Objective: Although success rates for bone marrow
transplantation (BMT) continue to improve, there is still a high level
of morbidity and physical and emotional distress associated with BMT.
To date, limited research has focused on the assessment of and
screening for specific psychiatric disorders of patients facing BMT.
This is especially true with regard to identifying adjustment disorder
(AD), despite the fact that AD is the most prevalent psychiatric
diagnosis in cancer patients.
Methods: A sample of 95 BMT patients were interviewed using
the Structured Clinical Interview for Diagnostic and Statistical Manual
of Mental Disorders, 4th edition (SCID) and completed several commonly
used self-report instruments to determine if these tools could be used
to identify patients with adjustment disorder in need of further
assessment and intervention.
Results: Of these patients, 34.7% were diagnosed with
adjustment disorder, 11.6% with major depression, and 5.3% with
generalized anxiety disorder. The instruments were not found to be
predictive of AD. However, the results of a regression analysis showed
that the Social Subscale of the Functional Assessment of Cancer
Therapy–General (R2 Δ = 0.04, F
= 4.30, p < 0.05) was a significant predictor of adjustment
Significance of results: We conclude that there is little
efficacy in using existing scales for detecting adjustment disorders in
cancer patients undergoing bone marrow transplantation, and that other
tools for identifying patients with adjustment disorder who might
benefit from counseling are needed.