Prevalence of psychological distress and use of support services by cancer patients at Sydney hospitals


  • Shane Pascoe,

  • Sarah Edelman,

  • Antony Kidman

  • Sarah Edelman, Research Psychologist (Correspondence); Shane Pascoe, Graduate Research Student; Antony Kidman, Director

    Health Psychology Unit, The University of Technology, Sydney, Westbourne Street, Gore Hill, New South Wales 2065, Australia. Email:


Objective: The study aimed to estimate the prevalence of anxiety and depression within a cross section of cancer patients in the Sydney region, and to assess the use of and degree of satisfaction with available support services.

Method: A survey was conducted at oncology outpatient departments of four Sydney hospitals. Participants completed the Hospital Anxiety and Depression Scale (HADS) and a questionnaire seeking information on their use of patient support services, as well as demographic and clinical information.

Results: A total of 504 valid questionnaires were returned. Using a cut-off score of 11 on the HADS, the prevalence of clinically significant anxiety and depression was 11.5% and 7.1% respectively; 17% of patients had received individual counselling while 6.5% had attended support groups. The majority of patients who had attended counselling or support groups reported them to have been ‘extremely’ or ‘reasonably’ helpful (86% and 83% respectively). Of the patients who were experiencing clinically significant anxiety or depression, 75% had not received any counselling or psychological treatment. The main factors which predicted clinically significant anxiety or depression were: restricted activity levels, advanced disease, a non-English-speaking background and being female.

Conclusions: While the prevalence of clinically significant anxiety or depression detected by the HADS was reasonably low, a substantial number of possible cases were identified. The majority of affected patients were not accessing counselling or psychological treatment. Systematic screening of oncology patients at hospital entry might enable more immediate identification of clinically affected patients, who could then be referred for further testing or psychological treatment.