Behandeling van een aanpassingsstoornis na kanker

Objective

To determine the effectiveness of treatment for an adjustment disorder in accordance with the Dutch guideline for an adjustment disorder in cancer survivor (i.e. people living with or after cancer) on distress, psychological symptoms and quality of life.

Design

Prospective cohort in which cancer survivors completed questionnaires prior to and after they received treatment for an adjustment disorder in accordance with the Dutch guideline 'adjustment disorder in patients with cancer'.

Method

Using paired t-tests, the primary outcomes 'experienced distress' (Distress Thermometer) and 'psychological distress' (HADS) and secondary outcomes functioning, fatigue, and insomnia (EORTC-QLQ-C30) were compared before and after treatment. Clinically relevant improvement was also calculated for each outcome measure. The average costs per treatment were calculated based on the average number of sessions and the indexed NZA rate for the GGZ.

Results

A total of 563 cancer survivors received treatment and completed pre- and post-treatment questionnaires. They attended, on average, 11 treatment sessions. The average cost per treatment was €1.141. The results show a statistically significant decrease (p < .001) and a clinically relevant reduction in experienced distress, psychological distress, fatigue, insomnia and a clinically relevant improvement in functioning in cancer survivors following treatment for an adjustment disorder.

Conclusion

Treatment for adjustment disorder for cancer survivors seems to lead to, at manageable cost, improved quality of life. Inclusion of the guideline in the quality register of the Dutch National Health Care Institute and treatment in accordance with this guideline is recommended.

Conflict of interest and financial support: ICMJE forms provided by the authors are available online along with the full text of this article.