title: Psychosocial morbidity and its correlates in cancer patients of the Mediterranean area: findings from the Southern European Psycho-Oncology Study.
abstract: BACKGROUND
  A few and partial data are available on psychosocial morbidity among cancer patients in Mediterranean countries. As a part of a more general investigation (Southern European Psycho-Oncology Study-SEPOS), the rate of psychosocial morbidity and its correlation with clinical and cultural variables were examined in cancer patients in Italy, Portugal and Spain.
  
  
  METHODS
  A convenience sample of cancer outpatients with good performance status and no cognitive impairment were approached. The Hospital Anxiety-Depression scale (HAD-S), the Mini-Mental Adjustment to Cancer scale (Mini-MAC), and the Cancer Worries Inventory (CWI) were used to measure psychological morbidity, coping strategies and concerns about illness.
  
  
  RESULTS
  Of 277 patients, 34% had pathological scores ("borderline cases" plus "true cases") on HAD-S Anxiety and 24.9% on HAD-S Depression. Total psychiatric "caseness" was 28.5% and 16.6%, according to different HAD cut-offs (14 and 19, respectively). Significant relationships of HAD-S Anxiety, HAD-S Depression, HAD-S Total score, with Mini-MAC Hopeless and Anxious Preoccupation, and CWI score were found. No differences emerged between countries on psychosocial morbidity, while some differences emerged between the countries on coping mechanisms. Furthermore, Fatalism, Avoidance and marginally Hopeless were higher compared to studies carried out in English-speaking countries.
  
  
  CONCLUSIONS
  The relatively small sample size and the good performance status prevent us to generalize data on patients with different cancer sites and advanced phase of illness.
  
  
  CONCLUSIONS
  One-third of the patients presented anxiety and depressive morbidity, with significant differences in characteristics of coping in Mediterranean countries in comparison with English-speaking countries.
authors.affiliation: Department of Behaviour and Communication, Section of Psychiatry, University of Ferrara and Department of Mental Health and General University S. Anna Hospital, Corso Giovecca 203, 44100 Ferrara, Italy. luigi.grassi@unife.it
authors.forename: Luigi
authors.initials: L
authors.lastname: Grassi
authors.forename: Luzia
authors.initials: L
authors.lastname: Travado
authors.forename: Francisco Luis Gil
authors.initials: FL
authors.lastname: Moncayo
authors.forename: Silvana
authors.initials: S
authors.lastname: Sabato
authors.forename: Elena
authors.initials: E
authors.lastname: Rossi
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003431:Cross-Cultural Comparison; D003674:Defense Mechanisms; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000523:psychology*; D010348:Patient Care Team / Q000706:statistics & numerical data; D010555:Personality Inventory / Q000706:statistics & numerical data; D011174:Portugal; D012017:Referral and Consultation / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012803:Sick Role; D013030:Spain; D013223:Statistics as Topic; D013557:Switzerland