Allografting

Bone Marrow Transplantation (2005) 35, 77–83. doi:10.1038/sj.bmt.1704709 Published online 25 October 2004

Routine screening for psychosocial distress following hematopoietic stem cell transplantation

S J Lee1, F R Loberiza2, J H Antin1, T Kirkpatrick1, L Prokop1, E P Alyea1, C Cutler1, V T Ho1, P G Richardson1, R L Schlossman1, D C Fisher1, B Logan2 and R J Soiffer1

  1. 1Department of Adult Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
  2. 2Health Policy Institute, Medical College of Wisconsin, Milwaukee, WI, USA

Correspondence: Dr SJ Lee, Dana-Farber Cancer Institute, Boston, MA 02115, USA. E-mail: stephanie_lee@dfci.harvard.edu

Received 25 May 2004; Accepted 3 August 2004; Published online 25 October 2004.

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Abstract

The diagnosis and treatment of cancer is often associated with high levels of psychosocial distress, yet exploration of these issues is rarely included in routine oncologic care. We conducted a pilot study to evaluate the feasibility of screening for psychosocial distress after autologous and allogeneic stem cell transplantation. A total of 80 adults were enrolled in Boston, MA, USA. Subjects completed self-administered assessments prior to hospital admission, at their first clinic visit after hospital discharge, and at 100 days post transplant. Assessments included validated instruments assessing psychosocial distress and quality of life (QOL). Elevated levels of anxiety and/or depression were detected in 55% of those providing pre-transplant assessments and were associated with compromised QOL. Post transplant screening was successfully performed in 69% of subjects and identified that 44% had symptoms of depression, anxiety or post traumatic stress disorder. Pre-transplant distress was associated with detection of distress after transplantation (81 vs 13%, P<0.0001). In summary, we detected high levels of distress in transplant patients using self-administered tools. Pre-transplant distress appears to be highly predictive of distress post transplant and is a feasible marker to target screening and intervention programs.

Keywords:

screening, depression, anxiety, quality of life, stem cell transplantation