[Prevalence of adjustment disorder, acute and posttraumatic stress disorders as well as somatoform disorders in cancer patients]. / Prävalenz von Anpassungsstörung, Akuter und Posttraumati-scher Belastungsstörung sowie somatoformen Störungen bei Krebspatienten.

We aimed to systematically summarize the empirical evidence on the 4-week-, 12-month-, and lifetime prevalence of adjustment disorders, acute and posttraumatic stress disorders as well as somatoform disorders in cancer patients. We evaluated 64 English or German language original papers and systematic reviews that assessed the prevalence of affective and anxiety disorders using structured clinical interviews published between 1995 and 2010. Adjusted prevalence rates were calculated using a random-intercept model. We found the following pooled adjusted 4-week prevalence rates: For adjustment disorder 12.5% (95% CI 9.9-15.7), for posttraumatic stress disorder 2.6% (95% CI 1.7-4.0), for acute stress disorder 4.8% (95% CI 2.2-10.0) and for somatoform disorders 3.1% (95% CI 1.6-5.8). Our findings show the need for further research on representative studies that take into account the range of psychosocial stressors and supportive care needs.

Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis.

PURPOSE: This study aimed to evaluate the effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer. METHODS: Literature databases were searched to identify randomized controlled trials that compared a psycho-oncologic intervention delivered face-to face with a control condition. The main outcome measures were emotional distress, anxiety, depression, and quality of life. Outcomes were evaluated for three time periods: post-treatment, ≤ 6 months, and more than 6 months. We applied standard meta-analytic techniques to analyze both published and unpublished data from the retrieved studies. Sensitivity analyses and meta-regression were used to explore reasons for heterogeneity. RESULTS: We retrieved 198 studies (covering 22,238 patients) that report 218 treatment-control comparisons. Significant small-to-medium effects were observed for individual and group psychotherapy and psychoeducation. These effects were sustained, in part, in the medium term (≤ 6 months) and long term (> 6 months). Short-term effects were evident for relaxation training. Studies that preselected participants according to increased distress produced large effects at post-treatment. A moderator effect was found for the moderator variable "duration of the intervention," with longer interventions producing more sustained effects. Indicators of study quality were often not reported. Small-sample bias indicative of possible publication bias was found for some effects, particularly with individual psychotherapy and relaxation training. CONCLUSION: Various types of psycho-oncologic interventions are associated with significant, small-to-medium effects on emotional distress and quality of life. These results should be interpreted with caution, however, because of the low quality of reporting in many of the trials.

[Prevalence of affective and anxiety disorders in cancer: systematic literature review and meta-analysis]. / Prävalenz affektiver und Angststörungen bei Krebs: Systematischer Literaturreview und Metaanalyse.

We aimed to systematically summarize the empirical evidence on the 4-week-, 12-month-, and lifetime prevalence of affective and anxiety disorders in cancer patients. We evaluated 89 English or German language original papers and systematic reviews that assessed the prevalence of affective and anxiety disorders using structured clinical interviews published between 1995 and 2010. Adjusted prevalence rates were calculated using a random-intercept model. The pooled adjusted 4-week prevalence of affective disorders was 11.1% (95% CI 8.1-15.1), and 10.8% (95% CI 6.8-16.7) based on German studies. The pooled adjusted 4-week prevalence of anxiety disorders was 10.2% (95% CI 6.9-14.8), and 13.5% (95% CI 7.1-24.3) based on German studies. The findings show the need for further research on representative studies that take into account the range of psychosocial stressors and supportive care needs in addition to the prevalence of mental disorders.