title: Co-morbid mental health conditions in cancer patients at working age--prevalence, risk profiles, and care uptake.
abstract: OBJECTIVE
  This study examined the prevalence of mental health conditions in cancer patients, the role of socioeconomic position in relation to that, and the use of professional mental health care.
  
  
  METHODS
  Prospective cohort with measurements at the beginning of inpatient treatment (baseline) and 3, 9, and 15 months after baseline using structured clinical interviews based on DSM-IV, questionnaires, and medical records.
  
  
  RESULTS
  At baseline, 149 out of 502 cancer patients (30%) were diagnosed with a mental health condition. Prevalence was associated with unemployment (odds ratio [OR] 2.0), fatigue (OR 1.9), and pain (OR 1.7). Of those with mental health conditions, 9% saw a psychotherapist within 3 months of the diagnosis, 19% after 9 months, and 11% after 15 months. Mental health care use was higher in patients with children ≤18 years (OR 3.3) and somatic co-morbidity (OR 2.6). There was no evidence for an effect of sex on the use of mental health care.
  
  
  CONCLUSIONS
  Few cancer patients with psychiatric disorders receive professional mental health care early enough. If patients are unemployed or if they suffer from fatigue or pain, special attention should be paid because the risk of having a mental health condition is increased in these patients.
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre, Johannes Gutenberg University, Mainz, Germany.|Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany.|Division of Psychosocial Oncology, University of Leipzig, Leipzig, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Singer
authors.affiliation: Division of Psychosocial Oncology, University of Leipzig, Leipzig, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Szalai
authors.affiliation: Breast Cancer Centre, University of Leipzig, Leipzig, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Briest
authors.affiliation: Cancer Epidemiology Unit, University of Oxford, Oxford, UK.
authors.forename: A
authors.initials: A
authors.lastname: Brown
authors.affiliation: Department of Otolaryngology, University of Leipzig, Leipzig, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Dietz
authors.affiliation: Department of Obstetrics and Gynecology, University of Leipzig, Leipzig, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Einenkel
authors.affiliation: Department of Surgery, University of Leipzig, Leipzig, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Jonas
authors.affiliation: Department of Medical Sociology and Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Konnopka
authors.affiliation: Department of Radiation-Oncology, University of Leipzig, Leipzig, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Papsdorf
authors.affiliation: Breast Cancer Centre, Hospital St. Elisabeth, Leipzig, Germany.
authors.forename: D
authors.initials: D
authors.lastname: Langanke
authors.affiliation: Department of Social Medicine, Occupational Health, and Public Health, University of Leipzig, Leipzig, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Löbner
authors.affiliation: Department of Maxillofacial Surgery, University of Leipzig, Leipzig, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Schiefke
authors.affiliation: Department of Urology, University of Leipzig, Leipzig, Germany.
authors.forename: J-U
authors.initials: JU
authors.lastname: Stolzenburg
authors.affiliation: Cancer Centre, Hospital St. Georg, Leipzig, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Weimann
authors.affiliation: Department of Pulmonology, University of Leipzig, Leipzig, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Wirtz
authors.affiliation: Department of Medical Sociology and Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors.forename: H H
authors.initials: HH
authors.lastname: König
authors.affiliation: Department of Social Medicine, Occupational Health, and Public Health, University of Leipzig, Leipzig, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Riedel-Heller
mesh_terms: D000275:Adjustment Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D001008:Anxiety Disorders / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D015331:Cohort Studies; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000523:psychology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D008605:Mental Health Services / Q000706:statistics & numerical data*; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D012923:Social Class; D014478:Unemployment / Q000523:psychology / Q000706:statistics & numerical data*
keywords: bladder cancer; cancer; cervix cancer; head and neck neoplasms; oncology