Utilization of professional psychological care in a large German sample of cancer patients.
Although one-third of cancer patients are perceived to have a need for psychological support based on the percentage of mental disorders, little is known about the actual utilization of psychological care in cancer. We aimed to assess cancer patients' reported use of psychological care and its correlates in a large, representative sample.



In a multicenter, cross-sectional study in Germany, 4020 cancer patients (mean age 58 years, 51% women) were evaluated. We obtained self-reports of use of psychotherapy and psychological counseling. We measured distress with the Distress Thermometer, symptoms of depression with the Patient Health Questionnaire, anxiety with the Generalized Anxiety Disorder Scale, and social support with the Illness-specific Social Support Scale. In a subsample of 2141, we evaluated the presence of a mental disorder using the Composite International Diagnostic Interview.



In total, 28.9% (95% confidence interval 27.4%-30.4%) reported having used psychotherapy or psychological counseling or both because of distress due to cancer. Independent correlates of utilization included age (odds ratio [OR] = 0.97 per year], sex (male, OR = 0.55), social support (OR = 0.96), symptoms of depression (OR = 1.04) and anxiety (OR = 1.08), the diagnosis of a mental disorder (OR = 1.68), and a positive attitude toward psychosocial support (OR = 1.27). Less than half of those currently diagnosed with a mental disorder reported having taken up psychological support offers.



Special efforts should be made to reach populations that report low utilization of psychological care in spite of having a need for support.
Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany.
Hermann
H
Faller
Department of Psychooncology, Tumor Biology Center, University Medical Center Freiburg, Freiburg, Germany.
Joachim
J
Weis
Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Uwe
U
Koch
Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.|Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Mainz, Mainz, Germany.
Elmar
E
Brähler
Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Martin
M
Härter
Division of Psychooncology, Department for Psychosomatic and General Clinical Medicine, University Hospital Heidelberg, Heidelberg, Germany.
Monika
M
Keller
Department and Outpatient Clinic of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Holger
H
Schulz
Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Karl
K
Wegscheider
Department of Psychooncology, Tumor Biology Center, University Medical Center Freiburg, Freiburg, Germany.
Anna
A
Boehncke
Rhein-Jura-Klinik, Bad Säckingen, Germany.|Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.
Bianca
B
Hund
Department of Psychiatry and Psychotherapy, University Medical Center Freiburg, Freiburg, Germany.
Katrin
K
Reuter
Department of Medical Psychology and Psychotherapy, Medical Sociology and Rehabilitation Sciences, and Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany.
Matthias
M
Richard
Department of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Susanne
S
Sehner
Institute of Clinical Psychology and Psychotherapy and Center of Clinical Epidemiology and Longitudinal Studies (CELOS), Technical University Dresden, Dresden, Germany.
Hans-Ulrich
HU
Wittchen
Department of Medical Psychology and Medical Sociology, University Medical Center Leipzig, Leipzig, Germany.
Anja
A
Mehnert
D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D003376:Counseling / Q000458:organization & administration*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000523:psychology / Q000628:therapy*; D010817:Physician-Patient Relations; D011613:Psychotherapy; D012944:Social Support
cancer; emotional distress; mental disorder; oncology; psychological care; utilization