Initial report on two trial projects using the brief symptoms inventory (BSI)- 18 as a screening instrument to detect distress earlier in cancer patients.

Dr. Morry Edwards, Ph.D. Director of Mind-Body Connections Program, Center for Cancer Care, Goshen IN and Director of Psychological Services, Kalamazoo Hematology and Oncology, Kalamazoo, MI

The Brief Symptoms Inventory (BSI)- 18 is an inexpensive and effective screening instrument to detect cancer patients who could be at risk for significant psychosocial distress. When used early after cancer diagnosis, the BSI- 18 may enable clinicians to offer interventions that may prevent complications arising from psychosocial distress and be more easily accepted by the patient. One set of norms for the BSI- 18 has been developed using a sample of oncology patients. Four factors were isolated: Somatization (SOM), Depression (DEP), Anxiety (ANX), and Global Severity (GSI). Appropriate cutoff scores have been differentiated by gender and criteria for a positive “case” has been set at a score of > 63 on the GSI or any two subscales where the T- score is > 63. Two pilot projects have been initiated to explore the utility of the BSI- 18 for detecting at risk patients and offering timely referrals to social work, psychology, psychiatry, pastoral care, or psychotrophic medication through the oncologist. One setting is a community cancer clinic at a hospital, which receives 40-50 new treatment patients a month. The other is a solo practitioner with a high ongoing referral base. It is hoped that the use of this screening instrument will be incorporated as a standard part of the intake process and may also have utility as an outcome measure. This poster presentation will address the benefits and problems with implementation.