title: High level of distress in long-term survivors of thyroid carcinoma: results of rapid screening using the distress thermometer.
abstract: BACKGROUND
  Cancer patients are at increased risk for distress. The Distress Thermometer (DT) and problem list (PL) are short-tools validated and recommended for distress screening in cancer patients.
  
  
  OBJECTIVE
  To investigate the level of distress and problems experienced by survivors of differentiated non-medullary thyroid carcinoma (DTC), using the DT and PL and whether this correlates with clinical and demographical variables.
  
  
  METHODS
  All 205 DTC patients, under follow-up at the outpatient clinic of our university hospital, were asked to fill in the DT and PL, hospital anxiety and depression scale (HADS), illness cognition questionnaire (ICQ) and an ad hoc questionnaire. Receiver Operator Characteristic analysis (ROC) was used to establish the optimal DT cut-off score according to HADS. Correlations of questionnaires scores with data on diagnosis, treatment and follow-up collected from medical records were analyzed.
  
  
  RESULTS
  Of the 159 respondents, 145 agreed to participate [118 in remission, median follow-up 7.2 years (range 3 months-41 years)]. Of these, 34.3% rated their distress score ≥5, indicating clinically relevant distress according to ROC analysis. Patients reported physical (86%) over emotional problems (76%) as sources of distress. DT scores correlated with HADS scores and ICQ subscales. No significant correlations were found between DT scores and clinical or demographical characteristics except for employment status.
  
  
  CONCLUSIONS
  Prevalence of distress is high among patients with DTC even after long-term remission and cannot be predicted by clinical and demographical characteristics. DT and PL are useful screening instruments for distress in DTC patients and could easily be incorporated into daily practice.
authors.affiliation: Department of Endocrinology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Sean H P P
authors.initials: SH
authors.lastname: Roerink
authors.forename: Mischa
authors.initials: M
authors.lastname: de Ridder
authors.forename: Judith
authors.initials: J
authors.lastname: Prins
authors.forename: Angelique
authors.initials: A
authors.lastname: Huijbers
authors.forename: Hans J H
authors.initials: HJ
authors.lastname: de Wilt
authors.forename: Henri
authors.initials: H
authors.lastname: Marres
authors.forename: Han
authors.initials: H
authors.lastname: Repping-Wuts
authors.forename: Nike M M L
authors.initials: NM
authors.lastname: Stikkelbroeck
authors.forename: Henri J
authors.initials: HJ
authors.lastname: Timmers
authors.forename: Ad R M M
authors.initials: AR
authors.lastname: Hermus
authors.forename: Romana T
authors.initials: RT
authors.lastname: Netea-Maier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000453:epidemiology; D001835:Body Weight; D002277:Carcinoma / Q000523:psychology; D004522:Educational Status; D004651:Employment; D005221:Fatigue / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D009426:Netherlands / Q000453:epidemiology; D010292:Paresthesia / Q000453:epidemiology; D011569:Psychiatric Status Rating Scales; D012372:ROC Curve; D012017:Referral and Consultation; D012893:Sleep Wake Disorders / Q000453:epidemiology; D013315:Stress, Psychological / Q000175:diagnosis* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013964:Thyroid Neoplasms / Q000523:psychology*; D055815:Young Adult