Measurement of psychological distress in patients with intracranial tumours: the NCCN distress thermometer

Abstract

Identification of patients suffering from elevated psychosocial distress, the sources of the distress, and the necessary treatment of the distress can be rather difficult within the neurosurgical setting (e.g., lack of time, cognitive or aphasic disorders of the patients). The distress thermometer (DT) is a single-item rapid distress screening tool by use of which these difficulties can be minimized. The objective of this study was to determine the optimum DT cut-off score that would identify significant distress in patients with intracranial tumours thus validating its use in the neurosurgical setting. In all, 150 patients were tested either during in-patient stay or during a follow-up examination before and after the neurosurgical removal of a primary intracranial neoplasm. Patients were administered the DT with the hospital anxiety and depression scale (HADS), the gold standard against which the DT was compared. The area under the receiver operating characteristics curve (ROC) was ≥0.82. Thus, the ability of the DT to correctly identify patients as significantly distressed was excellent. The DT ranges from 0 to 10. Its optimum cut-off score for identifying distressed patients was at or above 6 (sensitivity ≥ 88%; specificity ≥ 53%). The DT is a valid and practicable screening instrument for assessment of levels and sources of distress in patients with intracranial tumours in the neurosurgical setting.