Differences in prevalence rates of psychological distress and mental disorders in inpatients and outpatients with breast and gynaecological cancer.

Research has demonstrated that in a significant number of patients, mental disorders occur with cancer. However, it is not known whether there is a difference for comorbidity in patients who are treated in hospitals versus outpatient care. The present study initially screened patients for psychological distress and quality of life with breast and gynaecological cancer. Instruments used were the General Health Questionnaire-12 and the Hospital Anxiety and Depression Scale, and for quality of life, the SF-36 Health Survey was used. In the next stage, a subsample of patients was assessed with standardized clinical interview (Composite International Diagnostic Interview) for the detection of mental disorders according to the Diagnostic and Statistical Manual of Mental Disorders, 4(th) Edn. The frequency of psychologically distressed patients in inpatient care is about 10% higher than in outpatient care. A higher risk (OR = 1.2-2.0) for mental disorders is found for inpatients compared with outpatients in all prevalence periods. Although differences in psychological distress, quality of life and prevalences of mental disorders failed to achieve statistical significance, the descriptive results indicate that inpatients with breast or gynaecological cancer suffer more often from psychological distress and comorbid mental disorders than outpatients. Outpatient treatment can therefore be considered as an important alternative to inpatient care, as patients with comparable disease severity adjust similarly or even better without full hospital care.