Why Do Adult Patients With Cancer Not Seek Help for Their Depressive Symptoms?:The Role of Illness Perceptions, Coping, and Social Support

Background: Up to 75% of cancer patients with depressive symptoms do not make use of psychological care.Objective: To examine how perceptions of and coping with depressive symptoms and perceived social support in adults with cancer are associated with their need for psychological care, concurrently and over time.Methods: In this longitudinal study, 127 participants who received a cancer diagnosis in the past 5 years, experienced at least moderate depressive symptoms, and were not receiving psychological help, completed 2 self-report questionnaires (3 months apart) including the brief Illness Perception Questionnaire and brief Coping Orientation to Problems Experienced Inventory and Social Support List.Results: Participants with stronger belief in the efficacy of psychological care and more likely to use avoidant coping reported a greater need for psychological care at both data points. Social support was not significantly associated with perceived need for psychological care.Conclusions: Stronger perceived treatment control and greater use of avoidant coping were significantly associated with a greater perceived need for psychological care.Implications for practice: People with cancer may benefit from being informed about the efficacy of depression treatment. Furthermore, health care professionals should be aware that avoidant coping may complicate psychological care seeking for a group of adults with cancer experiencing depressive symptoms and having a need for psychological care.Foundational: Illness perceptions and coping mechanisms can predict cancer patients’ need for psychological care. Providing information about treatment options and its efficacy, together with targeting avoidant coping may increase adequate decision-making and possibly the uptake of psychological care

Understanding care needs of cancer patients with depressive symptoms:The importance of patients' recognition of depressive symptoms

Objective The majority of cancer patients with depressive symptoms does not perceive a need for psychological care. Reasons for this are still unclear. We examined the mediating role of cancer patients' perceptions of depressive symptoms in the relationship between depressive symptoms and perceived need for psychological care. Methods For this cross-sectional study, we recruited 127 Dutch cancer patients with moderate to severe levels of depressive symptoms (Patient Health Questionnaire [PHQ]-9 >= 10) who did not receive professional psychological care. Depressive symptoms were measured with the PHQ-9 questionnaire, by using three different depression score operationalizations. We used mediation analyses to test the mediating role of patients' illness perceptions (measured with subscales of the Brief Illness Perception Questionnaire) in the relation between depressive symptoms and need for care. Results Whilst results did not show significant direct associations between depressive symptoms and perceived need for psychological care, we found positive indirect effects of severity (B = 0.07, SE = 0.04, p < 0.02), meeting the DSM-5 diagnosis (B = 0.45, SE = 0.26, p < 0.02) and having relatively more affective symptoms (B = 2.37, SE = 1.10, p < 0.02) on need for care through the identity perception. Conclusions Including assessments of patients' recognition of depressive symptoms and their perceptions of depression treatment efficacy might improve depression screening in cancer patients by more accurately identifying those with a need for psychological care. Moreover, improving patients' knowledge and recognition of symptoms as being depressive symptoms might be a possible target point in increasing care needs and hereby optimizing the uptake of psychological care in cancer patients with depressive symptoms