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Cancer patients' reluctance to discuss psychological distress with their physicians was not associated with underrecognition of depression by physicians: A preliminary study

Published online by Cambridge University Press:  18 June 2009

Toru Okuyama ,
Chiharu Endo ,
Takashi Seto ,
Masashi Kato ,
Nobuhiko Seki ,
Tatsuo Akechi ,
Toshiaki A. Furukawa ,
Kenji Eguchi  and
Takashi Hosaka
Toru Okuyama*
Affiliation:
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan Course of Specialized Clinical Care, Psychiatry, Tokai University School of Medicine, Tokai, Japan
Chiharu Endo
Affiliation:
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan Course of Specialized Clinical Care, Psychiatry, Tokai University School of Medicine, Tokai, Japan
Takashi Seto
Affiliation:
Course of Internal Medicine, Medical Oncology, Tokai University School of Medicine, Tokai, Japan Department of Thoracic Oncology, National Kyushu Cancer Center, Kyushu, Japan
Masashi Kato
Affiliation:
Course of Specialized Clinical Care, Psychiatry, Tokai University School of Medicine, Tokai, Japan
Nobuhiko Seki
Affiliation:
Course of Internal Medicine, Medical Oncology, Tokai University School of Medicine, Tokai, Japan Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Teikyo, Japan
Tatsuo Akechi
Affiliation:
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
Toshiaki A. Furukawa
Affiliation:
Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
Kenji Eguchi
Affiliation:
Division of Medical Oncology, Department of Internal Medicine, Teikyo University School of Medicine, Teikyo, Japan Oncology Center, Tokai University School of Medicine, Tokai, Japan
Takashi Hosaka
Affiliation:
Course of Specialized Clinical Care, Psychiatry, Tokai University School of Medicine, Tokai, Japan
*
Address correspondence and reprint requests to: Toru Okuyama, Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601Japan. E-mail: okuyama@med.nagoya-cu.ac.jp
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Abstract

Objective:

To investigate the association between cancer patients' reluctance for emotional disclosure to their physician and underrecognition of depression by physicians.

Methods:

Randomly selected ambulatory patients with lung cancer were evaluated by the Hospital Depression and Anxiety Scale (HADS), and those with scores over the validated cutoff value for adjustment disorder or major depressive disorder were included in this analysis. The data set included the responses to the 13-item questionnaire to assess four possible concerns of patients in relation to emotional disclosure to the treating physician (“no perceived need to disclose emotions,” “fear of the negative impact of emotional disclosure,” “negative attitude toward emotional disclosure,” “hesitation to disturb the physician with emotional disclosure”). The attending physicians rated the severity of depression in each patient using 3-point Likert scales (0 [absent] to 2 [clinical]). Depression was considered to be underrecognized when the patients had a HADS score above the cutoff value, but in whom the depression rating by the attending physician was 0.

Results:

The HADS score was over the cutoff value in the 60 patients. The mean age was 65.1 ± 10.0, and 82% had advanced cancer (Stage IIIb or IV or recurrence). Depression was underrecognized in 44 (73%) patients. None of the four factors related to reluctance for emotional disclosure was associated with the underrecognition of depression by the physicians. None of the demographic or cancer–related variables were associated with depression underrecognition by physicians.

Significance of results:

The results did not support the assumption that patients' reluctance for emotional disclosure is associated with the underrecognition of depression by physicians.

Keywords

OncologyCommunicationPsycho-OncologyDepressionQuality of life
Type
Original Articles
Information
Palliative & Supportive Care , Volume 7 , Issue 2 , June 2009 , pp. 229 - 233
Copyright
Copyright © Cambridge University Press 2009

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