title: Psychological distress and unsatisfied need for psychosocial support in adolescent and young adult cancer patients during the first year following diagnosis.
abstract: OBJECTIVE
  Identifying at-risk adolescent and young adult (AYA) cancer patients and referring them to age-appropriate psychosocial support services may be instrumental in reducing psychological distress and promoting psychosocial adaptation. The purpose of this study is to identify trajectories of clinically significant levels of distress throughout the first year following diagnosis and to distinguish factors, including supportive care service use, that predict the extent to which AYAs report distress.
  
  
  METHODS
  In this prospective multisite study, 215 AYAs aged 15-39 years were assessed for psychological distress and psychosocial support service use within the first 4 months of diagnosis and again 6 and 12 months later. On the basis of distress scores, respondents were assigned to one of four distress trajectory groups (Resilient, Recovery, Delayed, and Chronic). Multiple logistic regression analyses examined whether demographics, clinical variables, and reports of unsatisfied need for psychosocial support were associated with distress trajectories over 1 year.
  
  
  RESULTS
  Twelve percent of AYAs reported clinically significant chronic distress throughout the first 12 months following diagnosis. An additional 15% reported delayed distress. Substantial proportions of AYAs reported that needs for information (57%), counseling (41%), and practical support (39%) remained unsatisfied at 12 months following diagnosis. Not getting counseling needs met, particularly with regard to professional mental health services, was observed to be significantly associated with distress over time.
  
  
  CONCLUSIONS
  Substantial proportions of AYAs are not utilizing psychosocial support services. Findings suggest the importance of identifying psychologically distressed AYAs and addressing their needs for mental health counseling throughout a continuum of care.
authors.affiliation: School of Social Work, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Brad J
authors.initials: BJ
authors.lastname: Zebrack
authors.forename: Virginia
authors.initials: V
authors.lastname: Corbett
authors.forename: Leanne
authors.initials: L
authors.lastname: Embry
authors.forename: Christine
authors.initials: C
authors.lastname: Aguilar
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Meeske
authors.forename: Brandon
authors.initials: B
authors.lastname: Hayes-Lattin
authors.forename: Rebecca
authors.initials: R
authors.lastname: Block
authors.forename: David T
authors.initials: DT
authors.lastname: Zeman
authors.forename: Steven
authors.initials: S
authors.lastname: Cole
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000523:psychology* / Q000628:therapy; D015331:Cohort Studies; D003863:Depression / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D020380:Needs Assessment; D009369:Neoplasms / Q000523:psychology*; D011446:Prospective Studies; D055500:Resilience, Psychological; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology* / Q000628:therapy; D055815:Young Adult
keywords: adolescent; distress; psychosocial; young adult