Psychosocial distress and desire for support among inpatients with skin cancer.

BACKGROUND: Regular assessment of psychosocial distress is an important component of adequate psycho-oncological and social support in cancer patients. To date, relevant studies on skin cancer patients have primarily included individuals with melanoma. OBJECTIVES: (1) Does the need for psychosocial support vary with the type of skin cancer? (2) Do mentally distressed patients desire support? (3) From the various individuals in the treatment team, whom do patients choose as potential contact person? PATIENTS UND METHODS: Inpatients with skin cancer were asked to self-assess their psychosocial situation using the Hornheide questionnaire. In addition, they were asked about their desire for psychosocial support and the preferred potential contact person. RESULTS: The need for support among the 116 patients surveyed varied significantly depending on the diagnosis (p = 0.007). However, the direct comparison between patients with melanoma (n = 38; 32.8 %) and squamous cell carcinoma (n = 9; 7.8 %) (p = 0.724) or other types of skin cancer (n = 20; 17.2 %) (p = 0.366) revealed no such difference. The prevalence of psychosocial distress (n = 49; 42.2 %) and the desire for support (n = 20; 17.4 %) showed considerable differences. Patients primarily chose a physician (n = 14/35) or a psychologist (n = 13/35) as potential "go-to" person for their mental distress. CONCLUSIONS: Apart from psychosocial distress, the desire for support should be assessed, and patients should be provided access to additional psychosocial care options. With respect to the need for psychosocial support, it does not seem to be justified to preferentially - or even exclusively - consider melanoma patients in clinical practice and research.

Psychosocial burden and desire for support in outpatients with skin cancer.

BACKGROUND: An important basis for adequate psycho-oncological and psychosocial care of cancer patients is the regular assessment of their psychosocial distress and thus their need for care. For this purpose, there are numerous questionnaires available. The objective of the present study was to assess whether distressed patients require professional support and which screening instrument outpatients with skin cancer prefer. PATIENTS AND METHODS: In a cross-sectional survey, we asked outpatients with skin cancer to fill out three questionnaires assessing psychosocial stress, and to indicate which one they considered most adequate. Patients were offered the following three instruments: Hornheide Questionnaire (27 items), Hornheide Screening Instrument (7 items), and the Distress Thermometer. In addition, we inquired about the patients' desire for support. RESULTS: (1) Comparing subjective distress and patients' declared desire for support revealed a marked divergence. While one-third of the 137 patients were identified as being in need of care, only 11.5% of the sample requested such support. (2) 63.7% of patients chose the long version of the Hornheide Questionnaire. CONCLUSIONS: In addition to their psychosocial burden, patients' desire for support should be assessed. Moreover, apart from screening tools, other ways to provide access to psychosocial care should be considered.

[Not quite the same: illness beliefs regarding burnout and depression among the general population]. / Nicht ganz dasselbe: Krankheitsvorstellungen von Burnout und Depression in der Allgemeinbevölkerung.

OBJECTIVE: This study examined illness beliefs of the lay public associated with the diagnostic labels burnout and depression. METHODS: Representative population survey in Germany 2011, using unlabelled case vignettes of a person suffering from depression. Following presentation of the vignette, respondents were asked openly how they would call the problem described. Agreement with various illness beliefs was elicited with Likert-scaled items. RESULTS: Seeing the problem as inherited predicted use of the label depression (OR 1.29, p < 0.001), while stress at work as a perceived cause was associated with use of the label burnout (OR 1.56, p < 0.001). Belief that the problem described resembled everyday experiences (belief in a symptom continuum) also predicted using the label burnout instead of depression (OR 1.31, p < 0.05). CONCLUSION: Although overlapping with beliefs about depression, the diagnostic label burnout is also associated with specific illness beliefs among the general public.

[Calling it "Burnout" Instead of "Depression" - A Strategy to Avoid Stigma?]. / "Burnout" statt "Depression" - eine Strategie zur Vermeidung von Stigma?

OBJECTIVE: To find out to what extent the German public uses the term "burnout" to label a depressive episode, and to examine how this label relates to stigmatizing attitudes and treatment recommendations. METHODS: Representative population surveys in Germany 2001 (n = 5025) and 2011 (n = 3642), using unlabeled case vignettes of mental disorders. RESULTS: Labeling a depressive episode "burnout" increased from 0.3 % in 2001 to 10.2 % in 2011. Schizophrenia and alcohol dependence were labeled "burnout" far less frequently. Compared to the label "depression", "burnout" was associated with less desire for social distance, but also with less recommendation of psychotherapy, medication, and seeing a psychiatrist. CONCLUSION: While provoking less desire for social distance than "depression", using the label "burnout" carries the risk of increasing the proportion of untreated depressive episodes.