Psychological morbidity and health-related quality of life in patients with differing awareness of cancer diagnosis: a cross-sectional study.
OBJECTIVE
Concealment of cancer diagnosis from patients is not rare worldwide and physicians in mainland China are in fact discouraged from disclosing a cancer diagnosis to cancer patients. Preventing worsened psychological morbidity is at the core of the argument for nondisclosure. The purpose of this study was to quantify anxiety, depression, and distress among patients with various degrees of awareness of their cancer diagnosis. Quality of life was also measured.


METHODS
Using a cross-sectional and blinded design, the Hospital Anxiety and Depression Scale questionnaire, the Distress Thermometer, and the SF-36 Health Survey were administered to 287 hospitalized patients with oral and maxillofacial tumors. Independently, the patients' awareness of disease was assessed with semistructured interviews.


RESULTS
Hospital Anxiety and Depression Scale, Distress Thermometer, and SF-36 did not identify significant differences in scores among the hospitalized patients with various degrees of awareness of their cancer diagnosis: an awaiting diagnosis group, a concealed diagnosis group, and a disclosed diagnosis group.


CONCLUSIONS
Before surgery, inpatients who were hospitalized because of oral and maxillofacial tumors with various degrees of awareness of their cancer diagnosis had similar psychological morbidity and quality of life. Informing hospitalized cancer patients of their diagnosis before surgery may not deteriorate their psychiatric condition or their quality of life.