographics and clinical characteristics and scores and outcomes was evaluated using the chi-square test. Fifty-four patients (30 females) of median age 60 years (range 36-81) were evaluated in the study. Thirty-four patients (63%) scored high on GAD-7, 40 (74%) on PHQ-9, and 8 (15%) on PC-PTSD-5 scales, respectively. Twenty-nine out of the 54 patients who underwent initial assessment with the psychometric scales (53.7%) accepted to be referred to the Psycho-Oncology service and were triaged via semi-structured interview while the rest 25/54 (46.3%) patients declined further assessment. Twenty-two of the patients who were interviewed (76%) required further specialist Psycho-Oncology intervention and the rest were signposted to community services. Patients younger than 65 years of age were more likely to score high according to the GAD-7 tool (p = 0.036). White Caucasian patients tended to score higher in the PHQ-9 questionnaire compared to non-white ones (p = 0.07). Prior history of mental disorder was significantly associated with higher scores in both GAD-7 (p = 0.041) and PC-PTSD-5 tools (p = 0.016). Patients who accepted a referral for psycho-oncology intervention demonstrated statistically elevated levels of anxiety on GAD-7 (p = 0.007) and diminished levels of depression on PHQ-9 (p = 0.042) compared to those who declined the referral. A clinical pathway involving a stepwise approach of psychometric scale evaluation and semi-structured interview can appropriately identify cancer patients with distress requiring further psychological support.
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Date
2025
Publisher
Collections
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Article
Citation
Anderson D, Vlachostergios PJ, Simpson L, Bruce SS, Fitzpatrick N, Connell J, et al. A feasibility study of distress screening with psychometric evaluation and referral of cancer patients. Scientific reports. 2025 Mar 26;15(1):10397. PubMed PMID: 40140408. Pubmed Central PMCID: PMC11947445. Epub 2025/03/27. eng.