Mental Health Disorder Burden Unveiled in German Cancer Patients

Mental health disorders are common among cancer patients in Germany

medwireNews: Almost a third of cancer patients in Germany are affected by at least one mental health disorder, suggests research published in the Journal of Clinical Oncology.

The 4-week prevalence of any mental health disorder was 31.75%, with the most common diagnoses being anxiety disorders (11.45%), adjustment disorders (11.07%) and mood disorders (6.48%). In addition, 5.27% of patients were diagnosed with somatoform or conversion disorders, while 4.50% had nicotine dependence and 0.33% alcohol abuse or dependence.

However, the prevalence significantly varied depending on tumour type, report Anja Mehnert, from University Medical Center Leipzig in Germany, and co-authors.

“Our findings emphasize the importance of providing target-group–oriented cancer-entity–specific psychological interventions”, they write.

The team used the PHQ-9 self-report measure for depression to screen 4020 patients attending 30 acute care, outpatient or cancer rehabilitation centres in Germany. In all, 2141 of the patients scored 9 or above and went on to complete an adapted form of the computer-assisted Composite International Diagnostic Interview for mental health disorders.

The highest 4-week prevalence of mental health disorders was found among patients with breast cancer (41.59%), head and neck cancer (40.78%), malignant melanoma (38.98%), kidney and urinary tract cancer (36.36%), female genital cancer (36.07%) and haematological cancers (33.33%).

By contrast, mental health disorders were less prevalent among patients with pancreatic cancer (20.25%), stomach and oesophagus cancer (21.21%), prostate cancer (21.55%), bladder cancer (26.58%), lung cancer (28.28%) and colorectal cancer (28.35%).

“Several known risk factors might contribute to these findings, including different disease stages, treatment phases, and medical conditions, such as the presence of pain and functional impairments”, the researchers hypothesise.

Anja Mehnert et al acknowledge that age, gender, educational attainment and other socioeconomic factors likely contribute to differences in the prevalence of mental health disorders among cancer patients.

“In this analysis, however, we present the prevalence estimates for mental disorders not adjusted for any of those risk factors to provide valid data necessary to determine the overall need for implementing psychosocial support for cancer patients”, they explain.


Mehnert A, Brähler E, Faller H, et al. Four-week prevalence of mental disorders in patients with cancer across major tumor entities. J Clin Oncol; Advance online publication 6 October 2014 doi: 10.1200/JCO.2014.56.0086

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