Poster Presentation Clinical Oncology Society of Australia 2014 Annual Scientific Meeting

The Northern Health Outpatient Psycho-Oncology Service: Referral patterns and change in psychological distress over time.  (#440)

Hunter Mulcare 1
  1. Northern Health, Epping, Vic, Australia

Aims: Only a small proportion of cancer patients access psychological help despite one third of patients experiencing significant psychological distress following their diagnosis. Data on the use of psychological services can help identify patient groups that are under serviced. This poster will present preliminary data on a project aiming to identify which patients attend the psycho-oncology service, what psychological problems they present with, and how these change over time.  

Methods: Patients attending the service are given a Hospital Anxiety and Depression Scale and a 12-item measure of psychological adjustment at their first, third and sixth appointments with the psychologist. Disease and demographic data are collected as well.

Results: Preliminary results from 13 of 18 patients referred between March and August 2014 (2 non English speaking, 3 declined) indicate that patients referred were predominantly females (10), without metastatic disease (10), middle aged (average 53.1 years), and had breast cancer (8) or colorectal cancer (2). At first appointment, two-thirds (8) of patients reported significant anxiety; one-third (4) had significant depressive symptoms, whilst one-third (4) reported significant symptoms of both. Longitudinal data available for 10 participants indicates significant decreases in both anxiety (11.1 to 9, p =.04) and depression symptoms (8.5 to 6,p=.03) at Time 2. Cognitive distress decreased at time 2 (p=0.03) whilst fighting spirit, emotional distress and cognitive avoidance had not changed significantly (FS p =0.77, ED p= 0.12, CA p = 0.09).

Discussion: The majority of patients referred for psychology have significant levels of psychological distress, particularly anxiety. This suggests either anxiety is the most prevalent form of distress in patients treated at the hospital, or that it is more easily recognised by referrers and depressed patients are less commonly referred. Longitudinal data indicates distress decreases over time.  The over representation of breast cancer patients referred likely reflects the role of the breast cancer nurses and the lack of similar effective screening in other tumour streams.