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Factors associated with psychological distress in cancer patients.

We studied the mental health of 1,278 patients with cancer and 645 family members of patients with cancer to delineate clinical and demographic characteristics associated with poor psychological status. For both patients and their matched relatives, there was a direct relationship between poorer mental health scores and younger age. Highly significant age differences emerged as well for subscale scores of anxiety, depression, and general positive affect in patients, and for depression, emotional ties, and loss of control in relatives. Treatment status, performance status, and sex also contributed significantly to mental health scores. Patients at greatest risk for psychological problems are young, female, receiving palliative or active treatment as opposed to follow-up care, and symptomatic or not fully ambulatory. Clinicians should be alert to the potential for psychological problems among patients in these categories.