title: Perceived need for psychosocial support depending on emotional distress and mental comorbidity in men and women with cancer.
abstract: OBJECTIVE
  Although elevated levels of distress are supposed to constitute a need for psychosocial support, the relation between elevated distress and need for support does not appear to be straightforward. We aimed to determine cancer patients' perceived need for psychosocial support, and examine the relation of need to both self-reported emotional distress and the interview-based diagnosis of a mental disorder.
  
  
  METHODS
  In a multicenter, cross-sectional study in Germany, 4020 cancer patients (mean age 58 years, 51% women) were evaluated. We obtained self-reports of need for psychosocial support. We measured distress with the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) and depressive symptoms with the Patient Health Questionnaire (PHQ-9). In a subsample, we evaluated the presence of a mental disorder using the Composite International Diagnostic Interview (CIDI).
  
  
  RESULTS
  32.1% (95%-CI 30.6 to 33.6) of patients perceived a need for psychosocial support. Younger age, female sex, and higher education were associated with more needs, being married and living with a partner with fewer needs, respectively. While up to 51.2% of patients with elevated distress levels reported a need for psychosocial support, up to 26.1% of those without elevated distress levels perceived such a need. Results were similar across distress assessment methods.
  
  
  CONCLUSIONS
  Our findings emphasize that the occurrence of mental distress is one important but not an exclusive factor among different motives to report the need for psychosocial support. We should thus consider multifaceted perspectives, facilitators and barriers when planning and implementing patient-centered psychosocial care services.
authors.affiliation: Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Klinikstrasse 3, 97070 Würzburg, Germany. Electronic address: h.faller@uni-wuerzburg.de.
authors.forename: Hermann
authors.initials: H
authors.lastname: Faller
authors.affiliation: Department of Psychooncology, Tumor Biology Center, University of Freiburg, Breisacher Strasse 117, 79106 Freiburg, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Weis
authors.affiliation: Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
authors.forename: Uwe
authors.initials: U
authors.lastname: Koch
authors.affiliation: Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, 04103 Leipzig, Germany; Department of Psychosomatic Medicine and Psychotherapy, Universal Medical Center Mainz, Untere Zahlbacherstrasse 8, 55131 Mainz, Germany.
authors.forename: Elmar
authors.initials: E
authors.lastname: Brähler
authors.affiliation: Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Härter
authors.affiliation: Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 155, 69120 Heidelberg, Germany.
authors.forename: Monika
authors.initials: M
authors.lastname: Keller
authors.affiliation: Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Schulz
authors.affiliation: Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
authors.forename: Karl
authors.initials: K
authors.lastname: Wegscheider
authors.affiliation: Department of Psychooncology, Tumor Biology Center, University of Freiburg, Breisacher Strasse 117, 79106 Freiburg, Germany.
authors.forename: Anna
authors.initials: A
authors.lastname: Boehncke
authors.affiliation: Rhein-Jura-Klinik, Bad Säckingen, Germany; Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstrasse 5, 79104 Freiburg, Germany.
authors.forename: Bianca
authors.initials: B
authors.lastname: Hund
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Hauptstrasse 5, 79104 Freiburg, Germany.
authors.forename: Katrin
authors.initials: K
authors.lastname: Reuter
authors.affiliation: Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Klinikstrasse 3, 97070 Würzburg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Richard
authors.affiliation: Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Sehner
authors.affiliation: Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, 04103 Leipzig, Germany; Psychosocial Counselling Center for Cancer Patients, Schlobigplatz 23, 08056 Zwickau, Germany.
authors.forename: Carina
authors.initials: C
authors.lastname: Szalai
authors.affiliation: Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technical University Dresden, Chemnitzer Strasse 46, 01187 Dresden, Germany.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
authors.affiliation: Department of Medical Psychology and Medical Sociology, Section of Psychosocial Oncology, University Medical Center Leipzig, Philipp-Rosenthal-Strasse 55, 04103 Leipzig, Germany.
authors.forename: Anja
authors.initials: A
authors.lastname: Mehnert
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D011788:Quality of Life; D012938:Social Perception; D012944:Social Support; D013315:Stress, Psychological / Q000209:etiology*
keywords: Cancer; Emotional Distress; Mental Disorder; Needs; Psychosocial Support