title: Screening for psychological distress in follow-up care to identify head and neck cancer patients with untreated distress.
abstract: The purpose of the study is to investigate screening in follow-up care to identify head and neck cancer (HNC) patients with untreated psychological distress.
  
  
  
  From November 2009 until December 2012, we investigated the use of OncoQuest (a touch screen computer system to monitor psychological distress (Hospital Anxiety and Depression Scale (HADS)) and quality of life (HRQOL; EORTC QLQ-C30 and H&N35 module) in routine follow-up care. Patients who screened positive for psychological distress (HADS-T >14, HADS-A >7, or HADS-D >7) were asked whether they received psychological or psychiatric treatment.
  
  
  
  During the study period of 37 months, OncoQuest was used by 720 individual HNC patients, of whom 714 had complete HADS data. Psychological distress was present in 206 patients (29 %). Of those patients who fulfilled in- and exclusion criteria (n = 137), 25 received psychological treatment (18 %). Receipt of psychological treatment was significantly related to a higher score on the HADS total scale (19.6 vs. 16.9; p = 0.019), a lower (worse) score on the EORTC QLQ-C30 scale emotional functioning (46.0 vs. 58.6; p = 0.023), a higher (worse) score on fatigue (58.2 vs. 46.4; p = 0.032), problems with sexuality (44.1 vs. 34.4; p = 0.043), oral pain (43.8 vs. 28.8; p = 0.011) and speech problems (37.0 vs. 25.3; p = 0.042).
  
  
  
  Screening for psychological distress via OncoQuest is beneficial because 82 % of HNC patients identified with an increased level of distress who do not yet receive mental treatment were identified. Patients who did receive treatment reported more distress and worse quality of life, which may be explained because patients with more severe problems maybe more inclined to seek help or might be detected easier by caregivers and referred to supportive care more often.
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, PO Box 7057, 1007, MB, Amsterdam, The Netherlands.
authors.forename: Anne-Marie H
authors.initials: AM
authors.lastname: Krebber
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, PO Box 7057, 1007, MB, Amsterdam, The Netherlands.
authors.forename: Femke
authors.initials: F
authors.lastname: Jansen
authors.affiliation: Department of Clinical Psychology, VU University, Van der Boechorststraat 1, 1081, BT, Amsterdam, The Netherlands.
authors.forename: Pim
authors.initials: P
authors.lastname: Cuijpers
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, PO Box 7057, 1007, MB, Amsterdam, The Netherlands.
authors.forename: C René
authors.initials: CR
authors.lastname: Leemans
authors.affiliation: Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, PO Box 7057, 1007, MB, Amsterdam, The Netherlands. im.verdonck@vumc.nl.|Department of Clinical Psychology, VU University, Van der Boechorststraat 1, 1081, BT, Amsterdam, The Netherlands. im.verdonck@vumc.nl.
authors.forename: Irma M
authors.initials: IM
authors.lastname: Verdonck-de Leeuw
mesh_terms: D000328:Adult; D000359:Aftercare; D000368:Aged; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D005221:Fatigue / Q000209:etiology / Q000523:psychology; D005260:Female; D006258:Head and Neck Neoplasms / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D013315:Stress, Psychological / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires
keywords: Anxiety; Depression; Head and neck cancer; Oncology; Screening for psychological distress