gms | German Medical Science

Objective: Cerebral gliomas are associated with high rates of anxiety, depression and health-related impairment of quality of life. Using different distress screening assessments patients with increased distress are offered psychooncological intervention. Less is known about the impact of psychooncological treatment or disease-specific impact factors on a successful therapy.

Methods: Patients with histopathologically diagnosed glioma screened at different time-points (before psychological treatment, afterwards and every 3 month) using three different self-assessment instruments (Hospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), EORTC-QLQ-C30 B20) as well as one external assessment questionnaire (psychooncological base documentation, PoBADO). Screening data are correlated with social and demographic data.

Results: Since April 2012, 512 patients (median age 56 years, 291 men, 221 women) were screened for their psychological distress at our neurosurgical department (median observation time 27 months). 158 (30.9%) patients underwent a psychological intervention. Data of 70 patients with screening assessments before and after psychooncologic intervention (mean 2 therapy sessions within 14 days) could be further analyzed. 31 patients (44.3%) of these presented an initial conspicuous screening. There was no significant difference regarding HADS (p=0.31), DT (p=0.76) or EORTC emotional functioning score (p=0.19) at the first screening during psychooncological intervention. EORTC future uncertainty seems to be higher after the first intervention (before m= 26.5, after first therapy m= 49.5, (p=0.000001)). In patients with only one intervention the HADS-A was increased in comparison with patients who received >1 intervention. We could also not observe a distress decrease in the course of therapy.

Conclusion: Independent from distress screening results psychooncologic intervention is favored by neurooncologic patients. As a short-term effect of psychooncological intervention patients presented an increased future uncertainty as well as anxiety scale (HADS-A), which may be explained by the confrontation with disease specific problems. In long-term analyses this observation was evened out. Effects of psychooncologic intervention seems not to be possibly quantified by further distress screening assessments. Therefore ongoing analyses are needed for further elucidation.