Risk factors associated with distress in a patient with cancer:
(1) history of substance abuse
(2) history of depression, anxiety or other psychiatric disorder
(3) history of suicide attempt
(4) history of physical and/or sexual abuse
(5) cognitive impairment
(6) presence of barriers to communication
(7) presence of a high level of comorbidity
(8) presence of social problems (see below)
(9) presence of serious religious or spiritual concerns
Social problems that may increase distress:
(1) conflicts with family and/or caregiver
(2) no or little social support
(3) living alone
(4) economic problems
(5) limited access to health care
(6) need to care for someone else, especially children
A patient with one or more of these risk factors should be screened for distress.
