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Management of Psychosocial Distress by Oncologists

Dr. Muriel is with the Department of Psychosocial Oncology and Palliative Care and Dr. Kornblith is with the Department of Psycho-oncology Research, Dana-Farber Cancer Institute, 44 Binney St., Boston, MA 02115 (e-mail: amuriel{at}partners.org). Ms. Hwang, Dr. Greer, Dr. Greenberg, and Dr. Pirl are with the Department of Psychiatry and Dr. Temel and Dr. Schapira are with the Hematology and Oncology Unit, Massachusetts General Hospital, Boston.

OBJECTIVE: Little is known about the nature of psychosocial care delivered by oncologists. The goal of this study was to survey oncologists about their management of psychosocial distress, referencing the National Comprehensive Cancer Network guidelines. METHODS: A random sample of 1,000 oncologists were sent an e-mail requesting their participation in an online survey; nonrespondents were sent the survey through postal mail. Regression analyses were conducted to identify independent predictors of care. RESULTS: Forty-six percent (448 of 965) of oncologists responded. Practice locations included: community (63%), cancer center (25%), and hospital (7%). Respondents estimated that over one-third of their patients (mean±SD=38%±22%) experience psychosocial distress warranting intervention, although only 225 of 447 (50%) indicated having mental health services affiliated with their practice. Nearly half (212 of 447, 47%) reported only initiating a referral for psychosocial services, and 214 of 447 (48%) reported both making a referral and starting psychiatric medications, mainly selective serotonin reuptake inhibitors and benzodiazepines. CONCLUSIONS: Most oncologists delivered some level of psychosocial care, although only half had affiliated mental health services.

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				S. Gulliver Psychosocial Distress in Cancer Patients' Families Psychiatr Serv, November 1, 2009; 60(11): 1559 - 1560. [Full Text] [PDF]

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