Psychological distress in cancer patients undergoing radiation therapy treatment

Support Care Cancer. 2013 Apr;21(4):1043-51. doi: 10.1007/s00520-012-1624-3. Epub 2012 Oct 24.


Purpose: The objective of this study was to examine the likely presence of, and factors associated with, anxiety, depression and overall psychological distress in cancer outpatients undergoing radiation therapy treatment in Sydney, Australia.

Methods: A touchscreen computer survey was conducted in four radiation therapy treatment centre waiting rooms. Patients waiting to receive treatment completed the survey which included questions about demographic and disease characteristics, survey acceptability and the Hospital Anxiety and Depression Scale (HADS).

Results: A total of 454 patients (70 %) completed the touchscreen computer survey. The likely presence of anxiety (HADS-A ≥11), depression (HADS-D ≥11) and overall psychological distress (HADS-T ≥15) was 15, 5.7 and 22 %, respectively. Cancer type was found to be associated with each HADS screening category. The majority of patients reported high survey acceptability and willingness to complete similar touchscreen computer surveys in the treatment centre waiting room on additional occasions.

Conclusions: As radiotherapy patients frequently attend the radiation oncology department, routine screening and intervention for elevated levels of psychological distress in this setting appears to be feasible. High survey completion rates and high patient-rated acceptability support this approach to screening. The likely presence of psychological distress is reported for this sample; however, the selection of HADS threshold scores is likely to have influenced the reported rates. Further research is needed to identify how cancer type impacts on likely caseness across the different HADS classifications examined.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety Disorders / epidemiology
  • Confidence Intervals
  • Cross-Sectional Studies
  • Depressive Disorder / epidemiology
  • Female
  • Humans
  • Likelihood Functions
  • Logistic Models
  • Male
  • Middle Aged
  • Neoplasms / psychology*
  • Neoplasms / radiotherapy*
  • New South Wales / epidemiology
  • Odds Ratio
  • Stress, Psychological / epidemiology*
  • User-Computer Interface
  • Young Adult