Utility of routine psychological screening in the childhood cancer survivor clinic.
OBJECTIVE
This study examined the utility of routine psychologic screening in a childhood cancer survivor clinic by evaluating patient acceptance, comparing subjects' symptoms to normative data, examining the utility of specific tests, and identifying risk factors associated with psychological distress.


METHODS
During their annual clinic visit, 101 adult survivors of childhood cancer (median age, 25 years) completed the Symptom Checklist 90 Revised (SCL-90), as well as the Short Form 36 (SF-36), Beck Depression Inventory (BDI), and one additional suicide question. Psychological distress was operationally defined according to the published SCL-90 clinical case rule, classifying subjects with a consistent pattern of symptom elevations as clinical cases.


RESULTS
The majority of subjects (80%) completed the screening in less than 30 minutes and reported little (15%) or no (84%) distress. Sixty-four percent believed it would help "very much" or "moderately" in getting to know them, and 35% thought it would help "slightly." On the SCL-90, 32 subjects (31.7%) had a positive screen, indicating significant psychological distress. All subjects with clinically significant symptoms on the BDI and SF-36 Mental Health Scale were cases on the SCL-90 (case-positive). Suicidal symptoms were reported in 13.9% of the sample, all of whom were SCL-90 cases. In a logistic regression model, subjects' dissatisfaction with physical appearance, poor physical health, and treatment with cranial radiation were associated with psychological distress.


CONCLUSIONS
Results demonstrate that routine psychological screening can be successfully integrated into the cancer survivor clinic and may be effective in identifying those survivors with significant distress who require further evaluation.
Recklitis
Christopher
C
David B. Perini Jr. Quality of Life Clinic, The Dana-Farber Cancer Institute, Boston, MA, USA. christopher_recklitis@dfci.harvard.edu
O'Leary
Tara
T
Diller
Lisa
L
D000293:Adolescent; D000328:Adult; D000554:Ambulatory Care Facilities; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D011581:Psychological Tests; D011788:Quality of Life; D012647:Self-Assessment; D017741:Survivors / Q000523:psychology*