Artikel
Postoperative psychooncological screening of neurosurgical patients – identifying risk factors increasing pyschooncological distress
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Veröffentlicht: | 8. Juni 2016 |
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Gliederung
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Objective: Patients with intracranial lesions are associated with high rates of anxiety and depressive symptoms in 15-38%. Early diagnosis and psychooncological treatment is of high relevance to relieve psychological distress. Routine screening during hospitalization in a neurosurgical setting does still not exist. Therefore we were interested to identify risk factors for increased psychological distress to facilitate further psychooncological consultation for these patients.
Method: Patients who were electively admitted for surgery of intracranial lesions were postoperatively screened for their psychological distress using two different self-assessment instruments the Distress Thermometer (DT) and the Hospital Anxiety and Depression Scale (HADS) and one external questionnaire Psychooncological base documentation (PO- Bado). Screening results were correlated with the neurosurgical diagnosis, socio-demographic data and EORTC QLQ-C30-BN20.
Results: In a bi-centric study setting 505 patients (median age 54 years, 241 men, 264 women) could be analyzed from October 2013 to March 2015. According to diagnosis patients were divided into: Group A (n=279) patients with malignant cerebral lesions (anaplastic gliomas (n=194), brain metastasis (n=65), other malignant diagnosis (n=20)); Group B (n=226)) with benign lesions (vascular diagnoses (n=39), meningioma (n=110), pituitary tumors (n=33), other diagnosis (n=44)). 289 patients (57.2%) presented positive screening (Group A (n=173); Group B (n=116)). Significant increased distress was observed in young women (p=0.02), in patients with tumor recurrence (p=0.002) and positive psychological anamneses (p<0.001). Coherence between positive screening tests and reduced global health was demonstrated in 73,1%.
Conclusions: Our results implicate high emotional distress caused by neurosurgical treatment independent from diagnosis. We could identify important factors with significant impact on psychological distress. There is also a clear congruence between reduced global health, higher rates of future uncertainty and increased psychooncological distress.