title: Is psychological distress in men recently diagnosed with testicular cancer associated with their neuropsychological test performance?
abstract: OBJECTIVE
  To study the level of cancer-related distress (CRD) and variables associated with CRD in recently diagnosed testicular cancer patients (TCPs), and to explore associations between distress levels and neuropsychological test performance at the same time-point.
  
  
  METHODS
  As part of a prospective study of their psychological and cognitive functioning, 135 TCPs completed the Impact of Event Scale (IES) as a measure of CRD at a median of 37 days after diagnosis. They also completed the Hospital Anxiety and Depression Scale (HADS) and the Positive and Negative Affect Schedule (PANAS). Among 135 TCPs, 131 were interviewed and 129 were also tested with a neuropsychological battery. All investigations were done after orchidectomy but before any additional treatment. The associations between neuropsychological test-scores and IES, HADS and PANAS were examined.
  
  
  RESULTS
  Twenty-four percent (95%CI 17%-31%) of the TCPs reported clinically significant CRD (IES-total score>26). No demographic or cancer-related variables were associated with the CRD-level. In univariate analyses, previous mental problems, sleeping problems, a higher level of neuroticism, daily smoking and hazardous alcohol-use were significantly associated with the CRD-level. In multivariate analysis neuroticism, smoking and alcohol-use remained significantly associated with CRD. Four out of 18 neuropsychological test-scores were significantly associated with at least one distress-measure. Increasing distress-levels were associated with decreasing test performance on some measures of attention, working memory and executive functions.
  
  
  CONCLUSIONS
  In newly diagnosed TCPs, the scores on neuropsychological tests should be considered in relation to co-existing mental distress. Future studies should consider adjustment for this on relevant tests.
authors.affiliation: National Resource Center for Late Effects, Department of Oncology, Oslo University Hospital, The Norwegian Radium Hospital, Montebello, Oslo, Norway. Tone.Skaali@oslo-universitetssykehus.no
authors.forename: Tone
authors.initials: T
authors.lastname: Skaali
authors.forename: Sophie D
authors.initials: SD
authors.lastname: Fosså
authors.forename: Stein
authors.initials: S
authors.lastname: Andersson
authors.forename: Carl W
authors.initials: CW
authors.lastname: Langberg
authors.forename: Gustav
authors.initials: G
authors.lastname: Lehne
authors.forename: Alv A
authors.initials: AA
authors.lastname: Dahl
mesh_terms: D000293:Adolescent; D000328:Adult; D003863:Depression / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D009664:Norway; D011446:Prospective Studies; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000523:psychology*; D055815:Young Adult